The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER): Study design and progress

TLDR

Baseline clinical characteristics show multiple vascular risk factors and unhealthy lifestyle factors, indicating a window of opportunity for prevention. The study aims to identify individuals at increased risk of late‑life cognitive impairment early and develop interventions to prevent or delay its onset. The FINGER trial is a multi‑center, randomized, controlled study enrolling 1,200 at‑risk adults, delivering a 2‑year multidomain intervention of nutrition, exercise, cognitive training, social activity, and metabolic/vascular risk management, with a control group receiving standard health advice, and assessing cognitive performance with the modified Neuropsychological Test Battery, Stroop, and Trail Making tests. All 1,200 participants have been enrolled and the 2‑year intervention is proceeding as planned, with secondary outcomes including dementia, disability, depressive symptoms, vascular risk factors, quality of life, health resource use, and neuroimaging measures.

Abstract

Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) is a multi-center, randomized, controlled trial ongoing in Finland.Participants (1200 individuals at risk of cognitive decline) are recruited from previous population-based non-intervention studies. Inclusion criteria are CAIDE Dementia Risk Score ≥6 and cognitive performance at the mean level or slightly lower than expected for age (but not substantial impairment) assessed with the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological battery. The 2-year multidomain intervention consists of: nutritional guidance; exercise; cognitive training and social activity; and management of metabolic and vascular risk factors. Persons in the control group receive regular health advice. The primary outcome is cognitive performance as measured by the modified Neuropsychological Test Battery, Stroop test, and Trail Making Test. Main secondary outcomes are: dementia (after extended follow-up); disability; depressive symptoms; vascular risk factors and outcomes; quality of life; utilization of health resources; and neuroimaging measures.Screening began in September 2009 and was completed in December 2011. All 1200 persons are enrolled and the intervention is ongoing as planned. Baseline clinical characteristics indicate that several vascular risk factors and unhealthy lifestyle-related factors are present, creating a window of opportunity for prevention. The intervention will be completed during 2014.The FINGER is at the forefront of international collaborative efforts to solve the clinical and public health problems of early identification of individuals at increased risk of late-life cognitive impairment, and of developing intervention strategies to prevent or delay the onset of cognitive impairment and dementia.