認知症予防を目指した多因子介入研究（J–MINT）の成果と今後の展望

抄録

Aim : Various risk factors for dementia have been reported. In Japan, a multimodal intervention adapted to the lifestyle of Japanese people was conducted (J–MINT).

Methods : Subjects were older persons aged 65–85 with mild cognitive impairment. The study evaluated the effects of a multimodal intervention program (vascular management, exercise and nutritional guidance, and cognitive training) on cognitive function.

Results : We enrolled 531 participants ; the retention rate up to 18 months was 76.5%. The primary endpoint, cognitive function composite score changes, showed no statistically significant group differences between the intervention and control groups. The adherent intervention group, which participated in more than 70% of exercise classes, showed significant cognitive improvement compared to the non–adherent and control groups. There were improvements in dietary diversity, social engagement, blood pressure, BMI, and reduced incidence of frailty. In APOE4 carriers, cognitive function declined over time in the control group, but was maintained over 18 months in the intervention group. In an analysis stratified by blood biomarkers, the effect of the multifactorial intervention was more pronounced in the group with higher levels of GFAP, a marker reflecting inflammation in the brain.

Discussion : The multidomain intervention improved cognitive function, physical function, and social participation. To quickly return the results of the J–MINT study to society, it is necessary to verify the effectiveness and cost–effectiveness of a program adapted to the real world.