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HATICE Healthy AgingThrough Internet Counsellingin the Elderly

Collaborative project co-funded by the European Unions' Seventh Framework Programme (FP7, 2007-2013) under grant agreement No 305374.

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HATICE is the first major research project following the launch of the European Dementia Prevention Initiative (EDPI) in 2011. Cardiovascular risk factors including hypertension, diabetes, obesity, smoking and lack of physical exercise are common in the elderly and increase the risk of myocardial infarction, stroke and dementia.

Main aims of HATICE:
  1. Develop an innovative, interactive internet intervention platform to optimise treatment of cardiovascular disease in the elderly
  2. Test this new intervention in a randomised controlled trial to investigate whether new cardiovascular disease and cognitive decline can be prevented

HATICE, page 2 of 6

First HATICE PhD defense by Susan Jongstra

On 22 September 2017 Susan Jongstra will be the first to obtain a PhD degree based on the HATICE project. As a PhD student Susan was involved in the ongoing trials evaluation, the design of the generic intervention, and the controlled trial itself.

Her thesis covers a broad spectrum of issues involving eHealth in cardiovascular risk management to prevent cognitive decline. Not only the rationale and design of the HATICE trial is presented, but also the extensive, profound and time-consuming process of developing an internet platform for the prevention of cardiovascular disease in older adults. Based on data from the preDIVA trial, the added predictive value of a neuropsychological test of visual memory (Visual Association Test, VAT) over and above a cognitive screening instrument (Mini Mental State Examination, MMSE) was assessed. It seemed that such a short, simple test as the VAT has substantial incremental value for distinguishing older individuals that are at increased risk of developing dementia. For more information, or a copy of the thesis, please contact Susan: s.jongstra[at]amc.uva.nl

In January 2017, Susan has started her training to become a neurologist at the Academic Medical Center in Amsterdam, the Netherlands.

FINGER, MAPT and preDIVA trials all published in high ranking journals

The results of the MAPT trial have recently been published in Lancet Neurology(1). The 3-year MAPT study was the first trial to evaluate the effectiveness of a multidomain lifestyle intervention, omega-3 fatty acid supplementation, or both interventions combined, compared to a placebo, on cognitive decline. In the main analysis, there were no significant effects on cognitive decline. However, the results of exploratory subgroup analyses suggested that the combined polyunsaturated fatty acid and multidomain intervention or the multidomain intervention alone might help to slow cognitive decline in people most likely to undergo decline—i.e., those with an increased dementia risk score, and those with evidence of brain amyloid pathology. This publication concludes the very successful range of publications of the finished trials in the HATICE consortium. Previously, the FINGER trial showed in the Lancet(2) that a multidomain intervention could improve or maintain cognitive functioning in at-risk elderly people from the general population. PreDIVA showed in a secondary analysis in the Lancet(3) that 6 years of nurse-led intensive vascular care did not lead to a reduction of all-cause dementia, but seemed effective for the prevention of dementia in participants with untreated baseline hypertension at baseline and persons adherent to the intervention. The data of these trials were pooled in a specially designed pooled data platform to provide valuable input for the design of the HATICE trial on the effects of a blended internet intervention which included 2725 participants and will be finished in December 2017(4).

References

  1. Andrieu S, Guyonnet S, Coley N, Cantet C, Bonnefoy M, Bordes S, et al. Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): a randomised, placebo-controlled trial. Lancet Neurol. 2017.
  2. Ngandu T, Lehtisalo J, Solomon A, Levalahti E, Ahtiluoto S, Antikainen R, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet. 2015;385(9984):2255-63.
  3. Moll van Charante EP, Richard E, Eurelings LS, van Dalen JW, Ligthart SA, van Bussel EF, et al. Effectiveness of a 6-year multidomain vascular care intervention to prevent dementia (preDIVA): a cluster-randomised controlled trial. Lancet. 2016.
  4. Richard E, Jongstra S, Soininen H, Brayne C, Moll van Charante EP, Meiller Y, et al. Healthy Ageing Through Internet Counselling in the Elderly: the HATICE randomised controlled trial for the prevention of cardiovascular disease and cognitive impairment. BMJ Open. 2016;6(6):e010806.