The Multidomain Alzheimer Preventive Trial (MAPT): A new approach for the prevention of Alzheimer's disease

Abstract

Because no effective curative approaches are available yet, preventive approaches in the field of Alzheimer disease (AD) are needed. In the past, several studies have suggested that many factors may be involved in the occurrence of AD in the late ages. Because of the probable multifactorial nature of AD, it would seem logical to initiate multidomain interventions designed to examine their potential synergistic effects. The aim of the MAPT study is to evaluate the efficacy of a multidomain intervention (nutritional, physical and cognitive training) and omega 3 treatment in the prevention of cognitive decline in frail elderly persons aged 70 years or over. This study also aimed to collect imaging and biological data which could be used for future AD prevention and treatment trials. MAPT is a 3-year randomized controlled trial conducted by university hospital practitioners specializing in memory disorders in 4 French cities (Bordeaux, Limoges, Montpellier and Toulouse). This study plans to enrol 1200 frail elderly subjects with at least one the following criteria: subjective memory complaint spontaneously expressed to their general practitioner, limitation in one instrumental activity of daily living (IADL), and slow walking speed. Subjects are randomized in one of the following 4 groups: omega 3 alone, multidomain intervention alone, omega 3 plus multidomain intervention, or placebo group (n = 300 each). The principal outcome measure is the change in cognitive function at 3 years determined by the Grober and Buschke Test. The multidomain intervention includes training/information sessions and preventive consultations. The training/information sessions are based on recommendations relative to nutrition, physical exercise, cognitive stimulation (reasoning and memory training) and social activities. They are dispensed with the following frequency: twice a week for 1 month, then once a week for 1 month, then once a month for the rest of the follow-up period. The preventive consultations are standardised and designed to detect any hearing or visual disorders, mood disorders, anxiety, malnutrition, walking and balance problems, fear of falling and poor oral and dental health in collaboration with general practitioner. Recruitment in the MAPT study is still in process and will last 2 years. Final results should be available in 2013.