Abstract
Targeting dementia prevention, first trials addressing multiple modifiable risk factors showed promising results in at-risk populations. In Germany, AgeWell.de is the first large-scale initiative investigating the effectiveness of a multi-component lifestyle intervention against cognitive decline. We aimed to investigate the recruitment process and baseline characteristics of the AgeWell.de participants to gain an understanding of the at-risk population and who engages in the intervention. General practitioners across five study sites recruited participants (aged 60–77 years, Cardiovascular Risk Factors, Aging, and Incidence of Dementia/CAIDE dementia risk score ≥ 9). Structured face-to-face interviews were conducted with eligible participants, including neuropsychological assessments. We analyzed group differences between (1) eligible vs. non-eligible participants, (2) participants vs. non-participants, and (3) between intervention groups. Of 1176 eligible participants, 146 (12.5%) dropped out before baseline; the study population was thus 1030 individuals. Non-participants did not differ from participants in key sociodemographic factors and dementia risk. Study participants were M = 69.0 (SD = 4.9) years old, and 52.1% were women. The average Montreal Cognitive Assessment/MoCA score was 24.5 (SD = 3.1), indicating a rather mildly cognitively impaired study population; however, 39.4% scored ≥ 26, thus being cognitively unimpaired. The bandwidth of cognitive states bears the interesting potential for differential trial outcome analyses. However, trial conduction is impacted by the COVID-19 pandemic, requiring adjustments to the study protocol with yet unclear methodological consequences.
Highlights
A growing body of evidence highlights the enormous potential for dementia prevention if modifiable risk factors were addressed
Following the consent to participate, respective GPP were trained in all recruitment procedures by AgeWell.de-study personnel during an appointment at the GPP
Case findings were conducted by the general practitioner (GP) or other practice personnel in association with the AgeWell.destudy personnel or independently if desired
Summary
A growing body of evidence highlights the enormous potential for dementia prevention if modifiable risk factors were addressed. It is estimated that 40% of all cases of dementia in high-income countries (HIC) and 50% in low- and middle-income countries (LMIC) could be prevented or at least delayed if the following twelve risk factors were eliminated: low education in early life, hearing loss, traumatic brain injury, hypertension, obesity, alcohol consumption above 21 units a week in midlife, diabetes mellitus, depression, physical inactivity, smoking, social isolation, and exposure to air pollution in later life [1]. The dementia prevention capacity provides hope in the face of population aging all around the world, which is associated with a significant increase in the number of people living with dementia, in LMIC. Dementia is the main cause of disability among older individuals, and it comes with a heavy burden for everyone involved: patients, relatives, and caregivers, and societies as a whole, causing costs equivalent to 1% of the global world product [3,4]
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