There are currently around 1.8 million people living with dementia in Germany. Due to increased life expectancy, the proportion will continue to grow: based on data from the Federal Statistical Office, experts expect up to two million cases in 2033. For the first time, an intervention study was carried out to prevent mental decline in older GP patients. The results were produced under the leadership of the Faculty of Medicine at Leipzig University and published in the specialist journal "Alzheimer’s & Dementia".
Knowledge of controllable risk factors that delay or even prevent dementia has improved significantly in recent years. For example, sufficient exercise, good social integration and a healthy diet can help to maintain mental performance. Lifestyle changes that address several risk factors simultaneously have proven to be particularly effective in preventing dementia. Initial intervention studies from other countries show that lifestyle changes can also be effective in preventing mental decline in older age.
A study with a so-called multi-component intervention in older people has now also been conducted in Germany for the first time, under the leadership of the Institute of Social Medicine, Occupational Medicine and Public Health (ISAP) at the Faculty of Medicine. As part of the AgeWell.de study, a total of 1,030 older GP patients aged between 60 and 77 were examined at five locations across Germany, accompanied in the implementation of the preventive measures and observed for 24 months. The participants were randomly assigned to an intervention or control group.
Depressive symptoms in women reduced
The study measures included optimizing nutrition and medication, as well as increasing physical, social and mental activity. Trained study assistants helped the participants with the implementation. If necessary, people with depressive symptoms were given additional support. All participants received the normal level of care from their GP. The people in the control group received one-off written health information on the content of the intervention.
At the end of the study, the subjectively perceived state of health of the participants had improved significantly. In women, depressive symptoms decreased as a result of the intervention. However, we were unable to identify any significant differences in mental performance during this relatively short follow-up period. But we were able to show that the risk profile of the study participants improved as a result of the intervention, i.e. established risk factors for dementia were positively influenced," says Andrea Zülke, study coordinator of AgeWell.de and scientist at ISAP. In particular, the participants’ diet and blood pressure levels improved. Factors that also counteract other clinical pictures, such as cardiovascular diseases.
Participants from high-risk groups
"With AgeWell.de, we have shown that multi-component interventions for a healthy lifestyle in old age can also be implemented in Germany; in total, we were able to recruit over 1,000 participants from high-risk groups for the study. These were not the typical participants in prevention studies - we really were able to include people with an increased risk: 40 percent had diabetes, 54 percent had high blood pressure and 55 percent were obese. The results on changing the risk profile are encouraging. We assume that such intervention studies need longer observation periods so that the effects of lifestyle changes can develop their full potential," explains Steffi G. Riedel-Heller, Director of the Institute of Social Medicine, Occupational Medicine and Public Health (ISAP) at Leipzig University.
The project was funded by the Federal Ministry of Education and Research (BMBF).
Original publications in Alzheimer’s & Dementia:
Effects of a multi-domain intervention against cognitive decline on dementia risk profiles - results from the AgeWell.de-trial. DOI: 10.1002/alz.14097
A multidomain intervention against cognitive decline in an at-risk-population in Germany: Results from the cluster-randomized AgeWell.de trial. DOI: 10.1002/alz.13486
