A Mediterranean Diet and Walking Intervention to Reduce Cognitive Decline and Dementia Risk in Independently Living Older Australians: The MedWalk Randomized Controlled Trial Experimental Protocol, Including COVID-19 Related Modifications and Baseline Characteristics.
Study Goal
The researchers aimed to determine whether longer-term adherence to regular walking, combined with a Mediterranean-style diet and delivered through motivational interviewing and cognitive-behavioral therapy (MI-CBT), could reduce age-associated cognitive decline and dementia risk factors in older adults.
Results Summary
The study is ongoing, with baseline testing completed for 157 participants, but final results on walking's effects on cognitive decline, mood, cardiovascular function, and other secondary outcomes are pending. The trial retains sufficient power to address its aims despite COVID-19-related adjustments.
Population
Independently living adults aged 60-90 years without cognitive impairment, recruited from retirement villages and the wider community in Australia.
Effective Dosage
Not specified
Duration
12 months
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Mediterranean-style diet and regular walking, delivered through motivational interviewing and cognitive-behavioral therapy (MI-CBT) | decrease | age-associated cognitive decline | older, independently living individuals without cognitive impairment | - | reduce | #1 |
Mediterranean-style diet and regular walking, delivered through motivational interviewing and cognitive-behavioral therapy (MI-CBT) | decrease | dementia risk factors | older, independently living individuals without cognitive impairment | - | reduce | #2 |
MedWalk intervention | neutral | visual memory and learning assessed from errors on the Paired Associates Learning Task of the Cambridge Neuropsychological Test Automated Battery | 60-90-year-old people from independent living retirement villages and the wider community | 12-month | change | #3 |
MedWalk intervention | neutral | cognition | 60-90-year-old people from independent living retirement villages and the wider community | - | include | #4 |
MedWalk intervention | neutral | mood | 60-90-year-old people from independent living retirement villages and the wider community | - | include | #5 |
MedWalk intervention | neutral | cardiovascular function | 60-90-year-old people from independent living retirement villages and the wider community | - | include | #6 |
MedWalk intervention | neutral | biomarkers related to nutrient status and cognitive decline | 60-90-year-old people from independent living retirement villages and the wider community | - | include | #7 |
MedWalk intervention | neutral | MI-CBT effectiveness | 60-90-year-old people from independent living retirement villages and the wider community | - | include | #8 |
MedWalk intervention | neutral | Mediterranean diet adherence | 60-90-year-old people from independent living retirement villages and the wider community | - | include | #9 |
MedWalk intervention | neutral | physical activity | 60-90-year-old people from independent living retirement villages and the wider community | - | include | #10 |
MedWalk intervention | neutral | quality of life | 60-90-year-old people from independent living retirement villages and the wider community | - | include | #11 |
MedWalk intervention | neutral | cost-effectiveness | 60-90-year-old people from independent living retirement villages and the wider community | - | include | #12 |
MedWalk intervention | neutral | health economic evaluation | 60-90-year-old people from independent living retirement villages and the wider community | - | include | #13 |
MedWalk | decrease | interventions that could substantially reduce dementia incidence | the community | substantially | inform | #14 |
MedWalk | decrease | interventions that could ameliorate cognitive decline | the community | - | inform | #15 |
BACKGROUND: Several clinical trials have examined diet and physical activity lifestyle changes as mitigation strategies for risk factors linked to cognitive decline and dementias such as Alzheimer's disease. However, the ability to modify these behaviors longer term, to impact cognitive health has remained elusive. OBJECTIVE: The MedWalk trial's primary aim is to investigate whether longer-term adherence to a Mediterranean-style diet and regular walking, delivered through motivational interviewing and cognitive-behavioral therapy (MI-CBT), can reduce age-associated cognitive decline and other dementia risk factors in older, independently living individuals without cognitive impairment. METHODS: MedWalk, a one-year cluster-randomized controlled trial across two Australian states, recruited 60-90-year-old people from independent living retirement villages and the wider community. Participants were assigned to either the MedWalk intervention or a control group (maintaining their usual diet and physical activity). The primary outcome is 12-month change in visual memory and learning assessed from errors on the Paired Associates Learning Task of the Cambridge Neuropsychological Test Automated Battery. Secondary outcomes include cognition, mood, cardiovascular function, biomarkers related to nutrient status and cognitive decline, MI-CBT effectiveness, Mediterranean diet adherence, physical activity, quality of life, cost-effectiveness, and health economic evaluation.Progress and Discussion:Although COVID-19 impacts over two years necessitated a reduced timeline and sample size, MedWalk retains sufficient power to address its aims and hypotheses. Baseline testing has been completed with 157 participants, who will be followed over 12 months. If successful, MedWalk will inform interventions that could substantially reduce dementia incidence and ameliorate cognitive decline in the community. TRIAL REGISTRATION: Registered on the Australia New Zealand Clinical Trials Registry ANZCTR 12620000978965 (https://www.anzctr.org.au).