Behavioral Interventions to Prevent or Delay Dementia: Protocol for a Randomized Comparative Effectiveness Study
Open accessAbstract
BACKGROUND: Currently, people at risk for dementia and their caregivers are confronted with confusing choices about what behavioral interventions are most effective. OBJECTIVE: The objective of this study is to determine which empirically supported behavioral interventions most impact the outcomes highly valued by patients with mild cognitive impairment and their partners. METHODS: This protocol describes a comparative effectiveness trial targeting 300 participants with mild cognitive impairment and their study partners. The trial is being conducted at the Mayo Clinic campuses in Arizona, Florida, Minnesota, and the University of Washington in Seattle. The study examines the contribution of five behavioral interventions (yoga, memory compensation training, computerized cognitive training, support groups, and wellness education) on primary outcomes of participant and partner quality of life and self-efficacy. In this unique 10-day multicomponent intervention, groups of couples were randomized to have one of the five interventions withheld while receiving the other four. Although the longitudinal follow-up is still under way, enrollment results are available and reported. RESULTS: In total, 272 couples have been enrolled in the trial and follow-up visits continue. Outcomes will be assessed at the end-of-intervention and 6-, 12-, and 18-month follow-ups. We anticipate reporting on our primary and secondary outcomes across time points in the next 2 years. CONCLUSIONS: This paper describes the protocol for a randomized comparative effectiveness study of behavioral interventions to prevent or delay dementia. We describe of the rationale, design, power analysis, and analysis plan. Also because enrollment is complete and we are in follow-up phases of the study, we have included enrollment data from the trial. TRIAL REGISTRATION: ClinicalTrials.gov NCT02265757; http://clinicaltrials.gov/ctsshow/ NCT02265757 (Archived by WebCite at http://www.webcitation.org/6ueRfwSYv).
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With regard to mood, well-being and quality of life, no therapeutic effects in MCI patients, neither at short-term (3 months) nor at long-term (24 months) follow-up, were detected in most studies, including four randomized controlled trials and one randomized non-controlled trial.
“With regard to mood, well-being and quality of life no therapeutic effects in MCI patients, neither at short-term (3 months) nor at long-term (24 months) follow-up, were detected in most studies, including four randomized controlled trials [48–51, 54, 59, 60] and one randomized non-controlled trial [52, 53].”
From Psychotherapeutic interventions in individuals at risk for Alzheimer’s dementia: a systematic review (2022) · cites this paper as [52]
Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredLong-term follow-up assessments (6 or more months post-intervention) were described in 14 publications.
“Long-term follow-up assessments (6 or more months post-intervention) were described in 14 publications [37, 39, 43, 48, 49, 51–53, 59, 60, 62, 63, 68, 69].”
From Psychotherapeutic interventions in individuals at risk for Alzheimer’s dementia: a systematic review (2022) · cites this paper as [52]
A total of 10 research groups described psychoeducational interventions in individuals with MCI in addition to cognitive rehabilitation, cognitive training, mindfulness-based stress reduction, behavioral activation, or enriched by a recovery model approach.
“A total of 10 research groups described psychoeducational interventions in addition to cognitive rehabilitation [38, 50], cognitive training [52, 53, 59, 60, 65], mindfulness-based stress reduction (MBSR) [46, 47, 57, 58], behavioral activation [44, 45, 48, 49, 51, 54], or enriched by a recovery model approach [67]”
From Psychotherapeutic interventions in individuals at risk for Alzheimer’s dementia: a systematic review (2022) · cites this paper as [52]
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Cummings, L. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108587921.002 · Cited by 3 · see citing works
DeFeis, B. L., Ying, G., Kurasz, A. M., Wit, L. D., Amofa, P., Chandler, M. J., Locke, D. E. C., Shandera‐Ochsner, A. L., Phatak, V. S., & Smith, G. E. (2021) · Journal of Alzheimer s Disease · doi:10.3233/jad-210582 · Cited by 3 · see citing works
Self-citationChandler, M. J., Graff-Radford, M. R., Lucas, P. H., Locke, D. E. C., Crook, J. E., Ball, C. T., Caselli, M., Lunde, A. M., Phatak, V. S., & Smith, G. E. (2021) · OBM Geriatrics · doi:10.21926/obm.geriatr.2101147 · Cited by 2 · see citing works
Self-citationZendehbad, A. S., Noroozıan, M., Barzkar, F., & Shati, M. (2026) · Applied Neuropsychology Adult · doi:10.1080/23279095.2026.2644379 · Cited by 1 · see citing works
Drugs and thyroid interaction.
