The LEISURE Study: A Longitudinal Randomized Controlled Trial Protocol for a Multi-Modal Lifestyle Intervention Study to Reduce Dementia Risk in Healthy Older Adults

Article type: Research Article

Authors: Treacy, Ciara^a | Levenstein, Jacob M.^a | Jefferies, Annelise^a | Metse, Alexandra P.^{b; c} | Schaumberg, Mia A.^{b; d; e; f} | Villani, Anthony^b | Boucas, Ana P.^a | Hermens, Daniel F.^a | Lagopoulos, Jim^a | Andrews, Sophie C.^{a; *}

Affiliations: [a] Thompson Institute, University of the Sunshine Coast, Maroochydore DC, QLD, Australia | [b] School of Health, University of the Sunshine Coast, Maroochydore DC, QLD, Australia | [c] School of Psychological Sciences, University of Newcastle, University Drive, Callaghan, NSW, Australia | [d] School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, Australia | [e] Sunshine Coast Health Institute, Sunshine Coast Hospital and Health Service, Birtinya, QLD, Australia | [f] Manna Institute, University of the Sunshine Coast, QLD, Australia

Correspondence: [*] Correspondence to: Sophie C. Andrews, Thompson Institute, University of the Sunshine Coast, Maroochydore DC, QLD, Australia. Tel.: +61 7 5459 4476; E-mail: [email protected].

Abstract: Dementia is understood to arise from a mixed etiology, enveloping chronic inflammatory and vascular impacts on the brain, driven by a constellation of modifiable risk factors which are largely mediated by lifestyle-related behaviors. These risk factors manifest over a prolonged preclinical period and account for up to 40% of the population attributable risk for dementia, representing viable targets for early interventions aimed at abating disease onset and progression. Here we outline the protocol for a 12-week randomized control trial (RCT) of a multimodal Lifestyle Intervention Study for Dementia Risk Reduction (LEISURE), with longitudinal follow-up at 6-months and 24-months post-intervention. This trial integrates exercise, diet, sleep, and mindfulness to simultaneously target multiple different etiopathogenetic mechanisms and their interplay in a healthy older adult population (aged 50–85 years), and assesses dementia risk reduction as the primary endpoint. The LEISURE study is located in the Sunshine Coast region of Australia, which has one of the nation’s highest proportions of adults aged over 50 years (36.4%), and corresponding dementia prevalence. This trial is novel in its inclusion of mindfulness and sleep as multidomain lifestyle targets, and in its comprehensive suite of secondary outcomes (based on psychological, physical health, sleep activity, and cognitive data) as well as exploratory neuroimaging (magnetic resonance imaging and electroencephalography) and molecular biology measures. These measures will provide greater insights into the brain-behavioral underpinnings of dementia prevention, as well as the predictors and impacts of the proposed lifestyle intervention. The LEISURE study was prospectively registered (ACTRN12620000054910) on 19 January 2020.

Keywords: Aging, Alzheimer’s disease, biomarkers, individualized medicine, neurobiology, prevention

DOI: 10.3233/JAD-230193

Journal: Journal of Alzheimer's Disease, vol. 94, no. 2, pp. 841-856, 2023