Dietary changes following a lifestyle-based intervention for dementia risk reduction : results from the AgeWell.de study

Purpose: We investigated the effects of a multidomain lifestyle intervention conducted in older adults at increased risk for dementia on participants’ diet. Methods: Secondary analyses of the cluster-randomized AgeWell.de-trial, testing a multidomain intervention (optimization of nutrition and medication, enhancement of physical, social and cognitive activity) in older adults at increased dementia risk. Intervention effects on a healthy diet (composite score) and its components were analyzed using Poisson- and logistic regression analyses. Stages of behavior change (transtheoretical model), and respective changes between baseline and follow-up were analyzed using mixed regression analyses. Results: A total of 819 individuals were analyzed (Mage = 69.0, SD = 4.9, nintervention/control group = 378/441). We observed a significant intervention effect on the healthy diet score (b = 0.06, IRR: 1.06, 95% CI: 1.01, 1.11). Changes were particularly due to increased fruit- and vegetable consumption, while other food components were not improved by the intervention. The intervention did not induce transitions to advanced stages of behavior change regarding a healthy diet, however, participants in the control group moved to initial stages of behavior change (OR = 1.95, 95% CI: 1.30, 2.92). Conclusion: A multidomain lifestyle intervention improved participants’ diet and maintained motivation to change in an at-risk-sample. However, only fruit- and vegetable consumption increased. Additional support might be necessary to encourage older adults to integrate new, healthier food components into their diet. Control group participants transitioned to initial stages of behavior change, stressing the need to encourage older adults to maintain a healthy diet as they age.