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Is more always better? Dose effect in a multidomain intervention in older adults at risk of dementia
Belleville S, Cloutier S, Mellah S, Willis S, Vellas B, Andrieu S, Coley N, Ngandu T et al.. Alzheimer's & dementia : the journal of the Alzheimer's Association, 2022-01-20
Topic: Risk, prevention and care in population studies
Background Little is known regarding the dose-response function in multidomain interventions for dementia prevention. Method The Multidomain Alzheimer Preventive Trial is a 3-year randomized controlled trial comprising cognitive training, physical activity, nutrition, and omega-3 polyunsaturated fatty acids for at-risk older adults. The dose delivered (number of sessions attended) was modeled against global cognition, memory, and fluency in 749 participants. Interaction effects were assessed for age, sex, education, dementia score (CAIDE), frailty score, and apolipoprotein E (APOE) ε4 status. Results The dose-response models were non-linear functions indicating benefits up to about 12 to 14 training hours or 15 to 20 multidomain sessions followed by a plateau. Participants who benefited from a higher dose included women, younger participants, frail individuals, and those with lower education or lower risk of dementia. Discussion The non-linear function indicates that a higher dose is not necessarily better in multidomain interventions. The optimal dose was about half of the potentially available sessions.
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APA 7th
Belleville, S., Cloutier, S., Mellah, S., Willis, S., Vellas, B., Andrieu, S., et al. (2022). Is more always better? Dose effect in a multidomain intervention in older adults at risk of dementia. Alzheimer's & dementia : the journal of the Alzheimer's Association. https://doi.org/10.1002/alz.12544
Vancouver
Belleville S, Cloutier S, Mellah S, Willis S, Vellas B, Andrieu S, et al. Is more always better? Dose effect in a multidomain intervention in older adults at risk of dementia. Alzheimer's & dementia : the journal of the Alzheimer's Association. 2022. doi:10.1002/alz.12544. PMID: 35049127.
BibTeX
@article{belleville2022-35049127,
author = {Belleville, S. and Cloutier, S. and Mellah, S. and Willis, S. and Vellas, B. and Andrieu, S. and Coley, N. and Ngandu, T. and others},
title = {{Is more always better? Dose effect in a multidomain intervention in older adults at risk of dementia}},
journal = {Alzheimer's \& dementia : the journal of the Alzheimer's Association},
year = {2022},
doi = {10.1002/alz.12544},
pmid = {35049127},
url = {https://doi.org/10.1002/alz.12544}
}
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Key findings
- Results The dose-response models were non-linear functions indicating benefits up to about 12 to 14 training hours or 15 to 20 multidomain sessions followed by a plateau.
- Participants who benefited from a higher dose included women, younger participants, frail individuals, and those with lower education or lower risk of dementia.
- Discussion The non-linear function indicates that a higher dose is not necessarily better in multidomain interventions.
Why it matters
This analysis of a 3-year multidomain prevention trial found that benefits rose up to about 12 to 14 training hours or 15 to 20 sessions, then leveled off. Doing more sessions than that was not better, so more intervention is not always more helpful for older adults at risk of dementia.
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Study details
- Study designrandomized controlled trial
- Participants749
- Evidence strengthHigh
How this study scored 71/100
Published in a leading specialty journal, and it is a randomised controlled trial. Scored zero for effect reported because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 68 of the 96 points we could judge it on, which is 71 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Alzheimer's & dementia : the journal of the Alzheimer's Association) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2022 — within 6 year(s) of the newest study here |
| Sample size | 2 / 4 | 749 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 4 / 7 | Cited 44 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 7.3 citations a year over 6 year(s) since 2022 |
| Impact for its field and year | 3 / 6 | Cited 6.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 4 other studies in this library |
| Still being cited | 2 / 4 | Cited 29 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | 3 / 3 | University of Washington: institution h-index 3,540 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 9 institution(s) in 4 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 35049127) |
| Free to read | 2 / 2 | Free to read |
| Points | 68 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 68 of the 96 points we could judge it on is 71 out of 100. |
| Total | 71 / 100 | — |
What each of these 20 components measures, and what this score is not →
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