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Modifiable dementia risk score to study heterogeneity in treatment effect of a dementia prevention trial: a post hoc analysis in the preDIVA trial using the LIBRA index.
- Source :
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Alzheimer's research & therapy [Alzheimers Res Ther] 2018 Jun 30; Vol. 10 (1), pp. 62. Date of Electronic Publication: 2018 Jun 30. - Publication Year :
- 2018
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Abstract
- Background: Selecting high-risk participants for dementia prevention trials based on a modifiable dementia risk score may be advantageous, as it increases the opportunity for intervention. We studied whether a multi-domain intervention can prevent all-cause dementia and cognitive decline in older people across three different levels of a modifiable dementia risk score.<br />Methods: Prevention of Dementia by Intensive Vascular Care (preDIVA) is a randomised controlled trial studying the effect of multi-domain vascular care during 6-8 years on incident all-cause dementia in community-dwelling people aged 70-78 years. For this post hoc analysis, we stratified preDIVA participants in tertiles based on their baseline LIfestyle for BRAin Health (LIBRA) index, a modifiable dementia risk score. With Cox proportional hazards regression, the intervention effect on dementia was assessed. The effect on cognition was measured every 2 years with the Mini-Mental State Examination and Visual Association Test.<br />Results: Dementia developed in 220 of 3274 (6.7%) participants. In participants with a low, intermediate and high LIBRA index, the hazard ratio (HR) of the intervention on incident dementia was respectively 0.71 (95% CI 0.45-1.12), 1.06 (95% CI 0.66-1.69) and 1.02 (95% CI 0.64-1.62). Also, when adding the non-modifiable risk factors age, education and sex to the index, results were comparable (respectively HR 0.88, 95% CI 0.54-1.43; HR 0.91, 95% CI 0.57-1.47; HR 0.92, 95% CI 0.59-1.41). There was no statistically significant intervention effect on cognition during follow-up across the LIBRA groups.<br />Conclusions: In the preDIVA study population aged 70-78 years, the LIBRA modifiable dementia risk score did not identify a (high-)risk group in whom the multi-domain intervention was effective in preventing dementia or cognitive decline.<br />Trial Registration: International Standard Randomised Controlled Trial Number registry, ISRCTN29711771 . Registered on 14 February 2006.
- Subjects :
- Aged
Cognitive Dysfunction epidemiology
Cognitive Dysfunction prevention & control
Cohort Studies
Dementia psychology
Female
Humans
Male
Proportional Hazards Models
Randomized Controlled Trials as Topic
Risk Factors
Dementia epidemiology
Dementia prevention & control
Life Style
Outcome Assessment, Health Care methods
Psychiatric Status Rating Scales
Subjects
Details
- Language :
- English
- ISSN :
- 1758-9193
- Volume :
- 10
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Alzheimer's research & therapy
- Publication Type :
- Academic Journal
- Accession number :
- 29960597
- Full Text :
- https://doi.org/10.1186/s13195-018-0389-4