The cost effectiveness of a multidomain intervention on physical, cognitive, vascular, dietary and psychosocial outcomes among community dwelling older adults with cognitive frailty in Malaysia: The AGELESS Trial
Abstract Background Cognitive frailty (CF) in older adults is a potentially reversible syndrome that may benefit from lifestyle-based multidomain interventions. This study assessed the AGELESS intervention’s impact on cognitive, physical, vascular, dietary, and psychosocial outcomes, along with its...
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2025-05-01
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| Series: | Alzheimer’s Research & Therapy |
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| Online Access: | https://doi.org/10.1186/s13195-025-01722-w |
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| author | Pavapriya Ponvel Suzana Shahar Devinder Kaur Ajit Singh Arimi Fitri Mat Ludin Ponnusamy Subramaniam Norhayati Ibrahim Hasnah Haron Aniza Ismail Chin Ai-Vyrn Mazlyfarina Mohamad Hidayah Fadzil Norhayati Mustafa Khalid A’isyah Mohammad Safien Jamilah Mohammad Hanipah Azyana Ibrahim Jenni Lehtisalo Miia Kivipelto Francesca Mangialasche |
| author_facet | Pavapriya Ponvel Suzana Shahar Devinder Kaur Ajit Singh Arimi Fitri Mat Ludin Ponnusamy Subramaniam Norhayati Ibrahim Hasnah Haron Aniza Ismail Chin Ai-Vyrn Mazlyfarina Mohamad Hidayah Fadzil Norhayati Mustafa Khalid A’isyah Mohammad Safien Jamilah Mohammad Hanipah Azyana Ibrahim Jenni Lehtisalo Miia Kivipelto Francesca Mangialasche |
| author_sort | Pavapriya Ponvel |
| collection | DOAJ |
| description | Abstract Background Cognitive frailty (CF) in older adults is a potentially reversible syndrome that may benefit from lifestyle-based multidomain interventions. This study assessed the AGELESS intervention’s impact on cognitive, physical, vascular, dietary, and psychosocial outcomes, along with its cost-effectiveness, in a Low-Middle-Income Country (LMIC). Methods The AGELESS randomized controlled trial recruited 106 older adults (above 60 years) from Klang Valley, Malaysia, with (pre)-CF (≥ 1 Fried’s criteria and Clinical Dementia Rating scale = 0.5). Participants were randomly assigned to a 24-month multidomain intervention (physical activity, cognitive training, nutritional and psychological counselling, cardiovascular care) or control group (educational module). Primary outcomes, assessed at baseline, 12 and 24 months, included the modified Neuropsychological Tests Battery (mNTB) and physical performance measures. Intervention costs were calculated to determine Incremental Cost-Effectiveness Ratios (ICERs). An intention-to-treat analysis was conducted to account for attrition. Results The trial occurred during the COVID-19 pandemic. Despite a 50% dropout rate, adherence among remaining participants was over 50% for all intervention components (range 53%-91%). The intervention led to significant improvements in selected parameters of cognitive function, physical performance, anthropometry, and dietary patterns (for all parameters, p < 0.05 for interaction time*group in repeat-measures ANOVA). The cost per participant was RM 1592.74 (≈USD 355.05) in the multidomain arm, and RM 488.21 (≈USD 108.83) in the control arm. The ICER computation indicated the 2-min step test as the most cost-effective measure (ICER RM 149.19 ≈USD33.26). Conclusion The AGELESS trial demonstrates that a multidomain, lifestyle-based intervention can improve cognitive and physical function in older adults with (pre)-CF. This cost-effective approach highlights CF as a modifiable health condition and supports its potential inclusion in health policy to promote healthy aging and reduce health risks in LMICs, where there is a larger prevention potential due to prevalent lifestyle-related risk factors. |
| format | Article |
| id | doaj-art-8dca392792b24b67a805e58d6ea6da1b |
| institution | DOAJ |
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| publishDate | 2025-05-01 |
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| series | Alzheimer’s Research & Therapy |
| spelling | doaj-art-8dca392792b24b67a805e58d6ea6da1b2025-08-20T03:10:17ZengBMCAlzheimer’s Research & Therapy1758-91932025-05-0117112310.1186/s13195-025-01722-wThe cost effectiveness of a multidomain intervention on physical, cognitive, vascular, dietary and psychosocial outcomes among community dwelling older adults with cognitive frailty in Malaysia: The AGELESS TrialPavapriya Ponvel0Suzana Shahar1Devinder Kaur Ajit Singh2Arimi Fitri Mat Ludin3Ponnusamy Subramaniam4Norhayati Ibrahim5Hasnah Haron6Aniza Ismail7Chin Ai-Vyrn8Mazlyfarina Mohamad9Hidayah Fadzil10Norhayati Mustafa Khalid11A’isyah Mohammad Safien12Jamilah Mohammad Hanipah13Azyana Ibrahim14Jenni Lehtisalo15Miia Kivipelto16Francesca Mangialasche17Center of Wellness and Healthy Aging, Faculty of Health Sciences, Universiti Kebangsaan MalaysiaCenter of Wellness and Healthy Aging, Faculty of Health Sciences, Universiti Kebangsaan MalaysiaCenter of Wellness and Healthy Aging, Faculty of Health Sciences, Universiti Kebangsaan MalaysiaCenter of Wellness and Healthy Aging, Faculty of Health Sciences, Universiti Kebangsaan MalaysiaCenter of Wellness and Healthy Aging, Faculty of Health Sciences, Universiti Kebangsaan MalaysiaCenter of Wellness and Healthy Aging, Faculty of Health Sciences, Universiti Kebangsaan MalaysiaCenter of Wellness and Healthy Aging, Faculty of Health Sciences, Universiti Kebangsaan MalaysiaDepartment of Public Health Medicine Faculty of