South Korean study to prevent cognitive impairment and protect brain health through multidomain interventions via face-to-face and video communication platforms in mild cognitive impairment (SUPERBRAIN-MEET): A randomized controlled trial

Abstract

Introduction: We investigated the efficacy of a multidomain intervention (MI) via face-to-face and video communication platforms using a tablet personal computer application in patients with mild cognitive impairment (MCI).

Methods: Three hundred participants with MCI and ≥ 1 modifiable dementia risk factor, aged 60-85 years, were randomly assigned to either the MI group, who underwent a 24-week intervention, or the control group, who received usual care.

Results: The overall adherence rate to MI was 84.7%. The adjusted mean change from baseline at 24 weeks in the total scale index score of the repeatable battery for the assessment of neuropsychological status was 8.43 in the MI group and 4.26 in the control group (difference, 4.17; 95% confidence interval, 1.92-6.43; p < 0.001). MI showed significant beneficial effects on cognition in both apolipoprotein E (APOE) ε4 carriers and noncarriers.

Discussion: MI can exert beneficial effects on the cognition of patients with MCI.

Trial registration: ClinicalTrials.gov identifier: NCT05023057 HIGHLIGHTS: Although the controls also demonstrated improved performance in cognition, multidomain interventions showed significantly greater benefits for cognition in MCI compared to the controls in a randomized controlled trial. Multidomain interventions improved depression and quality of life. Multidomain interventions significantly positively impacted cognition in both APOE ε4 carriers and noncarriers. Multidomain interventions may be more effective for amnestic than nonamnestic MCI.

Keywords: cognition; dementia; exercise; lifestyle; mild cognitive impairment; prevention; randomized controlled trial.

FIGURE 1

Overview of the trial profile. MI, multidomain intervention; mITT, modified intention‐to‐treat.

FIGURE 2

Adjusted mean changes in the RBANS total scale index score from baseline at each visit point. The adjusted mean changes from baseline, standard errors (SE, indicated by bars), and p‐value were all derived using a mixed model for repeated measures, with the trial group, visit, center by recruitment rate (≥ 2 subjects/month or < 2 subjects/month), and trial group × visit interaction as fixed effects, subject and study center as random effects, and the baseline value as a covariate. Compared to the control group, the RBANS total scale index score significantly improved in the multidomain intervention group at 12 weeks (6.71 [SE = 0.60] vs. 3.17 [0.62], p < 0.001) and 24 weeks (8.43 [0.62] vs. 4.26 [0.64], p < 0.001). RBANS, Repeatable Battery for the Assessment of Neuropsychological Status.

FIGURE 3

Adherence rates for each intervention domain in the multidomain intervention group. Bars represent the 95% confidence intervals.

FIGURE 4

Forest plot of the results of subgroup analysis of the changes in the RBANS total scale index score (A) and MMSE score (B) at 24 weeks by sex, MCI subtype, and APOE genotype. APOE, apolipoprotein E; CI, confidence interval; MCI, mild cognitive impairment; MI, multidomain intervention; MMSE, Mini‐Mental State Examination. RBANS, Repeatable Battery for the Assessment of Neuropsychological Status.