Berberoğlu, M. (2003) · PubMed · Cited by 1 · see citing works
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Self-citationCummings, L. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108587921.004 · Cited by 1 · see citing works
Progressive Supranuclear Palsy
Cummings, L. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108587921.007
Cummings, L. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108587921.005
Cummings, L. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108587921.006
Cummings, L. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108587921.012
Cummings, L. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108587921.008
Cummings, L. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108587921.011
Cummings, L. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108587921.003
Cummings, L. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108587921.015
(2020) · Cambridge University Press eBooks · doi:10.1017/9781108587921.013
Cummings, L. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108587921.010
Cummings, L. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108587921.014
Cummings, L. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108587921.009
Bonner‐Jackson, A. (2024) · Oxford University Press eBooks · doi:10.1093/med/9780197690024.003.0015
Fallows, R., & Pearson, C. M. (2026) · Springer eBooks · doi:10.1007/978-3-032-22457-6_6
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Self-citation
- Authors
- Smith, G., Chandler, M., Locke, D. E., Fields, J., Phatak, V., Crook, J., Hanna, S., Lunde, A., Morris, M., Graff-Radford, M., Hughes, C. A., Lepore, S., Cuc, A., Caselli, M., Hurst, D., Wethe, J., Francone, A., Eilertsen, J., Lucas, P., Hoffman Snyder, C., Kuang, L., Becker, M., Dean, P., Diehl, N., Lofquist, M., Vanderhook, S., Myles, D., & Cochran, D.
- Affiliations
- University of Florida (US)
- Mayo Clinic in Florida (US)
- Mayo Clinic in Arizona (US)
- Mayo Clinic (US)
- University of Nebraska Medical Center (US)
- University of Washington (US)
- VA Puget Sound Health Care System (US)
- Corresponding author
- Smith, Glenn
- ORCID
- Smith, Glenn
- Chandler, Melanie
- Locke, Dona EC
- Fields, Julie
- Phatak, Vaishali
- Crook, Julia
- Hanna, Sherrie
- Lunde, Angela
- Morris, Miranda
- Graff-Radford, Michelle
- Hughes, Christine A
- Lepore, Susan
- Cuc, Andrea
- Caselli, Maria
- Hurst, Duane
- Wethe, Jennifer
- Francone, Andrea
- Eilertsen, Jeanne
- Lucas, Pauline
- Hoffman Snyder, Charlene
- Kuang, LeeAnn
- Becker, Marigrace
- Dean, Pamela
- Diehl, Nancy
- Lofquist, Marvin
- Vanderhook, Shirley
- Myles, Diana
- Cochran, Denise
- Venue
- JMIR Research Protocols
- Publisher
- JMIR Publications Inc.
- Published
- 2017-11-27
- Volume
- 6
- Issue
- 11
- Pages
- e223
- ISSN
- 1929-0748 (ISSN-L)
- PMC
- PMC5725623
- OpenAlex
- W2768481555
- Cited by
- 42
- References
- 64
- Citations by year
- 2026: 3 · 2024: 2 · 2022: 3 · 2021: 10 · 2020: 17 · 2019: 5 · 2018: 1
- FWCI
- 5.17
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR Research Protocols (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (P50AG005136)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Keywords
- dementia prevention, mild cognitive impairment, behavioral interventions, couples, yoga, computerized cognitive training, support groups, wellness education, quality of life, self-efficacy, caregivers, comparative effectiveness
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