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A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial
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"To our knowledge, the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) is the first large, longer-term, and methodologically robust trial showing that a multidomain intervention can improve or maintain cognitive functioning and reduce the risk of cognitive decline among older at-risk individuals. FINGER targeted the at-risk segment of the general elderly population, not patients in a clinical setting."
In a double-blind randomised controlled trial we enrolled individuals aged 60-77 years recruited from previous national surveys.
We randomly assigned participants in a 1:1 ratio to a 2 year multidomain intervention (diet, exercise, cognitive training, vascular risk monitoring), or a control group (general health advice).
Findings from this large, long-term, randomised controlled trial suggest that a multidomain intervention could improve or maintain cognitive functioning in at-risk elderly people from the general population.
We noted significant intervention effects on the primary outcome (overall cognition), main cognitive secondary outcomes (executive functioning and processing speed), and other secondary outcomes (BMI, dietary habits, and physical activity). We noted no significant effect on memory, although post-hoc analyses showed an effect on more complex memory tasks (abbreviated memory score). There were also beneficial effects on risk of cognitive decline in post-hoc analyses. The multidomain lifestyle-based intervention was feasible and safe. Dropout rates were low, and adherence to intervention domains was high.
Findings from this large, long-term, randomised controlled trial suggest that a multidomain intervention could improve or maintain cognitive functioning in at-risk elderly people from the general population.
About a third of cases of Alzheimer's disease worldwide could be attributable to low education, physical inactivity (the highest population-attributable risk in the USA, Europe, and the UK), obesity, hypertension, diabetes, smoking, and depression.
The worldwide prevalence of Alzheimer's disease could be reduced by 8ยท3% by 2050 with relative reductions of 10% per decade in the prevalence of each of these factors. Such small changes imply large effects, and if the beneficial effects on cognition observed in FINGER will lead to even a modest delay in onset of dementia and Alzheimer's disease, it would have a huge effect on both individual and societal levels.
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