Agewell.de

Background

As effective treatment options are still lacking, exhausting all available prevention options is an important part of combating dementia, a disease of civilization. Given the complex nature of dementia, approaches that simultaneously attack several risk factors appear to be particularly promising. Internationally, corresponding multi-component prevention approaches are showing initial promising results (e.g. FINGER study by Kivipelto and colleagues, 2013). In Germany, comparable research initiatives are currently lacking as a starting point for the successful transfer of such complex interventions into care.

Aim of the project

The aim of AgeWell.de is therefore to conduct a multi-center, cluster-randomized, controlled, multi-component intervention study for the prevention of cognitive decline in older GP patients for the first time in Germany. The study is explicitly designed so that, if successful, recommendations are made for implementation in the regular care landscape.

Project schedule

A total of 1,030 elderly GP patients (60-77 years) with an increased risk of dementia were recruited in four survey centers (Leipzig, Greifswald, Munich, Kiel) and randomly assigned to an intervention group (IG) or control group (CG). The IG participants received a multi-component intervention program over a period of 2 years, which consisted of physical and social activity, cognitive training, optimization of nutrition and medication, management of vascular risk factors and, if necessary, other interventions (e.g. bereavement counseling, counseling for depression). The CG participants received general health advice on the intervention components in addition to regular GP care. Of the 1,030 participants at the start of the study, 819 took part in the 24-month follow-up examination. No differences in global cognitive performance were found between groups (average marginal effect = 0.010, 95% confidence interval: -0.113, 0.133). Perceived limitations in implementing the intervention due to the COVID-19 pandemic did not affect the effectiveness of the intervention. Although the intervention did not show improvement in global cognitive performance, it led to improvements in health-related quality of life in the overall sample. In addition, the multidisciplinary intervention reduced depressive symptoms in women.

Bibliography

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Beteiligte Einrichtungen

Gesamtprojektleitung

Prof. Dr. med. Steffi G. Riedel-Heller, MPH

Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Medizinische Fakultät, Universität Leipzig

Projektleitung in den Studienzentren

Prof. Dr. med. Wolfgang Hoffmann, Priv.-Doz. Dr. Jochen René Thyrian

Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Greifswald

Prof. Dr. med. Hanna Kaduszkiewicz

Institut für Allgemeinmedizin, Christian-Albrechts-Universität zu Kiel

Prof. Dr. med. Jochen Gensichen          

Institut für Allgemeinmedizin, LMU Klinikum der Universität München

Prof. Dr. med. Walter E. Haefeli, Prof. Dr. med. David Czock                 

Abteilung Klinische Pharmakologie und Pharmakoepidemiologie, Universitätsklinikum Heidelberg

Prof. Dr. med. Hans-Helmut König     

Zentrum für Psychosoziale Medizin, Institut für Gesundheitsökonomie und Versorgungsforschung, Universitätsklinikum Hamburg-Eppendorf

Birgitt Wiese, Dipl.-Math.

Institut für Allgemeinmedizin, Medizinische Hochschule Hannover

Prof. Dr. med Thomas Frese

Institut für Allgemeinmedizin, Medizinische Fakultät, Martin-Luther-Universität Halle-Wittenberg