Who Benefited the Most? Effectiveness of a Lifestyle Intervention Against Cognitive Decline in Older Women and Men – Secondary Analysis of the AgeWell.de-trial - 21/11/24

Doi : 10.14283/jpad.2024.13 
Felix G. Wittmann 1, , A. Pabst 1, A. Zülke 1, M. Luppa 1, I. Blotenberg 4, M.I. Cardona 4, A. Bauer 5, S. Fuchs 5, I. Zöllinger 6, L. Sanftenberg 6, C. Brettschneider 7, J. Döhring 8, L. Lunden 8, D. Czock 2, B. Wiese 3, J.R. Thyrian 4, 9, 10, W. Hoffmann 4, 9, T. Frese 5, J. Gensichen 6, H.-H. König 7, H. Kaduszkiewicz 8, S.G. Riedel-Heller 1
1 Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Phillip-Rosenthal-Str. 55, 04103, Leipzig, Germany 
2 Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Heidelberg, Germany 
3 Institute for General Practice, Work Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany 
4 Institute for Community Medicine, University Medicine Greifswald (UMG), Greifswald, Germany 
5 Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany 
6 Institute of General Practice/Family Medicine, University Hospital of LMU Munich, Munich, Germany 
7 Department of Health Economics and Health Service Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany 
8 Institute of General Practice, University of Kiel, Kiel, Germany 
9 site Rostock/Greifswald, German Centre for Neurodegenerative Diseases (DZNE), Greifswald, Germany 
10 Faculty V: School of Life Sciences, University of Siegen, Siegen, Germany 

a felix.wittmann@medizin.uni-leipzig.de felix.wittmann@medizin.uni-leipzig.de

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Abstract

Introduction

Differences between women and men matter in the prevalence and risk factors of dementia. We aimed to examine potential sex differences regarding the effectiveness by running a secondary analysis of the AgeWell.de trial, a cluster-randomized multicenter multi-domain lifestyle intervention to reduce cognitive decline.

Methods

Intention-to-treat analyses of women (n=433) and men (n=386) aged 60 to 77 years were used for models including interactions between intervention group allocation and sex followed by subgroup analysis stratified by sex on primary and secondary outcomes. Further, the same procedure was repeated for age groups (60–69 vs. 70–77) within sex-specific subgroups to assess the effectiveness in different age groups. Trial registration: German Clinical Trials Register (ref. number: DRKS00013555).

Results

No differences were found between women and men in the effectiveness of the intervention on cognitive performance. However, women benefitted from the intervention regarding depressive symptoms while men did not. Health-related quality of life was enhanced for younger intervention participants (60–69 years) in both women and men.

Conclusion

The AgeWell.de intervention was able to improve depressive symptoms in women and health-related quality of life in younger participants. Female participants between 60 and 69 years benefited the most. Results support the need of better individually targeted lifestyle interventions for older adults.

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Key words : Dementia, prevention, lifestyle, randomized controlled trial, sex differences


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Vol 11 - N° 2

P. 348-355 - Marzo 2024 Ritorno al numero
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