Findings highlight the importance of including underserved populations in dementia prevention research
Researchers at the Indiana University School of Medicine, Eskenazi Health, Regenstrief Institute and other partners have demonstrated the feasibility of conducting dementia prevention trials among older adults with limited formal education, a group at heightened risk for Alzheimer’s disease and related dementias.
The MINDSpeed trial, a randomized study, tested whether a diet rich in polyphenols, which are plant-based compounds found in foods like nuts and berries, and online speed-of-processing cognitive training could improve cognition in older adults with 12 or fewer years of education.
The study enrolled 180 participants aged 60 and older from Marion County, Indiana. Participants were randomized into one of four groups:
- Polyphenol rich snacks and cognitive training
- Polyphenol rich snacks and control games
- Control snacks and cognitive training
- Control snacks and control games
Over three months of active intervention, participants received home-delivered snacks and played online games using a study provided tablet and custom app, with cognitive assessments conducted at three months and six months. The trial met all feasibility goals for recruitment, retention and adherence.
Across all groups, participants experienced modest improvements in cognition, with effect sizes ranging from 0.15 to 0.35. While no single intervention arm outperformed the others, the results suggest that adults with limited education, a population often underrepresented in dementia research, can engage in and benefit from preventive strategies.
“Adults with fewer years of education face disproportionately higher risks for dementia but are often left out of prevention research,” said Regenstrief and IU School of Medicine’s Daniel O. Clark, PhD, lead author. “This study shows that not only can they be successfully recruited and retained, but they may also experience cognitive gains.”
Briana Sprague, PhD, study co-author, a Regenstrief research scientist and an assistant professor with the IU School of Medicine added, “We found that once participants were involved in the trial, they were engaged and interested. It is feasible to deliver cognitive training and brain healthy snacks to older adults in the community, even to those who are often underserved.”
The researchers note that longer and more intensive interventions may be needed to detect stronger effects, and that longer follow-up may be beneficial. They emphasize the importance of continuing to design dementia prevention trials tailored to adults with limited education.
“This study highlights that prevention strategies can and should reach populations who are often overlooked,” said Dr. Sprague. “By tailoring dementia prevention efforts to include adults with fewer years of education, we can begin to address disparities and ensure that more people have the opportunity to benefit.”
The paper, “Feasibility of lifestyle interventions for cognition in adults with low education,” is published in the peer-reviewed journal Alzheimer’s & Dementia.
Funding was provided by the National Institutes of Health’s National Institute on Aging.
Authors and affiliations as listed in the publication
Daniel O Clark1,2, Huiping Xu1,2,3, Christy C Tangney4, Annie W Lin5, Shannon L Risacher6,7, Andrew J Saykin6,7, Robert V Considine8, Holly J Garringer7,9, Lyndsi Moser10, Amy Carter11, Catherine M Miller1, Briana Sprague1,2, Christopher M Callahan1, Frederick W Unverzagt7,10
1Department of Medicine, Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
2Indiana University Center for Aging Research at Regenstrief Institute, Indianapolis, Indiana, USA.
3Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana, USA.
4Department of Clinical Nutrition, Rush University Medical Center, Chicago, Illinois, USA.
5The Hormel Institute, University of Minnesota, Austin, Minnesota, USA.
6Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA.
7Indiana Alzheimer’s Disease Research Center, Indiana University School of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
8Department of Medicine, Division of Endocrinology, Indianapolis, Indiana, USA.
9Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
10Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA.
11Eskenazi Health, Indianapolis, Indiana, USA.
Daniel O. Clark, PhD
In addition to his role as a research scientist with the Indiana University Center for Aging Research at Regenstrief Institute, Daniel O. Clark, PhD, is an associate professor of medicine at the Indiana University School of Medicine.
Briana N. Sprague, PhD
In addition to her role as a research scientist with the Indiana University Center for Aging Research at Regenstrief Institute, Briana Sprague, PhD, is an assistant professor of medicine at the Indiana University School of Medicine.
