Intervention to Prevent Stroke, Dementia Cuts Long-Term Care

Multidomain prevention program focusing on vascular risk factors lowers long-term care dependence

WEDNESDAY, July 18 (HealthDay News) -- In a real-world clinical setting, a multidomain prevention program for stroke and dementia can reduce the risk of long-term care (LTC) dependence, according to a study published online July 17 in the Journal of the American Heart Association.

Horst Bickel, Ph.D., of the Technische Universtät München in Munich, Germany, and colleagues conducted an eight-year, practice-based study to compare the need for LTC among 3,908 enrolled adults aged 55 and older who participated in a multidomain prevention program for stroke and dementia within a defined catchment area and 13,301 control participants living in a reference district who received standard medical care. The intervention consisted of repeated systematic identification of vascular risk factors, followed by treatment according to evidence-based guidelines. The expected number of cases of LTC dependence was calculated for usual medical care, and the observed number in the intervention district was compared with the expected number.

During the five-years following completion of the recruitment period the researchers identified significantly fewer incident cases of LTC dependence in the intervention district. The incidence was reduced significantly, by 10 percent in women and 9.6 percent in men.

"In conclusion, the results of our trial indicate that a multidomain intervention, intended to prevent stroke and dementia, can reduce the incidence of LTC dependence in a real-world setting," the authors write. "The public health impact of the two diseases possibly can be mitigated by improved control of vascular risk factors at the level of primary care."

The study was primarily funded by the health insurance company Allgemeine Ortskrankenkasse Bayern, and partially funded by the pharmaceutical industry. Several authors disclosed financial ties to the pharmaceutical industry.

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