The results of the MAPT trial have recently been published in Lancet Neurology(1). The 3-year MAPT study was the first trial to evaluate the effectiveness of a multidomain lifestyle intervention, omega-3 fatty acid supplementation, or both interventions combined, compared to a placebo, on cognitive decline. In the main analysis, there were no significant effects on cognitive decline. However, the results of exploratory subgroup analyses suggested that the combined polyunsaturated fatty acid and multidomain intervention or the multidomain intervention alone might help to slow cognitive decline in people most likely to undergo decline—i.e., those with an increased dementia risk score, and those with evidence of brain amyloid pathology. This publication concludes the very successful range of publications of the finished trials in the HATICE consortium. Previously, the FINGER trial showed in the Lancet(2) that a multidomain intervention could improve or maintain cognitive functioning in at-risk elderly people from the general population. PreDIVA showed in a secondary analysis in the Lancet(3) that 6 years of nurse-led intensive vascular care did not lead to a reduction of all-cause dementia, but seemed effective for the prevention of dementia in participants with untreated baseline hypertension at baseline and persons adherent to the intervention. The data of these trials were pooled in a specially designed pooled data platform to provide valuable input for the design of the HATICE trial on the effects of a blended internet intervention which included 2725 participants and will be finished in December 2017(4).
1. Andrieu S, Guyonnet S, Coley N, Cantet C, Bonnefoy M, Bordes S, et al. Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): a randomised, placebo-controlled trial. Lancet Neurol. 2017.
2. Ngandu T, Lehtisalo J, Solomon A, Levalahti E, Ahtiluoto S, Antikainen R, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet. 2015;385(9984):2255-63.
3. Moll van Charante EP, Richard E, Eurelings LS, van Dalen JW, Ligthart SA, van Bussel EF, et al. Effectiveness of a 6-year multidomain vascular care intervention to prevent dementia (preDIVA): a cluster-randomised controlled trial. Lancet. 2016.
4. Richard E, Jongstra S, Soininen H, Brayne C, Moll van Charante EP, Meiller Y, et al. Healthy Ageing Through Internet Counselling in the Elderly: the HATICE randomised controlled trial for the prevention of cardiovascular disease and cognitive impairment. BMJ Open. 2016;6(6):e010806.