Multimodal Interventions to Delay Dementia and Disability in Rural China (MIND‐China): an Update 2018‐2021

Abstract

AbstractBackgroundAround one‐third of people with dementia worldwide might be attributable to seven modifiable risk factors, implying that interventions to control these risk factors may delay the onset of dementia. Therefore, we initiated the multimodal interventions to delay dementia and disability in rural China (MIND‐China) in 2018 and updated the main progresses of the project in 2018‐2021.MethodsMIND‐China is designed as a community‐based 2‐year cluster‐randomized, controlled, multimodal intervention study, which targets people who are aged 60‐79 years and living in the rural communities of Yanlou Town, western Shandong Province, China. Following the baseline examination in 2018, 52 villages in Yanlou Town are randomly (cluster‐randomization) divided into three groups: control group (regular primary health care service), vascular intervention group, and multimodal intervention group. The vascular intervention includes healthy lifestyle guidelines and the national guidelines‐based medical treatment of major cardiometabolic risk factors. The multimodal intervention group receives, in addition to the interventions planned for vascular intervention, group physical exercise, personalized leisure activities, and cognitive training.ResultsIn March‐September 2018, 5,765 participants underwent the core module assessments via face‐to‐face interviews, clinical examinations, neuropsychological testings, and laboratory tests (74.9% of all eligible residents). The mean age was 70.9 years (SD 5.9), 57.2% were women, 40.6% were illiterate, and 88.3% were farmers. Specific modules of examination were performed for subsamples (e.g., brain MRI scans, genetic and blood biomarkers, physical function, sleep quality, audiometric testing, and OCT examination). In May‐September 2019, the pilot study was completed to test the feasibility of the intervention programs and the implementation procedure in 7 villages (2 villages in control group, 3 villages in vascular intervention group, and 2 villages in multimodal intervention group). Recruitment of participants for interventions started in October 2019. In July‐November 2021, we conducted the 1‐year follow‐up assessments of participants in the interventions.ConclusionBy the end of 2021, MIND‐China had completed baseline screening assessment, recruitment of intervention participants, and the first follow‐up assessments following the initiation of interventions. MIND‐China demonstrates the feasibility of implementing the multimodal interventions in rural communities. COVID‐19 has minimal impact so far on the project.