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@ARTICLE{Beyer:279037,
      author       = {Beyer, Frauke and Kleine, Lukas and Zülke, Andrea and
                      Luppa, Melanie and Mildner, Toralf and Gensichen, Jochen and
                      Frese, Thomas and Czock, David and Wiese, Birgitt and
                      König, Hans-Helmut and Kaduszkiewicz, Hanna and Hoffmann,
                      Wolfgang and Thyrian, Jochen René and Villringer, Arno and
                      Riedel-Heller, Steffi and Witte, A Veronica},
      title        = {{E}xploring the effect of multi-modal intervention against
                      cognitive decline on atrophy and small vessel disease
                      imaging markers in the {A}ge{W}ell.de imaging study.},
      journal      = {NeuroImage: Clinical},
      volume       = {46},
      issn         = {2213-1582},
      address      = {[Amsterdam u.a.]},
      publisher    = {Elsevier},
      reportid     = {DZNE-2025-00669},
      pages        = {103796},
      year         = {2025},
      abstract     = {Multimodal lifestyle interventions might help to maintain
                      healthy cognition in older age and to delay onset of
                      dementia. Here, we studied the effects of a multi-modal
                      lifestyle-based intervention, based on the FINGER trial, on
                      magnetic resonance imaging (MRI) markers of
                      hippocampal-limbic atrophy and cerebral small vessel disease
                      in older adults at increased risk for dementia in
                      Germany.Leipzig participants of the multicenter AgeWell.de
                      randomized controlled trial underwent neuroimaging before
                      and after a two year intervention at 3 Tesla MRI. We
                      extracted hippocampal volume and entorhinal cortex thickness
                      (ECT), free water fraction (FW), peak width of skeletonized
                      mean diffusivity (PSMD), white matter hyperintensity volume
                      and mean gray matter cerebral blood flow and assessed the
                      effect of the intervention on these imaging markers using
                      linear mixed models. We also tested the effect of the
                      intervention on the hippocampus-dependent Mnemonic
                      Similarity Test and fixel-based white matter
                      microstructure.56 individuals (mean (sd) age: 68.8 (4.2)
                      years, 26 females, 24/32 intervention/control group) were
                      included at baseline and 41 returned after an average of 28
                      months for the second assessment. ECT and FW exhibited
                      stronger decline in the intervention compared to the control
                      group in preregistered models but not when adjusted for
                      baseline differences. All other markers progressed similarly
                      across groups, however sample size was smaller than
                      expected. In exploratory analyses, cerebral blood flow
                      increased more in the intervention group and this change was
                      associated with decreases in systolic blood pressure.In this
                      group of older adults at risk for dementia, we find no
                      conclusive evidence whether a multi-modal lifestyle
                      intervention improves brain imaging markers of
                      neurodegeneration and small vessel disease. Preliminary
                      evidence suggested an association of the intervention,
                      increased cerebral blood flow and systolic blood pressure
                      reductions.ECT, entorhinal cortex thickness; FW, free water
                      fraction; WHO, world health organization; AD, Alzheimer's
                      disease; VCI, vascular cognitive impairment; FINGER, Finnish
                      Geriatric Intervention Study to Prevent Cognitive Impairment
                      and Disability; MTL, medial temporal lobe; MIND,
                      Mediterranean-DASH Intervention for Neurodegenerative Delay
                      diet; cSVD, cerebral small vessel disease; WMH, white matter
                      hyperintensities of presumed vascular origin; PSMD, peak
                      width of the mean diffusivity distribution; WW-FINGERS,
                      world wide FINGER studies; CAIDE, Cardiovascular Risk
                      Factors, Aging, and Incidence of Dementia; GPP, general
                      practitioner praxis; MRI, magnetic resonance imaging; MST,
                      Mnemonic Similarity Test; TE, echo time; TR, repetition
                      time; FA, flip angle; FOV, field of view; GRAPPA,
                      GeneRalized Autocalibrating Partial Parallel Acquisition;
                      CMRR, Center for Magnetic Resonance Research; BOLD, blood
                      oxygenation level dependent; pcASL: pseudo-continuous
                      arterial spin labeling; EPI, echo-planar imaging; FLAIR,
                      fluid attenuated inversion recovery; CBF, cerebral blood
                      flow; QA, quality assessment; GM, gray matter; HCV,
                      hippocampal volume; eICV, estimated intracranial volume;
                      DWI, diffusion-weighted imaging; MD, mean diffusivity; FA,
                      fractional anisotropy TBSS: tract-based spatial statistics;
                      CSF, cerebral spinal fluid; ISI, inter-stimulus interval;
                      LDI, lure discrimination index; REC, recognition score; CG,
                      control group; IG, intervention group; MoCA, Montreal
                      Cognitive Assessment; CASMIN, Comparative Analysis of Social
                      Mobility in Industrial Nations; BMI, body mass index;
                      SBP/DBP, systolic/diastolic blood pressure; OSF, open
                      science framework; LMM, linear mixed model; ANOVA, analysis
                      of covariance.},
      keywords     = {Humans / Female / Aged / Male / Cognitive Dysfunction:
                      diagnostic imaging / Cognitive Dysfunction: pathology /
                      Cognitive Dysfunction: prevention $\&$ control / Cerebral
                      Small Vessel Diseases: diagnostic imaging / Cerebral Small
                      Vessel Diseases: pathology / Atrophy: diagnostic imaging /
                      Magnetic Resonance Imaging: methods / Hippocampus: pathology
                      / Hippocampus: diagnostic imaging / Middle Aged / White
                      Matter: diagnostic imaging / White Matter: pathology / Aged,
                      80 and over / Cerebral Small Vessel Disease (Other) /
                      Dementia (Other) / Hippocampus (Other) / Lifestyle (Other) /
                      Magnetic Resonance Imaging (Other) / Multi-component
                      intervention (Other)},
      cin          = {AG Thyrian},
      ddc          = {610},
      cid          = {I:(DE-2719)1510800},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40378769},
      doi          = {10.1016/j.nicl.2025.103796},
      url          = {https://pub.dzne.de/record/279037},
}