Medicine, Universiti Kebangsaan MalaysiaDepartment of Medicine, Faculty of Medicine, Universiti MalayaCentre for Diagnostic, Faculty of Health Sciences, Universiti Kebangsaan MalaysiaCenter of Wellness and Healthy Aging, Faculty of Health Sciences, Universiti Kebangsaan MalaysiaCenter of Wellness and Healthy Aging, Faculty of Health Sciences, Universiti Kebangsaan MalaysiaCenter of Wellness and Healthy Aging, Faculty of Health Sciences, Universiti Kebangsaan MalaysiaCenter of Wellness and Healthy Aging, Faculty of Health Sciences, Universiti Kebangsaan MalaysiaCenter of Wellness and Healthy Aging, Faculty of Health Sciences, Universiti Kebangsaan MalaysiaDepartment of Public Health, Lifestyles and Living Environments Unit, Finnish Institute for Health and Welfare (THL)Institute of Public Health and Clinical Nutrition, University of Eastern FinlandDivision of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Alzheimer Research Center, Karolinska InstituteAbstract Background Cognitive frailty (CF) in older adults is a potentially reversible syndrome that may benefit from lifestyle-based multidomain interventions. This study assessed the AGELESS intervention’s impact on cognitive, physical, vascular, dietary, and psychosocial outcomes, along with its cost-effectiveness, in a Low-Middle-Income Country (LMIC). Methods The AGELESS randomized controlled trial recruited 106 older adults (above 60 years) from Klang Valley, Malaysia, with (pre)-CF (≥ 1 Fried’s criteria and Clinical Dementia Rating scale = 0.5). Participants were randomly assigned to a 24-month multidomain intervention (physical activity, cognitive training, nutritional and psychological counselling, cardiovascular care) or control group (educational module). Primary outcomes, assessed at baseline, 12 and 24 months, included the modified Neuropsychological Tests Battery (mNTB) and physical performance measures. Intervention costs were calculated to determine Incremental Cost-Effectiveness Ratios (ICERs). An intention-to-treat analysis was conducted to account for attrition. Results The trial occurred during the COVID-19 pandemic. Despite a 50% dropout rate, adherence among remaining participants was over 50% for all intervention components (range 53%-91%). The intervention led to significant improvements in selected parameters of cognitive function, physical performance, anthropometry, and dietary patterns (for all parameters, p < 0.05 for interaction time*group in repeat-measures ANOVA). The cost per participant was RM 1592.74 (≈USD 355.05) in the multidomain arm, and RM 488.21 (≈USD 108.83) in the control arm. The ICER computation indicated the 2-min step test as the most cost-effective measure (ICER RM 149.19 ≈USD33.26). Conclusion The AGELESS trial demonstrates that a multidomain, lifestyle-based intervention can improve cognitive and physical function in older adults with (pre)-CF. This cost-effective approach highlights CF as a modifiable health condition and supports its potential inclusion in health policy to promote healthy aging and reduce health risks in LMICs, where there is a larger prevention potential due to prevalent lifestyle-related risk factors.https://doi.org/10.1186/s13195-025-01722-wCognitive frailtyMultidomainInterventionCommunity dwellingOlder adults |
| spellingShingle | Pavapriya Ponvel Suzana Shahar Devinder Kaur Ajit Singh Arimi Fitri Mat Ludin Ponnusamy Subramaniam Norhayati Ibrahim Hasnah Haron Aniza Ismail Chin Ai-Vyrn Mazlyfarina Mohamad Hidayah Fadzil Norhayati Mustafa Khalid A’isyah Mohammad Safien Jamilah Mohammad Hanipah Azyana Ibrahim Jenni Lehtisalo Miia Kivipelto Francesca Mangialasche The cost effectiveness of a multidomain intervention on physical, cognitive, vascular, dietary and psychosocial outcomes among community dwelling older adults with cognitive frailty in Malaysia: The AGELESS Trial Alzheimer’s Research & Therapy Cognitive frailty Multidomain Intervention Community dwelling Older adults |
| title | The cost effectiveness of a multidomain intervention on physical, cognitive, vascular, dietary and psychosocial outcomes among community dwelling older adults with cognitive frailty in Malaysia: The AGELESS Trial |
| title_full | The cost effectiveness of a multidomain intervention on physical, cognitive, vascular, dietary and psychosocial outcomes among community dwelling older adults with cognitive frailty in Malaysia: The AGELESS Trial |
| title_fullStr | The cost effectiveness of a multidomain intervention on physical, cognitive, vascular, dietary and psychosocial outcomes among community dwelling older adults with cognitive frailty in Malaysia: The AGELESS Trial |
| title_full_unstemmed | The cost effectiveness of a multidomain intervention on physical, cognitive, vascular, dietary and psychosocial outcomes among community dwelling older adults with cognitive frailty in Malaysia: The AGELESS Trial |
| title_short | The cost effectiveness of a multidomain intervention on physical, cognitive, vascular, dietary and psychosocial outcomes among community dwelling older adults with cognitive frailty in Malaysia: The AGELESS Trial |
| title_sort | cost effectiveness of a multidomain intervention on physical cognitive vascular dietary and psychosocial outcomes among community dwelling older adults with cognitive frailty in malaysia the ageless trial |
| topic | Cognitive frailty Multidomain Intervention Community dwelling Older adults |
| url | https://doi.org/10.1186/s13195-025-01722-w |
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