Multidomain intervention for dementia prevention: a scoping review

多领域干预预防痴呆症:范围界定综述

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Abstract

PURPOSE: To map core components, outcomes, and challenges of multidomain dementia prevention interventions through a scoping review, and to compare differences in intervention effects between Chinese and non-Chinese countries/regions populations, thereby informing evidence-based strategies for localized interventions in China. DESIGN: JBI-guided scoping review using Arksey and O'Malley's framework. DATA SOURCES: Six databases (PubMed, Cochrane Library, Embase, Web of Science, CINAHL, PsycInfo) searched from inception to March 12, 2025. METHODS: Peer-reviewed studies on multidomain interventions were screened via a two-stage process (title/abstract → full-text) using EndNote 21. Initial searches identified 2,968 articles, and 18 randomized controlled trials (RCTs) were finally included after duplicate removal and eligibility screening. Data extraction and synthesis followed. RESULTS: Eighteen studies identified four core components of multidomain interventions: physical exercise, cognitive training, nutrition, and cardiovascular risk management. The more often reported implementation pattern was 3-5 weekly combined physical/cognitive sessions over 6-24 months. Regarding outcomes, cognitive function improvement, quality of life enhancement (+7.3 EQ-5D), and dementia risk reduction (40%) were reported in multiple studies, though inconsistent results existed. Subgroup analysis showed that Chinese studies had slightly lower cognitive improvement (MMSE +1.5-1.7) than Western studies (+1.8-2.1), but higher adherence (80% vs. 65% on average) due to family-participatory interventions. Key barriers included low adherence, resource limitations, and cultural disparities. CONCLUSION: Multidomain strategies are associated with addressing dementia risk factors, but existing evidence shows heterogeneity in intervention models and implementation barriers. Future research should focus on optimizing intervention models for Chinese populations, developing multidimensional assessments, and implementing culturally adaptive strategies to enhance scalability. IMPACT: These interventions are critical for dementia prevention in high-burden regions (e.g., China). Integrating evidence regarding differences between China and non-Chinese countries/regions into public health programs and tackling systemic barriers can enhance accessibility, equity, and feasibility, thus mitigating the societal impact of dementia amid global aging.

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