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Cognitive Benefit of a Multidomain Intervention for Older Adults at Risk of Cognitive Decline: A Cluster-Randomized Controlled Trial

  • Author Footnotes
    1 These authors contributed equally to this work and are joint first authors.
    Xiaomei Liu
    Footnotes
    1 These authors contributed equally to this work and are joint first authors.
    Affiliations
    Center on Aging Psychology (XL, ZM, XZ, ZZ, JL, JF, QS, JL), CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China

    Department of Psychology (XL, ZM, XZ, ZZ, JL, JF, QS, JL), University of Chinese Academy of Sciences, Beijing, China
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  • Author Footnotes
    1 These authors contributed equally to this work and are joint first authors.
    Zhuoya Ma
    Footnotes
    1 These authors contributed equally to this work and are joint first authors.
    Affiliations
    Center on Aging Psychology (XL, ZM, XZ, ZZ, JL, JF, QS, JL), CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China

    Department of Psychology (XL, ZM, XZ, ZZ, JL, JF, QS, JL), University of Chinese Academy of Sciences, Beijing, China
    Search for articles by this author
  • Xinyi Zhu
    Affiliations
    Center on Aging Psychology (XL, ZM, XZ, ZZ, JL, JF, QS, JL), CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China

    Department of Psychology (XL, ZM, XZ, ZZ, JL, JF, QS, JL), University of Chinese Academy of Sciences, Beijing, China
    Search for articles by this author
  • Zhiwei Zheng
    Affiliations
    Center on Aging Psychology (XL, ZM, XZ, ZZ, JL, JF, QS, JL), CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China

    Department of Psychology (XL, ZM, XZ, ZZ, JL, JF, QS, JL), University of Chinese Academy of Sciences, Beijing, China
    Search for articles by this author
  • Jing Li
    Affiliations
    Center on Aging Psychology (XL, ZM, XZ, ZZ, JL, JF, QS, JL), CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China

    Department of Psychology (XL, ZM, XZ, ZZ, JL, JF, QS, JL), University of Chinese Academy of Sciences, Beijing, China
    Search for articles by this author
  • Jiangning Fu
    Affiliations
    Center on Aging Psychology (XL, ZM, XZ, ZZ, JL, JF, QS, JL), CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China

    Department of Psychology (XL, ZM, XZ, ZZ, JL, JF, QS, JL), University of Chinese Academy of Sciences, Beijing, China
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  • Qi Shao
    Affiliations
    Center on Aging Psychology (XL, ZM, XZ, ZZ, JL, JF, QS, JL), CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China

    Department of Psychology (XL, ZM, XZ, ZZ, JL, JF, QS, JL), University of Chinese Academy of Sciences, Beijing, China
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  • Xiaoyan Han
    Affiliations
    Chaoyang District Center for Disease Control and Prevention (XH, XW), Beijing, China
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  • Xiaoning Wang
    Affiliations
    Chaoyang District Center for Disease Control and Prevention (XH, XW), Beijing, China
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  • Zhihui Wang
    Affiliations
    Chinese Center for Disease Control and Prevention (ZW, ZY), Beijing, China
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  • Zhaoxue Yin
    Affiliations
    Chinese Center for Disease Control and Prevention (ZW, ZY), Beijing, China
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  • Chengxuan Qiu
    Affiliations
    Aging Research Center (CQ), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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  • Juan Li
    Correspondence
    Send correspondence and reprint requests to: Juan Li, Ph.D., Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing 100101, China.
    Affiliations
    Center on Aging Psychology (XL, ZM, XZ, ZZ, JL, JF, QS, JL), CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China

    Department of Psychology (XL, ZM, XZ, ZZ, JL, JF, QS, JL), University of Chinese Academy of Sciences, Beijing, China
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work and are joint first authors.
Published:November 01, 2022DOI:https://doi.org/10.1016/j.jagp.2022.10.006

      HIGHLIGHTS

      • What is the primary question addressed by this study?
      • We investigated the effects of a 9-month community-based multidomain intervention of mindfulness meditation, cognitive training, exercise, and nutrition counseling on improving cognition compared to controls for Chinese older adults having risks of cognitive decline.
      • What is the main finding of this study?
      • Multidomain intervention had immediate benefits on improving cognitive performance measured by objective assessments and subjective cognitive abilities relative to the control, and the benefits on subjective cognitive abilities were retained for 1 year after the completion of the intervention.
      • What is the meaning of the finding?
      • Multidomain intervention that targeted multiple predictors of cognitive decline can have immediate benefits on improving cognitive performance for older adults at risk of cognitive decline. Long-term effects on cognition and individual differences in response to the intervention deserve further investigation.

      ABSTRACT

      Objective

      We sought to assess cognitive benefits of a community-based multidomain intervention for improving cognition among older adults at risk of cognitive decline (COMBAT).

      Design

      A two-armed cluster-randomized controlled trial.

      Setting and Participants

      Community-dwelling older adults aged 60 years or older and were at risk of cognitive decline (n = 209).

      Intervention

      In this 9-month intervention study, 10 community hospitals in Beijing, China, were randomized (1:1) to receive either a multidomain intervention of meditation, cognitive training, exercise, and nutrition counseling or usual care. The intervention was delivered with weekly 1-hour group training sessions and weekly home homework.

      Measurements

      Primary outcome was change in cognition as measured by a composite Z score of seven cognitive tests. Secondary outcomes included subjective cognitive abilities, positive and negative affective experiences, physical activity, and dietary habits. Assessments were administered at baseline, end of the intervention, and 1 year after completing the intervention (1-year follow-up).

      Results

      Immediately after the intervention, the intervention group showed significant enhancement in cognitive performance (p = 0.026). The between-group difference in the Z score of change of cognition was 0.20 (95% CI: 0.053, 0.35), with a Hedges’ g of 0.40 (95% CI: 0.29, 0.50). However, this cognitive benefit was not significant at 1-year follow-up.

      Conclusion

      This multidomain intervention was effective to improve cognition for at-risk individuals. Long-term effects on cognitive function and individual differences in response to the intervention deserve further investigation.

      KEY WORDS

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