Cognitive Benefit of a Multidomain Intervention for Older Adults at Risk of Cognitive Decline: A Cluster-Randomized Controlled Trial

•What is the primary question addressed by this study?We investigated the effects of a 9-month community-based multidomain intervention of mindfulness meditation, cognitive training, exercise, and nutrition counseling on improving cognition compared to controls for Chinese older adults having risks of cognitive decline.•What is the main finding of this study?Multidomain intervention had immediate benefits on improving cognitive performance measured by objective assessments and subjective cognitive abilities relative to the control, and the benefits on subjective cognitive abilities were retained for 1 year after the completion of the intervention.•What is the meaning of the finding?Multidomain intervention that targeted multiple predictors of cognitive decline can have immediate benefits on improving cognitive performance for older adults at risk of cognitive decline. Long-term effects on cognition and individual differences in response to the intervention deserve further investigation. We sought to assess cognitive benefits of a community-based multidomain intervention for improving cognition among older adults at risk of cognitive decline (COMBAT). A two-armed cluster-randomized controlled trial. Community-dwelling older adults aged 60 years or older and were at risk of cognitive decline (n = 209). In this 9-month intervention study, 10 community hospitals in Beijing, China, were randomized (1:1) to receive either a multidomain intervention of meditation, cognitive training, exercise, and nutrition counseling or usual care. The intervention was delivered with weekly 1-hour group training sessions and weekly home homework. Primary outcome was change in cognition as measured by a composite Z score of seven cognitive tests. Secondary outcomes included subjective cognitive abilities, positive and negative affective experiences, physical activity, and dietary habits. Assessments were administered at baseline, end of the intervention, and 1 year after completing the intervention (1-year follow-up). Immediately after the intervention, the intervention group showed significant enhancement in cognitive performance (p = 0.026). The between-group difference in the Z score of change of cognition was 0.20 (95% CI: 0.053, 0.35), with a Hedges’ g of 0.40 (95% CI: 0.29, 0.50). However, this cognitive benefit was not significant at 1-year follow-up. This multidomain intervention was effective to improve cognition for at-risk individuals. Long-term effects on cognitive fu