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.