The Effect of Multidomain Interventions on Global Cognition, Symptoms of Depression and Apathy - A Pooled Analysis of Two Randomized Controlled Trials

Q: What was the purpose of pooling data from the two trials?

To pool individual participant data from two multidomain intervention trials on cognitive function and depression symptoms, increasing statistical power and facilitating subgroup analyses.

Q: Did multidomain interventions improve global cognition, depression symptoms, or apathy overall?

No conclusive evidence showed differences between intervention and control groups for change in cognitive functioning scores, depression symptoms, or apathy in the pooled population.

Q: Were any subgroups affected by the intervention?

Yes. In participants with baseline MMSE <26, the MMSE declined less in intervention groups than in control groups, suggesting possible greater effectiveness in those with lower baseline cognition.

Oct 4, 2026

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Cardiovascular and lifestyle risk factors are linked to higher dementia and cognitive decline risk, and multidomain interventions have been used to target these factors. This pooled analysis combined individual participant data from two multidomain prevention trials, aiming to strengthen power and enable subgroup evaluations for cognition, depression symptoms, and apathy. Across 4162 participants free of dementia at baseline, intervention and control groups showed no conclusive differences in overall outcomes.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

Abstract

Introduction

Multidomain Interventions and Cognition

Table 1. Main characteristics of pooled trials

J Prev Alz Dis 2021; Published online September 15, 2021, [http://dx.doi.org/10.14283/jpad.2021.53](http://dx.doi.org/10.14283/jpad.2021.53) Original Research © The Author(s) The Effect of Multidomain Interventions on Global Cognition, Symptoms of Depression and Apathy – A Pooled Analysis of Two Randomized Controlled Trials M.G.H.E. den Brok1,2, M.P. Hoevenaar-Blom2, N. Coley5,6, S. Andrieu5,6, J. van Dalen1,2, Y. Meiller7, J. Guillemont5, C. Brayne8, W.A. van Gool3, E.P. Moll van Charante3,4, E. Richard1,3 On behalf of the preDIVA and MAPT/DSA groups* 1. Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behaviour, Department of Neurology, Nijmegen, the Netherlands; 2. Amsterdam University Medical Center, location AMC, Department of Neurology, Amsterdam, the Netherlands; 3. Amsterdam University Medical Center, location AMC, Department of Public and Occupational Health, Amsterdam, the Netherlands; 4. Amsterdam University Medical Center, location AMC, Department of General Practice, Amsterdam, the Netherlands; 5. Centre for Epidemiology and Research in Population health (CERPOP), INSERM-University of Toulouse UMR 1295, Toulouse, France; 6. Department of Epidemiology and Public Health, Toulouse University Hospital, Faculty of Medicine, Toulouse, France; 7. Department of Information and Operations Management, ESCP Europe, Paris, France; 8. Cambridge Public Health, University of Cambridge, Department of Psychiatry, Cambridge, United Kingdom; *The members of the preDIVA and MAPT/DSA study groups are listed at the end of the manuscript. Corresponding Author: Melina G.H.E. den Brok, MD, Department of Neurology (910), Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, the Netherlands, [Melina.denBrok@Radboudumc.nl](Melina.denBrok@Radboudumc.nl) Abstract BACKGROUND: Cardiovascular risk factors and lifestyle factors are associated with an increased risk of cognitive decline and dementia in observational studies, and have been targeted by multidomain interventions. OBJECTIVES: We pooled individual participant data from two multi-domain intervention trials on cognitive function and symptoms of depression to increase power and facilitate subgroup analyses. DESIGN: Pooled analysis of individual participant data. SETTING: Prevention of Dementia by Intensive Vascular Care trial (preDIVA) and Multidomain Alzheimer Preventive Trial (MAPT) . PARTICIPANTS: Community-dwelling individuals, free from dementia at baseline. INTERVENTION: Multidomain interventions focused on cardiovascular and lifestyle related risk factors. MEASUREMENTS: Data on cognitive functioning, depressive symptoms and apathy were collected at baseline, 2 years and 3-4 years of follow-up as available per study. We analyzed crude scores with linear mixed models for overall cognitive function (Mini Mental State Examination [MMSE]), and symptoms of depression and apathy (15-item Geriatric Depression Scale) . Prespecified subgroup analyses were performed for sex, educational level, baseline MMSE <26, history of hypertension, and history of stroke, myocardial infarction and/or diabetes mellitus. RESULTS: We included 4162 individuals (median age 74 years, IQR 72, 76) with a median follow-up duration of 3.7 years (IQR 3.0 to 4.1 years) . No differences between intervention and control groups were observed on change in cognitive functioning scores and symptoms of depression and apathy scores in the pooled study population. The MMSE declined less in the intervention groups in those with MMSE <26 at baseline (N=250; MD: 0.84; 95%CI: 0.15 to 1.54; p<0.001) . CONCLUSIONS: We found no conclusive evidence that multidomain interventions reduce the risk of global cognitive decline, symptoms of depression or apathy in a mixed older population. Our results suggest that these interventions may be more effective in those with lower baseline cognitive functioning. Extended follow-up for dementia occurrence is important to inf

FAQs

What was the purpose of pooling data from the two trials?

To pool individual participant data from two multidomain intervention trials on cognitive function and depression symptoms, increasing statistical power and facilitating subgroup analyses.

Did multidomain interventions improve global cognition, depression symptoms, or apathy overall?

No conclusive evidence showed differences between intervention and control groups for change in cognitive functioning scores, depression symptoms, or apathy in the pooled population.

Were any subgroups affected by the intervention?

Yes. In participants with baseline MMSE <26, the MMSE declined less in intervention groups than in control groups, suggesting possible greater effectiveness in those with lower baseline cognition.

Oct 4, 2026

Upload by mieayamfan