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Enhancing Neurocognitive Health via Activity, Nutrition and Cognitive Exercise (ENHANCE): A Randomized Controlled

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Summary

A 12-month multidomain intervention promoting healthy aging preserved brain grey matter volume and improved physical and cognitive function in older adults. Rural participants showed enhanced brain structure and cognitive gains, while urban participants excelled in physical performance.

Keywords:
brain structuremultidomain interventionneuroplasticityolder adultsurban–rural disparities

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Area of Science:

  • Neuroscience
  • Gerontology
  • Public Health

Background:

  • Multidomain interventions show promise for healthy aging but their impact on brain structure is unclear.
  • The ENHANCE trial investigated a 12-month group-based multidomain intervention in community-dwelling older adults.
  • The study specifically examined urban-rural disparities in intervention effects.

Purpose of the Study:

  • To assess the efficacy of a multidomain intervention on brain structure and function in older adults.
  • To evaluate differences in intervention outcomes between urban and rural participants.
  • To explore the intervention's impact on physical performance, cognition, and cardiometabolic biomarkers.

Main Methods:

  • A 12-month randomized controlled trial (ENHANCE) involving twice-weekly group sessions (physical exercise, cognitive training, nutrition education).
  • Control group received quarterly telephone education.
  • Primary outcome: voxel-based changes in brain grey matter volume (GMV) via MRI; Secondary outcomes: physical performance, cognition, nutrition, psychosocial, and cardiometabolic markers.

Main Results:

  • The intervention group showed significantly less GMV reduction in the left inferior temporal lobe compared to controls.
  • Enhanced physical performance and cognitive function were observed in the intervention group.
  • Subgroup analyses revealed differential effects: rural participants had preserved GMV and greater cognitive improvements, while urban participants showed greater GMV reduction but superior physical performance gains.

Conclusions:

  • Multidomain interventions can induce neuroplasticity in older adults.
  • Intervention effects on brain structure and function differ between urban and rural populations.
  • Tailored approaches considering sociocultural factors are needed for optimizing healthy aging across diverse populations.