Clinical Efficacy of Multidomain Interventions among Multimorbid Older People Stratified by the Status of Physio-Cognitive Declines: A Secondary Analysis from the Randomized Controlled Trial for Healthy Aging

Objectives To investigate the clinical efficacy of integrated multidomain intervention among community-living older adults with multimorbidity and physio-cognitive decline syndrome (PCDS). Design, Setting and Participants This is the secondary analysis from a randomized controlled trial that data of 340 participants with Montreal Cognitive Assessment (MoCA) scores >= 18 were excerpted for analysis. Intervention Sixteen 2-hour sessions per year were provided for participants, including physical exercise, cognitive training, dietician education and individualized integrated care for multimorbidity. Measurements Handgrip strength, 6-m walking speed, MoCA (total score and sub-domains), Cardiovascular Health Study (CHS) frailty score, quality of life, and serum biochemistry biomarkers. Results Overall, 96/340 (28.2%) of all participants have PCDS, and the integrated multidomain intervention significantly improved global cognitive performance (overall difference 1.1, 95% CI 0.4-1.8, p=0.003), and domains of concentration (overall difference 0.3, 95%CI 0.1-0.5, p=0.011), language (overall difference 0.2, 95%CI 0.1-0.3, p=0.006), abstract thinking (overall difference 0.1, 95%CI 0.0-0.3, p=0.027), and orientation(overall difference 0.2, 95%CI 0.0-0.4, p=0.013) across all timepoints among those with PCDS. Besides, interventions also significantly reduced frailty score among those with cognitive impairment no dementia (overall difference -0.3, 95%CI -0.5 - -0.1, p=0.011) and mobility impairment no disability (overall difference -0.3, 95%CI -0.4 - -0.1, p=0.004). and improved quality of life at domain of physical role limitation among those with PCDS (overall difference 5.3, 95%CI 0.3-10.4, p=0.038). Conclusions The integrated multidomain lifestyle intervention plus multimorbidity management significantly improved cognitive function, and enhanced quality of life among older adults with multimorbidity and PCDS in the communities.

Automated summary

The integrated multidomain intervention for community-living older adults with multimorbidity and physio-cognitive decline syndrome (PCDS) has shown significant clinical efficacy in improving cognitive function and quality of life.