Research indicates enhanced mental function in individuals who maintain an active lifestyle and engage in social interactions, alongside managing blood pressure and diabetes effectively.
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Improvements were also noted between the two groups in measurements of risk factors and quality of life, translating approximately to 145% and 8%, respectively, the researchers reported. The study was recently published in the journal JAMA Internal Medicine.
Older adults highly motivated to make changes
The study, known as SMARRT, for systematic multi-domain Alzheimer’s risk reduction trial, follows previous work from other researchers that has yielded contradictory results on the effects of health and lifestyle interventions. This study differed, though, in providing personal coaching that was customized to each participant.
“This is the first personalized intervention, focusing on multiple areas of cognition, in which risk factor targets are based on a participant’s risk profile, preferences, and priorities, which we think may be more effective than a one-size-fits-all approach,” said first author and lead investigator Kristine Yaffe, MD, vice chair of research in psychiatry and professor in the UCSF departments of neurology, psychiatry, and epidemiology and biostatistics.
“In an earlier survey of 600 older adults, we found that most were concerned about Alzheimer’s disease and related dementias. They wanted to know their personal risk factors and were highly motivated to make lifestyle changes to lower dementia risk,” said Yaffe, referring to her collaboration with co-lead investigator and co-author Eric B. Larson, MD, MPH, former vice president for research and health care intervention at Kaiser Permanente Washington.
Participants in the current study, as well as the earlier survey, were enrolled in Kaiser Permanente Washington and were between 70 and 89 years old. They had at least two of eight risk factors for dementia: physical inactivity, uncontrolled hypertension, uncontrolled diabetes, poor sleep, use of prescription medications associated with risk of cognitive decline, high depressive symptoms, social isolation, and current smoking status.
The intervention participants met with a nurse and health coach and selected specific risk factors they wanted to address. They received coaching sessions every few months to review their goals, which ranged from tracking hypertension to walking a certain number of steps per day or signing up for a class. The meetings started in person and switched to phone calls during the pandemic.
Non-intervention participants were similar in age, risk factors, and cognitive scores and received educational material, mailed every three months, on dementia risk reduction.
Pandemic did not offset study’s positive effects
“We were pleasantly surprised that the positive results of the trial were not offset by the impact of the pandemic,” said Larson, who is currently professor of medicine at
“Hopefully in the future, treatment of Alzheimer’s and related dementias will be like DOI: 10.1001/jamainternmed.2023.6279
The study was funded by the National Institute on Aging.