Cognitive Benefit of a Multidomain Intervention for Older Adults at Risk of Cognitive Decline: A Cluster- Randomized Controlled Trial

Objective: We sought to assess cognitive benefits of a community-based multi -domain intervention for improving cognition among older adults at risk of cog-nitive decline (COMBAT). Design: A two-armed cluster-randomized controlled trial. Setting and Participants: Community-dwelling older adults aged 60 years or older and were at risk of cognitive decline (n = 209). Intervention: In this 9-month intervention study, 10 community hospitals in Beijing, China, were randomized (1:1) to receive either a multidomain inter-vention of meditation, cognitive training, exercise, and nutrition counseling or usual care. The intervention was delivered with weekly 1-hour group training sessions and weekly home homework. Measurements: Primary outcome was change in cognition as measured by a composite Z score of seven cognitive tests. Secondary outcomes included subjective cognitive abilities, positive and nega-tive affective experiences, physical activity, and dietary habits. Assessments were administered at baseline, end of the intervention, and 1 year after com-pleting the intervention (1-year follow-up). Results: Immediately after the intervention, the intervention group showed significant enhancement in cogni-tive performance (p = 0.026). The between-group difference in the Z score of change of cognition was 0.20 (95% CI: 0.053, 0.35), with a Hedges' g of 0.40 (95% CI: 0.29, 0.50). However, this cognitive benefit was not significant at