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ToolsDemnitz-King, Harriet, Adeleke, Mariam, Barber, Julie A., Poppe, Michaela, Budgett, Jessica, Alberts, Sweedal, Duffy, Larisa, Minihane, Anne-Marie, Gillings, Rachel, Chapman, Hannah, Espinoza Jeraldo, Rosario Isabel, Kelsey, Oliver, Muralidhar, Malvika, Zabihi, Sedigheh, Aguirre, Elisa, Bass, Nicholas, Betz, Anna, Brodaty, Henry, Burton, Alexandra, Higgs, Paul, Hunter, Rachael Maree, Huntley, Jonathan, Kales, Helen C., Lang, Iain, Marchant, Natalie L., Morgan-Trimmer, Sarah, Rapaport, Penny, Rio, Miguel, Petersen, Irene, Walker, Zuzana, Walters, Kate, Banerjee, Sube, Rodda, Joanne, Palomo, Marina and Cooper, Claudia (2025) Remote, lower-intensity, multidomain lifestyle intervention for subjective cognitive decline or mild cognitive impairment (APPLE-Tree): A multicentre, single-masked, randomised controlled trial. Lancet Healthy Longevity. ISSN 2666-7568
Full text not available from this repository. (Request a copy)Abstract
Background: Trials of high-intensity, multidomain interventions show modifying lifestyle and psychological risk factors can slow cognitive decline. We aimed to evaluate if a lower-intensity, personally-tailored dementia prevention programme could improve cognition in adults with subjective cognitive decline (SCD) or mild cognitive impairment (MCI). Methods: We conducted a two-arm, single-masked, multi-site, randomised, clinical trial recruiting older adults with SCD or MCI in England. Participants were randomly assigned (1:1) to the 12-month APPLE-Tree intervention or control (usual care plus brief written dementia prevention information). Randomisation was blocked and stratified by site, with allocations assigned via a remote web-based system. The intervention promoted healthy lifestyles, social connections, enjoyable activities, and self-management of long-term conditions. It comprised ten, 1-hour group video-call sessions over six months, supplemented with alternating video-call ‘tea breaks’ and individual goal-setting calls between sessions. From months 6-12, participants continued with monthly online ‘tea breaks’. The primary outcome was cognition (Neuropsychological Test Battery [NTB] score) at 24-months, analysed using an intention-to-treat approach. This trial was pre-registered with ISRCTN Registry (ISRCTN17325135). Findings: Between October 5, 2020, and December 31, 2022, we assessed the eligibility of 1287 participants and randomised 746 who were eligible and consented: 374 to the intervention (177 [47%] women) and 372 to the control (173 [47%] women). The primary outcome analysis included 635/746 (85%) participants. Mean NTB scores increased in both groups over time, with greater improvement in the intervention group (mean [standard deviation] 24-month NTB: 0·33 [0·67] versus 0·21 [0·75]; adjusted mean difference: 0·06 [95%CI -0·00-0·13], p=0·055). Serious adverse events occurred in 35 (9·4%) intervention and 30 (8·1%) control participants; none were intervention related. Interpretation: APPLE-Tree is an accessible intervention, associated with small improvements in cognition of marginal statistical significance, indicative of potentially meaningful benefits. With remote delivery by non-clinical facilitators, it is optimised for broad implementation.
| Item Type: | Article |
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| Additional Information: | Funding information: This trial is funded by an Economic and Social Research Council/National Institute for Health Research programme grant (ES/S010408/1). |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health Faculty of Medicine and Health Sciences > Research Groups > Nutrition and Preventive Medicine |
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| Depositing User: | LivePure Connector |
| Date Deposited: | 31 Oct 2025 16:31 |
| Last Modified: | 31 Oct 2025 16:31 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/100872 |
| DOI: | 10.1016/j.lanhl.2025.100777 |
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