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Randomized Controlled Trial
. 2024 Dec 30;64(1):58.
doi: 10.1007/s00394-024-03563-z.

Dietary changes following a lifestyle-based intervention for dementia risk reduction - results from the AgeWell.de study

Andrea E Zülke #  1 , Iris Blotenberg #  2 , Melanie Luppa  3 , Margrit Löbner  3 , Juliane Döhring  4 , Martin Williamson  4 , Robert P Kosilek  5 , Irina Michel  5 , Anke Oey  6 , Christian Brettschneider  7 , Jochen Gensichen  5 , David Czock  8 , Birgitt Wiese  9 , Hans-Helmut König  7 , Thomas Frese  10 , Hanna Kaduszkiewicz  4 , Wolfgang Hoffmann  2   11 , René Thyrian #  2   11   12 , Steffi G Riedel-Heller #  3
Affiliations
Randomized Controlled Trial

Dietary changes following a lifestyle-based intervention for dementia risk reduction - results from the AgeWell.de study

Andrea E Zülke et al. Eur J Nutr. .

Abstract

Purpose: We investigated the effects of a multidomain lifestyle intervention conducted in older adults at increased risk for dementia on participants' diet.

Methods: Secondary analyses of the cluster-randomized AgeWell.de-trial, testing a multidomain intervention (optimization of nutrition and medication, enhancement of physical, social and cognitive activity) in older adults at increased dementia risk. Intervention effects on a healthy diet (composite score) and its components were analyzed using Poisson- and logistic regression analyses. Stages of behavior change (transtheoretical model), and respective changes between baseline and follow-up were analyzed using mixed regression analyses.

Results: A total of 819 individuals were analyzed (Mage = 69.0, SD = 4.9, nintervention/control group = 378/441). We observed a significant intervention effect on the healthy diet score (b = 0.06, IRR: 1.06, 95% CI: 1.01, 1.11). Changes were particularly due to increased fruit- and vegetable consumption, while other food components were not improved by the intervention. The intervention did not induce transitions to advanced stages of behavior change regarding a healthy diet, however, participants in the control group moved to initial stages of behavior change (OR = 1.95, 95% CI: 1.30, 2.92).

Conclusion: A multidomain lifestyle intervention improved participants' diet and maintained motivation to change in an at-risk-sample. However, only fruit- and vegetable consumption increased. Additional support might be necessary to encourage older adults to integrate new, healthier food components into their diet. Control group participants transitioned to initial stages of behavior change, stressing the need to encourage older adults to maintain a healthy diet as they age. AGEWELL.DE WAS PROSPECTIVELY REGISTERED IN THE GERMAN CLINICAL TRIALS REGISTER (DRKS; IDENTIFIER: DRKS00013555) ON DECEMBER 7TH, 2017: DRKS00013555.

Keywords: Behavior change; Dementia; Lifestyle intervention; Randomized controlled trial; Transtheoretical model.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare that they have no conflict of interest. Ethical approval: The responsible ethics board at the Medical Faculty of the University of Leipzig (coordinating study site; ethical vote number: 369/17-ek) and at all participating study sites approved the AgeWell.de-study. All participants provided written informed consent at their respective GP practice prior to participation. The AgeWell.de-study was conducted in accordance with the principles of the Declaration of Helsinki in its revised version from 2000.

Figures

Fig. 1
Fig. 1
Distribution of intervention- and control group participants across stages of health behavior change at baseline and follow-up
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