Abstract
Recent epidemiological studies have indicated numerous associations between vascular
and lifestyle related risk factors and incident dementia. However, evidence from randomised
controlled trials (RCT) showing effectiveness of interventions aimed at these risk
factors in preventing or postponing dementia onset is still lacking.
Three large RCTs on multi-component interventions to prevent dementia (preDIVA, FINGER,
MAPT) have been initiated in Europe to address these issues. Irrespective of some
methodological differences, all three studies target cardiovascular and lifestyle
related risk factors. Collaboration within the newly founded ‘European Dementia Prevention
Initiative’ (EDPI) will allow for a comprehensive exploration of optimal target population,
intervention and outcome measures, which are currently unknown. Combining data of
the ongoing studies and running simulation analyses will facilitate determining the
optimal design including accurate sample-size calculations for future multi-national
clinical trials on dementia prevention.
Interventions aiming at dementia prevention should be pragmatic and easy to implement
on a large scale in different health care systems, without generating high additional
costs or burden on participants or physicians. As the optimal age for intervention
precedes the optimal age for outcome assessment, traditional trial designs might lead
to suboptimal timing of either of the two. Separation of intervention and outcome
assessment in time is a potential solution, but requires studies with very long follow-up.
International collaboration of research groups with experience in dementia prevention
studies and well-organised logistics for these major projects is pivotal to success
for future large-scale dementia prevention studies. Founding of EDPI is an important first step in this direction.
Keywords
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Article info
Publication history
Published online: July 23, 2012
Accepted:
June 25,
2012
Received in revised form:
June 1,
2012
Received:
January 15,
2012
Identification
Copyright
© 2012 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
