Cardiovascular health and cognition in older adults: Variations across recruitment models and European countries in the MOPEAD project

Background The Models of Patient Engagement for Alzheimer's Disease (MOPEAD) project aimed to identify the most effective and cost-efficient recruitment model for detecting prodromal and mild Alzheimer's disease (AD) across five European countries. Objective To examine differences in cardiovascular risk factors and cognitive performance among countries and recruitment models using MOPEAD data. Methods Individuals aged 65–85 with a high risk for prodromal or mild AD were included. Four recruitment models were used: a web-based screening tool, an open house initiative (OHI), a primary care-based protocol for early detection of cognitive decline, and a tertiary care-based screening at a diabetologist clinic. Participants from Germany, Spain, the Netherlands, Sweden, and Slovenia were recruited. Cardiovascular risk factors were self-reported, and cognition was assessed using The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Results A total of 414 individuals (mean age 71.9, SD = 5.0) were included. Significant differences were observed in physical activity (p < 0.001), with individuals from Sweden and Slovenia being the most active. Dutch participants scored highest on most cognitive measures. Individuals recruited via web-based survey were youngest, most active (61.7%), and had the lowest rates of diabetes (12.0%) and heart disease (6.4%), as well as the best cognitive scores. Those recruited via diabetologist clinics displayed the highest cardiovascular risk and the lowest cognitive performance. Conclusions This study unveils significant disparities in cardiovascular health and cognition across recruitment strategies and European countries. The OHI shows promise for future recruitment in the context of disease-modifying AD treatments.