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Multidomain intervention did not significantly impact body weight in older adults at risk for dementiaMultidomain lifestyle programs did not change weight in older adults

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Key Takeaway
Note that multidomain interventions did not result in significant weight loss in older adults at risk for dementia.

This post-hoc analysis of a cluster-randomized trial evaluated the impact of a multidomain intervention on body weight in 678 older adults (aged 60 to 77 years) with a BMI $\geq$ 25 kg/m$^2$ at risk for dementia. The intervention included dietary counseling, enhanced physical, social, and cognitive activity, medication review, and management of cardiovascular risk factors and depressive symptoms.

At the 24-month follow-up, group allocation was not associated with body weight (95% CI: -0.51; 1.11). Other factors associated with body weight included older age (95% CI: -0.25; -0.03), higher education (95% CI: -2.55; 0.00), and higher baseline body weight (95% CI: 0.91; 0.98). Motivation and confidence regarding weight loss remained high and stable in both groups.

Safety data, including adverse events and tolerability, were not reported. A primary limitation of this study is that it is a post-hoc analysis. Clinically, the findings suggest that while multidomain interventions may improve lifestyle factors, they did not result in measurable weight loss in this specific population over 24 months.

How this fits prior evidence

How this fits prior evidence: This finding addresses a gap in the fragmented evidence for exercise and nutritional interventions in managing sarcopenic obesity in older adults. While the study confirms that multidomain interventions did not result in measurable weight loss in this cohort, it does not provide new data regarding the specific serum biomarkers like CRP and Vitamin D that show associations with sarcopenia and sarcopenic obesity.

For many older adults, managing weight is a key part of staying healthy and preventing cognitive decline. A study followed 678 adults aged 60 to 77 who were at risk for dementia. These participants took part in a multidomain program that included dietary counseling, more physical and social activity, and medication reviews.

Despite these active changes in lifestyle, the results showed that the program did not lead to measurable weight loss over 24 months. While the participants remained motivated and confident about their weight loss goals, their actual body weight did not change significantly based on whether they were in the intervention group or not.

Researchers did find that other factors, like age and education level, were linked to lower body weight. However, because this was a post-hoc analysis, the findings are limited. The data suggests that while these programs are great for engagement, they may not be the most effective way to achieve weight loss in this specific group.

What this means for you:
A 24-month program of diet and exercise did not result in weight loss for older adults at risk for dementia.

Common questions

Did the exercise and diet program help with weight loss?

No, the study found that the multidomain intervention, which included dietary counseling and increased physical activity, did not result in a significant change in body weight over the 24-month period.

How did the participants feel about their weight loss goals?

Even though their weight did not change, the participants' motivation and confidence regarding weight loss remained high and stable throughout the study, regardless of which group they were in.

Who was included in this study?

The study included 678 older adults between the ages of 60 and 77 who were at risk for dementia and had a body mass index of 25 or higher.

Study Details

Study typeRct
Sample sizen = 678
EvidenceLevel 2
Follow-up24.0 mo
PublishedOct 2026
View Original Abstract ↓
BACKGROUND: Lifestyle interventions provide a promising approach to address higher body weight as a risk factor for dementia. OBJECTIVE: The AgeWell.de-trial was primarily designed to preserve cognitive function and reduce dementia risk. In this post-hoc analysis, we investigated body weight following the multidomain intervention among older adults with overweight or obesity, as well as the role of motivation and confidence regarding weight loss. METHODS: Analyses used data from the cluster-randomized AgeWell.de-trial, testing a multidomain intervention (dietary counselling, enhancement of physical, social and cognitive activity, medication review, intervention for cardiovascular risk factors, depressive symptoms/grief, if applicable) over 24 months in adults aged 60 to 77 years at risk for dementia. Associations between intervention allocation and body weight at follow-up were analyzed using linear regression, controlling for covariates, based on multiply imputed data. RESULTS: The sample included n = 678 participants with a BMI ≥ 25 kg/m², mean age (SD): 68.9 (4.8), 52.1% female. Group allocation was not associated with body weight at 24-month follow-up (b (unstandardized regression coefficient) = -0.30, 95% CI: -0.51; 1.11). Older age (b = -0.14, 95% CI: -0.25; -0.03) and a high level of education (b = -1.28, 95% CI: -2.55; 0.00) were linked to lower body weight at follow-up, while higher baseline body weight predicted higher body weight at follow-up (b = 0.95, 95% CI: 0.91; 0.98). Levels of motivation and confidence regarding weight loss remained high but stable in both groups, regardless of group allocation. CONCLUSIONS: In this post-hoc analysis, group allocation was not associated with lower body weight at follow-up. Despite high levels of motivation and confidence regarding weight loss and favorable changes in diet and physical activity in the intervention group, these changes did not translate into measurable weight loss. TRIAL REGISTRATION: AgeWell.de was prospectively registered in the German Clinical Trials Register on December 7th, 2017 (DRKS trial identifier DRKS00013555).
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