Greek Interventional Geriatric Initiative to Prevent Cognitive Impairment and Disability (GINGER) – A pilot study
This pilot phase of GINGER aims to assess the feasibility and effects of a multi-level dementia risk reduction intervention in individuals with subjective cognitive decline . The study design incorporates a comprehensive set of trans-disciplinary assessments and interventions in multiple centers across Greece. The intervention domains include nutrition, physical activities, vision and hearing, vascular and metabolic parameters, anxiety and depressive symptoms, and insomnia. The GINGER findings will provide a solid foundation to pave the way to a network of evidence-based brain health clinics in Greece.
Location
On site assessments and interventions are delivered at dementia day care centers in Athens, Heraklion and Ioannina, at a University Hospital-based outpatient clinic in Heraklion and at the University-based Department of Physiotherapy in Patras.
Local setting
The study takes place in three different settings:
- Dementia day care centers (Athens, Ioannina, Heraklion)
- University Hospital-based outpatient clinics (Heraklion)
- Non-clinical university-based setting (Patras)
Organizations and collaborators
The GINGER network consists of clinical and/or research centers which bring together expertise from various fields and contribute to a comprehensive trans-disciplinary approach. The following Dementia Day Care Centers participate in the network:
- Dementia Day Care Center of Alzheimer Athens in Athens
- Day Care Center for people with dementia of the Society of Psychosocial Research and Intervention in Ioannina
- Alzheimer Day Care Center at the General University Hospital in Heraklion
- Patras Dementia Day Care Center of the Corporation for Succor and Care of Elderly and Disabled-FRODIZO
In addition, the clinicians and researchers of following university departments are members of the GINGER network:
- 1st Neurology Department of the National and Kapodistrian University of Athens
- Departments of Psychiatry and Neurology of the University of Crete, Department of Nutrition and Dietetics of the Harokopio University
- Department of Computer Science of the Ionian University
- Departments of Psychiatry and Physiotherapy of the University of Patras
Principal Investigator (PI)
Kostas Lyketsos, John Hopkins School of Medicine
Research team
Co-PI: Panagiotis Alexopoulos, Patras University General Hospital and University of Patras
Aim of the project
The objectives of this pilot phase are (i) evaluation of the protocol’s feasibility, (ii) assessment of intervention effects on the individual risk domains targeted by the interventions, (iii) estimation of the overall effects of the intervention on cognitive function, dementia risk and quality of life, (iv) satisfaction of participants.
Duration of the intervention
6 months
Project start date
2024
Project end date
2026
Current stage of the project
Ongoing
Number of study participants
100
Target population
Adults above the age of 55 years and with subjective cognitive decline
Outcomes
The main outcome measures will include (i) number and types of recommended interventions in which participants chose to participate, (ii) percentage of participants who did not adhere at all, partially complied, or adequately adhered in the first three months and throughout the study, (iii) participant satisfaction degree and (iv) changes over the intervention period in the domains targeted by the interventions in which the beneficiary participates, in cognitive performance, the CAIDE- and LIBRA score and quality of life, between baseline and the 3- and 6-month follow-ups.
Intervention
Domains:
- Physical activity
- Cognitive empowerment: delivered via online platforms
- Mental health and sleep
- Nutrition: based on the Mediterranean diet
- Hearing/vision support
- Management of metabolic and vascular risk factors
A transdisciplinary team assesses each participant and develops with him/her a personalized intervention plan targeting modifiable risk factors relevant to each individual. In addition to the cognitive empowerment intervention, everyone has the opportunity to choose up to three different arms of intervention based on the results of the individual assessment and personal preferences.
GINGER is not structured as “one-size-fits-all” but rather as a precision prevention approach. It considers anxiety and sleep symptoms as well as depression, which, if present, are treated with a structured online CBT intervention and/or pharmacotherapy. Moreover, hearing and vision assessment and support add valuable arrows to the prevention approach. The interventions are delivered online (cognitive empowerment, nutrition, cognitive and behavioural psychotherapy), in-person (sensory intervention, mental health and sleep intervention, management of metabolic and vascular risk factors) or hybridly (physical activity).
Results
No results have been published yet.
Acknowledgements
The pilot phase of GINGER is funded by the TIMA Foundation and the Andreas Mentzelopoulos Foundation and is supported by Ethniki Hellenic General Insurance Company S.A. and the Hellenic Society for Molecular Medicine and Personalized Diagnostics and Treatment.
Study protocol
Pilot study of the Greek Interventional Geriatric Initiative to Prevent Cognitive Impairment and Disability in individuals with subjective cognitive decline: paving the way towards brain health clinics in Greece
(Frontiers, 2025)
Protocol for the Physical Activity component of GINGER
Physical Activity Component of the Greek Interventional Geriatric Study to Prevent Cognitive Impairment and Disability (GINGER): Protocol Development and Feasibility Study
(MDPI, 2024)
