Authors: Carrie Peltz, Dori E Rosenberg, Lynn E Fleckenstein, Deborah E Barnes, Sascha Dublin, Benjamin H Balderson, Eric B Larson, Kristine Yaffe
Published: 2020-12-07
DOI: 10.1002/alz.041181
Source: Full article
AbstractBackgroundUp to 30% of dementia may be preventable by addressing modifiable risk factors. The Systematic Multidomain Alzheimer’s Risk Reduction Trial (SMARRT) is an on‐going two‐year pilot trial in the US comparing a personalized risk reduction intervention to usual care among at‐risk older adults without dementia in an integrated health care system. Here we show the constellation of risk factors experienced by older adults in the SMARRT trial, and which factors individuals in the intervention arm have chosen to target.MethodsSMARRT recruited participants aged 70‐89, without dementia, and with at least two risk factors verified by electronic medical records or validated questionnaires. Intervention participants work with a health coach and nurse to develop a personalized action plan to address risk factors of their choosing. Chi square tests were used to compare risk factors across men and women.ResultsOf the 148 participants enrolled as of January 2020, the average age was 76±5.1 years, 66% were male, and 80% were white. The most common risk factors were physical inactivity (80%), poorly controlled hypertension (50%), and sleep difficulty (48%) followed by taking medications that may affect cognition (19%), depressive symptoms (18%), poorly controlled diabetes (14%), social isolation (12%), and smoking (9%). Taking risky medications, poor sleep, and depressive symptoms were all more common in women while physical inactivity was more common in men (all p<0.01; see Table). In the intervention group (n=73), most people with poorly controlled hypertension (94%), physical inactivity (92%), and poorly controlled diabetes (83%) chose to work with their health coach or nurse to reduce those risks. Getting better sleep (66%), decreasing risky medications (62%), quitting smoking (50%), reducing depression (43%), and increasing social engagement (27%) were also targets of intervention in people with those risk factors.ConclusionsOlder adults with dementia risk factors are willing to make health and lifestyle changes as well as suggested changes to medical care to potentially lower their dementia risk. The SMARRT intervention may provide valuable information to shape future studies of behavior change to reduce dementia risk.