Public Health

Area of Science:

• Gerontology
• Public Health
• Neuroscience

Background:

• Cognitive frailty (CF) in older adults is a significant risk factor for dementia.
• Lifestyle-based multidomain interventions offer a potentially reversible approach to managing CF.
• The AGELESS randomized controlled trial (RCT) investigated such an intervention in Malaysia.

Purpose of the Study:

• To assess the 2-year effect of a multidomain intervention on cognitive, physical, and vascular health in older adults with (pre)-CF.
• To evaluate the cost-effectiveness of the intervention in a Low-Middle-Income Country (LMIC).
• To determine the intervention's impact on dementia risk reduction.

Main Methods:

• 106 Malaysian adults aged 60+ with (pre)-CF were randomized to a multidomain intervention or an educational module.
• The intervention included physical activity, cognitive training, nutritional, psychological, and cardiovascular care.
• Primary outcomes (cognitive and physical performance) were assessed over 24 months using the modified Neuropsychological Tests Battery (mNTB) and physical tests.

Main Results:

• Despite a 50% dropout rate during COVID-19, adherence exceeded 50% for all intervention components.
• Significant improvements were observed in verbal memory, visual memory, attention, working memory, lower body flexibility, walking speed, and cardiovascular endurance (p < 0.05).
• While (pre)-CF status did not significantly differ, the intervention demonstrated cost-effectiveness, with the 2-minute step test being most cost-effective at $34 USD.

Conclusions:

• Multidomain lifestyle interventions are cost-effective and sustainable for promoting healthy aging and reducing dementia risk.
• The AGELESS trial provides a successful model for developing preventive interventions in LMICs.
• This approach holds significant potential for dementia risk reduction in populations with prevalent lifestyle-related risk factors.