Efficacy of Multidomain Intervention Against Physio-cognitive Decline Syndrome: A Cluster-randomized Trial

Chih-Kuang Liang; Wei-Ju Lee; An-Chun Hwang; Chu-Sheng Lin; Ming-Yueh Chou; Li-Ning Peng; Ming-Hsien Lin; Liang-Kung Chen

doi:10.1016/j.archger.2021.104392

Efficacy of Multidomain Intervention Against Physio-cognitive Decline Syndrome: A Cluster-randomized Trial

Arch Gerontol Geriatr. 2021 Jul-Aug:95:104392. doi: 10.1016/j.archger.2021.104392. Epub 2021 Mar 13.

Authors

Chih-Kuang Liang¹, Wei-Ju Lee², An-Chun Hwang³, Chu-Sheng Lin⁴, Ming-Yueh Chou⁵, Li-Ning Peng³, Ming-Hsien Lin³, Liang-Kung Chen³

Affiliations

¹ Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City 81362, Taiwan; Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General hospital, Kaohsiung, Taiwan. No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City 81362, Taiwan; Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. No. 155, Sec.2, Linong Street, Taipei 112 Taiwan.
² Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. No. 155, Sec.2, Linong Street, Taipei 112 Taiwan; Department of Family Medicine, Taipei Veterans General Hospital, Yuanshan Branch, Yilan, Taiwan. No.386, Rongguang Rd., Neicheng, Yuanshan Township, Yilan County 264, Taiwan. Electronic address: leewju@gmail.com.
³ Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. No. 155, Sec.2, Linong Street, Taipei 112 Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan. No.201, Sec. 2, Shipai Rd., Beitou District, Taipei City 11217, Taiwan.
⁴ Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. No. 155, Sec.2, Linong Street, Taipei 112 Taiwan; Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. 1650 Taiwan Boulevard Sect. 4, Taichung 407204, Taiwan; Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan. 1650 Taiwan Boulevard Sect. 4, Taichung 407204, Taiwan.
⁵ Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City 81362, Taiwan; Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. No. 155, Sec.2, Linong Street, Taipei 112 Taiwan.

PMID: 33765656
DOI: 10.1016/j.archger.2021.104392

Abstract

Backgrounds: To investigate the efficacy of a community group-based intervention among community-dwelling older adults with physio-cognitive decline syndrome (PCDS).

Methods: A prospective cluster randomized controlled trial included 733 community-dwelling older adults with adjusted Montreal Cognitive Assessment (MoCA adj) scores >18 from 40 community-based sites across Taiwan. PCDS was defined as the concomitant presence of physical declines, i.e., slowness and/or weakness plus dysfunction in any cognitive domain. The multidomain intervention integrated physical exercise, cognitive training, nutritional advices and health education lessons. Conventional health education in control group entailed periodic telephone calls to offer participants health education and advice. The primary outcome was the mean differences of MoCA adj total scores and all domains of MoCA adj between baseline and 6- and 12-month follow-up in each group of PCDS, cognitive dysfunction, mobility-type frailty and normal functioning, and the secondary outcomes included the changes of frailty score, handgrip strength, gait speed and physical activity. Intervention effects were analysed using a generalized linear mixed model.

Results: Overall, 18.9% of the study sample had PCDS. Multidomain intervention for 12 months significantly improved cognitive performance in people with PCDS, and those with cognitive dysfunction only. An early benefit on visuo-spatial executive function was seen in older adults with mobility-type frailty. Intervention also improved frailty scores among participants with mobility-type frailty, handgrip strength for participants with PCDS, and gait speed in the normal group.

Conclusions: PCDS is a potentially reversible condition that may prevent subsequent disability and dementia, which deserves further investigation to confirm the long-term effects.

Keywords: Cognitive impairment; Community intervention; Dementia; Frailty; Physical function.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cognitive Dysfunction*
Frailty*
Hand Strength
Humans
Prospective Studies
Taiwan