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Several modifiable risk factors are associated with an increased risk for Alzheimer’s disease and dementia (Barnes and Yaffe, 2011; Norton, et al., 2014). Recently, it was estimated that 35% of dementia cases could be prevented by eliminating low education, mid-life hypertension, mid-life obesity, diabetes, depression, physical inactivity and smoking (Livingston, et al., 2017). A first long-term randomized control trial showed that multicomponent interventions could indeed help to maintain cognitive function in older individuals at risk for AD (Ngandu, et al., 2015). Evidence from single-component intervention trials suggests that interventions on physical activity, diet and specific cognitive function might help to maintain brain structure and function multicomponent intervention finger brain imaging (Brickman, et al., 2014; de Lange, et al., 2016; Erickson, et al., 2011; Witte, et al., 2014). Here, changes in hippocampus volume, microstructure and perfusion and white matter microstructure were reported. To date, only few neuroimaging studies on single component interventions, and even more so, on multicomponent interventions in older adults are available, and the underlying mechanisms of intervention-induced brain plasticity remain largely unknown. The study aims therefore to investigate intervention-related changes in brain structure and function in older adults at risk for AD. The study is based on the study, a multi-center, cluster-randomized trial investigating the effects of a two-year multicomponent intervention on cognitive function and dementia incidence in 1152 older participants at risk for AD. Briefly, participants are recruited by their general practitioner in four study centers (Kiel, Greifswald, Munich, Leipzig) and randomized into intervention and control group. The intervention includes diet counseling, a program to increase physical and social activity, cognitive training, management of cardiovascular risk factors and medication and psychological support. The control group receives general health information. The multicomponent intervention is similar to the intervention used in the FINGER study (Ngandu et al. 2015). investigates the subsample of the study recruited in Leipzig (N=288).We will invite participants from the intervention and control group of the study to MRI sessions before and after the intervention. Participants will additionally perform a computer-based test of pattern separation ability (Stark, et al., 2013). Pattern separation refers to the ability of creating distinct memory representations and strongly depends on the hippocampus, a region found to respond to physical and dietary interventions (Jonasson, et al., 2016; Köbe, et al., 2017). This cognitive function is particularly sensitive to the effects of aging and neurodegenerative disease.
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