Japan-Multimodal Intervention Trial for the Prevention of Dementia: A randomized controlled trial.

INTRODUCTION: We examined the efficacy of a multidomain intervention in preventing cognitive decline among Japanese older adults with mild cognitive impairment (MCI). METHODS: Participants aged 65-85 years with MCI were randomized into intervention (management of vascular risk factors, exercise, nutritional counseling, and cognitive training) and control groups. The primary outcome was changes in the cognitive composite score over a period of 18 months. RESULTS: Of 531 participants, 406 completed the trial. The between-group difference in composite score changes was 0.047 (95% CI: -0.029 to 0.124). Secondary analyses indicated positive impacts of interventions on several secondary health outcomes. The interventions appeared to be particularly effective for individuals with high attendance during exercise sessions and those with the apolipoprotein E ε4 allele and elevated plasma glial fibrillary acidic protein levels. DISCUSSION: The multidomain intervention showed no efficacy in preventing cognitive decline. Further research on more efficient strategies and suitable target populations is required. HIGHLIGHTS: This trial evaluated the efficacy of multidomain intervention in individuals with MCI. The trial did not show a significant difference in preplanned cognitive outcomes. Interventions had positive effects on a wide range of secondary health outcomes. Those with adequate adherence or high risk of dementia benefited from interventions.

Effects of fear of COVID-19 on older volunteers' willingness to continue their activities: REPRINTS cohort study.

AIM: This study examined the effects of fear of COVID-19 on older volunteers' willingness to continue activities that required face-to-face interactions. METHODS: From September to November 2020, a self-administered questionnaire survey was conducted with 481 older adult volunteers. A total of 423 responses were collected; 343 had no missing items and were included in the analysis. Analysis items included willingness to continue volunteer activities, fear of COVID-19, mental and physical health, and a group of items related to factors influencing the continuation of volunteer activities. RESULTS: The structural analysis of covariance indicated that volunteer orientation, which included items considered to be factors for continuing volunteer activities, had a significant positive influence on the willingness to continue activities. Fear of COVID-19 had a significant negative effect on the latent variable mental and physical health, which consisted of a subjective sense of health, but fear of COVID-19 and physical and mental health had no significant effect on the willingness to continue volunteering. CONCLUSIONS: Our results suggest that the willingness of older adults to continue volunteer activities during the COVID-19 pandemic is influenced by their volunteer orientation and is not affected by their fear of COVID-19. Geriatr Gerontol Int 2024; 24: 370-376.

Bidirectional associations of high-level cognitive domains with hand motor function and gait speed in high-functioning older adults: A 7-year study.

BACKGROUND: Whether age-related decline in the musculoskeletal system may contribute to a decline in cognitive performance or vice versa is unclear. Understanding the direction of their associations and the extent to which upper and lower extremities similarly predict subtle changes in high-level cognitive performance will help elucidate their mechanisms, especially that of the hand dexterity. METHODS: We evaluated the bidirectional associations of motor performance and high-level cognitive domains in 165 highly cognitively and physically healthy older adults. Motor performance tests consisted of handgrip strength, hand dexterity, assessed with the Purdue Pegboard Test (PPT), and usual and maximum gait speeds. High-level cognitive measures included executive function and information processing speed. The Trail Making Test (TMT)B and the letter and category fluency tests (LFT and CFT) evaluated executive function, while the TMTA and Digit Symbol assessed processing speed. Measurements were taken at baseline and at 2-, 5- and 7-year follow-up. RESULTS: Generalized linear mixed-effect models showed that baseline hand dexterity and its trajectory predicted changes in TMTB, CFT, TMTA, and Digit Symbol over time, and vice versa. Baseline maximum gait speed was associated with LFT over time and vice versa. No associations were found for handgrip and usual gait speed. CONCLUSION: The positive bidirectional association observed both in hand dexterity and maximum gait speed with executive function performance and that of hand dexterity with processing speed over time highlights a reciprocal relationship where each factor affects the other and both factors are dependent on each other, suggesting commonality in their neural basis.