ItaliaN Study With Tailored Multidomain Interventions to Prevent Functional and Cognitive Decline in Community-dwelling Older Adults
The goal of this interventional non-pharmacological study is to investigate the effects of a multi-domain intervention ( active intervention), compared to that followed by normal clinical practice (self-guided intervention), in older adults. The primary objective is whether these interventions can prevent functional and cognitive decline in at-risk subjects. The multi-domain interventions will include physical exercise, a Mediterranean diet-based nutritional plan, cognitive training, regular medical check-ups, oral hygiene treatments and counseling, monitoring and counseling on visual and auditory abilities, counseling on sleep hygiene and treatment, control of cardiovascular, metabolic, and infectious risk factors, adjustment of drug therapy, suggestions for improving social interactions.
• Aged 60 or older
• Mild/moderate vulnerability (Primary Care Frailty Index score between 0.07 and 0.21)
• Cardiovascular risk factors, Ageing and Incidence of Dementia (CAIDE) \> 6
• Clinical Dementia Rating (CDR) ≤ 0.5
• Presence of increased risk of developing dementia by family history (≥ 1 family member with dementia) and/or at least one modifiable risk factor, with Lifestyle Index ≥2. Lifestyle index evaluation: each Yes answer to the following questions = 1 point.
‣ Physical activity less than 2.5 hours per week (defined as physical activity intense enough to lead to sweating and breathlessness)\*
⁃ Diet: less than 5 servings of fruits and vegetables per day\*
⁃ Diet: less than 2 servings of fish per week\*
⁃ Hypertension: diagnosed by a physician or on medication, or Systolic Blood Pressure (SBP)\>140 mmHg, or Diastolic Blood Pressure (DBP)\>90 mmHg)
⁃ Diabetes: type 1 or type 2 diagnosed by a physician, or on medication, or HbA1C ≥7 % in the previous 6 months
⁃ Sleep disturbances, depressive symptoms, or mental/physical stress symptoms, for at least 1 month, judged by the physician to be disabling in daily life
⁃ BMI ≥ 25 kg/m\^2\*
⁃ Alcohol: \> 21 alcohol units/week\*. \*Based on international and WHO guidelines.
• Informed consent freely given and acquired before the start of the study