Observed Improvement in Cognition During a Personalized Lifestyle Intervention in People with Cognitive Decline.
Observed Improvement in Cognition During a Personalized Lifestyle Intervention in People with Cognitive Decline.
复制标题
DOI：
10.3233/jad-230004
复制
发表时间：
2023
影响因子：
4
通讯作者：
Bradley, Ryan
中科院分区：
文献类型：
--
作者：
Sandison, Heather;Callan, Nini G. L.;Rao, Rammohan V.;Phipps, John;Bradley, Ryan
关键词：
阿尔茨海默病（AD）是一种以进行性客观认知障碍（OCI）为特征的慢性疾病。没有单一疗法实质上改变了疾病进展，表明疾病是多因素的，可能需要多模式治疗方法。我们试图确定患有OCI的样本中的认知功能是否会根据认知下降的潜在因素（例如，营养状况、感染等）。参与者（n = 34）从加利福尼亚州圣地亚哥地区招募。 多模式干预包括生活方式的改变（即，运动、饮食和压力管理）、营养支持和药物。在四次临床访视中实际交付，并在四次研究访视时收集结局指标，分别发生在基线、1个月、3个月和6个月（主要终点）。在整个研究参与过程中，研究参与者每周都会接到营养支持电话。结果指标包括剑桥脑科学（CBS）测试和蒙特利尔认知评估（莫卡）。6个月时，平均莫卡评分从19.6±3.1改善至21.7±6.2（p = 0.013）。 观察到CBS记忆域平均评分[25.2（SD 23.3）至35.8（SD 26.9）; p <0.01]和CBS总体综合认知评分[24.5（SD 16.1）至29.7（SD 20.5）; p = 0.02]显着改善。 所有CBS域都得到了改进。在六个月的干预后，认知功能的多项指标得到改善。我们的研究结果支持多模式，个性化治疗方法的OCI的可行性和影响，并进一步研究。
Alzheimer’s disease (AD) is a chronic condition marked by progressive objective cognitive impairment (OCI). No monotherapy has substantially altered disease progression, suggesting the disease is multifactorial and may require a multimodal therapeutic approach. We sought to determine if cognitive function in a sample with OCI would change in response to a multimodal, individualized care plan based on potential contributors to cognitive decline (e.g., nutritional status, infection, etc.). Participants (n = 34) were recruited from the San Diego, CA area. The multimodal intervention included lifestyle changes (i.e., movement, diet, and stress management), nutraceutical support, and medications. It was delivered pragmatically over four clinical visits, and outcome measures were gathered at four study visits, occurring at baseline, one, three, and six months (primary endpoint). Study participants received weekly phone calls for nutrition support throughout study participation. Outcome measures included the Cambridge Brain Sciences (CBS) battery, and the Montreal Cognitive Assessment (MoCA). At 6 months, mean MoCA scores improved from 19.6±3.1 to 21.7±6.2 (p = 0.013). Significant improvement was observed in mean scores of the CBS memory domain [25.2 (SD 23.3) to 35.8 (SD 26.9); p < 0.01] and CBS overall composite cognition score [24.5 (SD 16.1) to 29.7 (SD 20.5); p = 0.02]. All CBS domains improved. Multiple measures of cognitive function improved after six months of intervention. Our results support the feasibility and impact of a multimodal, individualized treatment approach to OCI, warranting further research.