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Background/objectives: To evaluate the efficacy of a multidomain intervention to reduce lifestyle risk factors for Alzheimer's disease (AD) and improve cognition in individuals with subjective cognitive decline (SCD) or mild cognitive impairment (MCI)., Design: The study was an 8-week two-arm single-blind proof-of-concept randomized controlled trial., Setting: Community-dwelling individuals living in Canberra, Australia, and surrounding areas., Participants: Participants were 119 individuals (intervention n = 57; control n = 62) experiencing SCD or MCI., Intervention: The control condition involved four educational modules covering dementia and lifestyle risk factors, Mediterranean diet, physical activity, and cognitive engagement. Participants were instructed to implement this information into their own lifestyle. The intervention condition included the same educational modules and additional active components to assist with the implementation of this information into participants' lifestyles: dietitian sessions, an exercise physiologist session, and online brain training., Measurements: Lifestyle risk factors for AD were assessed using the Australian National University-Alzheimer's Disease Risk Index (ANU-ADRI), and cognition was assessed using Alzheimer's Disease Assessment Scale-Cognitive subscale, Pfeffer Functional Activities Questionnaire, Symbol Digit Modalities Test (SDMT), Trail Making Test-B, and Category Fluency., Results: The primary analysis showed that the intervention group had a significantly lower ANU-ADRI score (χ 2 = 10.84; df = 3; P = .013) and a significantly higher cognition score (χ 2 = 7.28; df = 2; P = .026) than the control group. A secondary analysis demonstrated that the changes in lifestyle were driven by increases in protective lifestyle factors (χ 2 = 12.02; df = 3; P = .007), rather than a reduction in risk factors (χ 2 = 2.93; df = 3; P = .403), and cognitive changes were only apparent for the SDMT (χ 2 = 6.46; df = 2; P = .040). Results were robust to intention-to-treat analysis controlling for missing data., Conclusion: Results support the hypothesis that improvements in lifestyle risk factors for dementia can lead to improvements in cognition over a short time frame with a population experiencing cognitive decline. Outcomes from this trial support the conduct of a larger and longer trial with this participant group., (© 2020 The American Geriatrics Society.)

Background: Up to 40% of incident dementia is considered attributable to behavioral and lifestyle factors. Given the current lack of medical treatments and the projected increase in dementia prevalence, a focus on prevention through risk reduction is needed. Objective: We aim to increase dementia risk knowledge and promote changes in dementia risk behaviors at individual and population levels. Methods: The Island Study Linking Aging and Neurodegenerative Disease (ISLAND) is a long-term prospective, web-based cohort study with nested interventions that will be conducted over a 10-year period. Target participants (n=10,000) reside in Tasmania and are aged 50 years or over. Survey data on knowledge, attitudes, and behaviors related to modifiable dementia risk factors will be collected annually. After each survey wave, participants will be provided with a personalized dementia risk profile containing guidelines for reducing risk across 9 behavioral and lifestyle domains and with opportunities to engage in educational and behavioral interventions targeting risk reduction. Survey data will be modeled longitudinally with intervention engagement indices, cognitive function indices, and blood-based biomarkers, to measure change in risk over time. Results: In the initial 12 months (October 2019 to October 2020), 6410 participants have provided baseline data. The study is ongoing. Conclusions: Recruitment targets are feasible and efforts are ongoing to achieve a representative sample. Findings will inform future public health dementia risk reduction initiatives by showing whether, when, and how dementia risk can be lowered through educational and behavioral interventions, delivered in an uncontrolled real-world context. [ABSTRACT FROM AUTHOR]

Background and Objectives This systematic review aimed to synthesize and quantify the associations of awareness of age-related change (AARC) with emotional well-being, physical well-being, and cognitive functioning. Research Design and Methods We conducted a systematic review with a correlational random effects meta-analysis. We included quantitative studies, published from January 1, 2009 to October 3, 2018, exploring associations between AARC and one or more of the following outcomes: emotional well-being, physical well-being, and cognitive functioning. We assessed heterogeneity (I 2) and publication bias. Results We included 12 studies in the review, 9 exploring the association between AARC and emotional well-being and 11 exploring the association between AARC and physical well-being. No study explored the association between AARC and cognitive functioning. Six articles were included in the meta-analysis. We found a moderate association between a higher level of AARC gains and better emotional well-being (r =.33; 95% CI 0.18, 0.47; p <.001; I 2 = 76.01) and between a higher level of AARC losses and poorer emotional (r = −.31; 95% CI −0.38, −0.24; p <.001; I 2 = 0.00) and physical well-being (r = −.38; 95% CI −0.51, −0.24; p <.001; I 2 = 83.48). We found a negligible association between AARC gains and physical well-being (r =.08; 95% CI 0.02, 0.14; p <.122; I 2 = 0.00). Studies were of medium to high methodological quality. Discussion and Implications There is some indication that AARC gains and losses can play a role in emotional well-being and that AARC losses are associated with physical well-being. However, the number of included studies is limited and there was some indication of heterogeneity. PROSPERO Registration CRD42018111472. [ABSTRACT FROM AUTHOR]