Efficacy of a multidomain intervention in older adults with vascular risks: The Japan-Multimodal Intervention Trial for the Prevention of Dementia (J-MINT).

INTRODUCTION: Whether untreated or uncontrolled vascular risk factors (VRFs), such as blood pressure, glycated hemoglobin, and high-density lipoprotein (HDL) and non-HDL cholesterol levels, modify the effects of multidomain interventions on cognitive decline in mild cognitive impairment (MCI) was examined. METHODS: Participants aged 65 to 85 years with MCI were randomized into intervention or control groups. The outcome was the change in the average Z score of the neuropsychological tests over 18 months. Interaction effects between the intervention and the presence of untreated or uncontrolled VRFs were assessed using a mixed-effects model for repeated measures. RESULTS: Among the participants, 298 had at least one untreated or uncontrolled VRF. Significant intervention and VRF interaction (p = 0.032) indicated significant cognitive benefits in individuals with VRFs (Z score difference: 0.11; 95% confidence interval: 0.02-0.20), unlike in those without VRFs. DISCUSSION: Individuals with untreated or uncontrolled VRFs may derive greater cognitive benefits from multidomain interventions. CLINICAL TRIAL REGISTRATION NUMBER: This trial was registered with the UMIN-CTR (UMIN000038671). HIGHLIGHTS: We examined whether untreated or uncontrolled vascular risk factors (VRFs) modified the intervention effect. A significant interaction was found between the multidomain intervention and VRFs. The intervention was effective in individuals with untreated or uncontrolled VRFs. Beneficial effects on systolic blood pressure and pulse pressure were observed. Beneficial effects on high-density lipoprotein cholesterol and triglycerides were noted.