Can dementia be prevented?
During consultations with our patients and their families we are often asked what can be done to prevent memory loss associated with aging. While science and medicine cannot conclusively provide answers at this time, research studies have provided insight into what might help prevent dementia. Looking back at recently published studies, one study stands out as a landmark study. If you are serious about preventing dementia, you need to know about the FINGER trial.
What is the FINGER trial?
FINGER (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) is one of the first intervention trials to prevent dementia using a ‘multi-domain’ approach (lots of different things), targeting lifestyle and vascular risk factors concurrently.
What was the aim?
FINGER aimed to prevent cognitive decline in at-risk elderly people from the general population using a multi-domain approach, rather than a single factor intervention.
Who took part?
Participants were aged 60 – 77 years (mean 69.4) with a CAIDE (Cardiovascular Risk Factors, Aging and Dementia) Dementia Risk Score of at least 6/15 points and cognition at mean level or slightly lower than expected for age. People with dementia were excluded.
What was the design?
Participants (1260) were randomly assigned to a two-year multi-domain intervention (diet, exercise, cognitive training & social interaction, vascular risk monitoring) or control group. The primary outcome was ‘change in cognition’ measured using a comprehensive neuropsychological test battery (cognitive function tests).
Who funded FINGER?
The Karolinska Institute a medical University and the largest medical academic research centre in Sweden, using multiple grants (disclosed), conducted FINGER.
What did FINGER show?
After two years, multi-domain interventions improved or maintained cognitive functioning in at-risk elderly people. Cognitive function in the intervention group was 25% higher than the control group. Executive functioning (the brain’s ability to organise and regulate thought processes) scores were 83% higher in the intervention group and processing speed was 150% higher. While overall memory scores were not improved, there was a benefit on complex memory tasks.
What is the take away message?
FINGER shows that multiple lifestyle changes improve memory and thinking in older adults at risk of cognitive decline. The study emphasises the importance of a healthy diet and regular exercise. Social activities and cognitive training are also important for preserving cognitive function, coupled with intensive management (by General Practitioners) of any existing metabolic and vascular risks that a person has.
Anything else?
FINGER participants will be followed for seven years and additional FINGER study reports will be available soon.
Further Reading
FINGER trial abstract: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60461-5/abstract
Medscape. News & Perspective. Neurology. Lifestyle Intervention Slows Cognitive Decline in Randomized Trial. Sue Hughes. 11 March 2015.
http://www.medscape.com/viewarticle/841355
Medscape. Commentary. Dementia Risk and Lifestyle: Making Sense of Conflicting Evidence. Richard Isaacson, MD & Max Lugavere. 5 June 2017.
http://www.medscape.com/viewarticle/880944
Study summary and commentary: Alzheimer’s Research and Prevention Foundation
http://www.alzheimersprevention.org/downloadables/FINGER-study-report-by-ARPF.pdf