Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability

Dementia Clinical Trial

— FINGER  

Official title:

Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT01041989
• Other study ID #: THL/TUET 122/2009
• Status: Active, not recruiting
• Phase: N/A
• Start date: September 2009
• Est. completion date: December 2025

Study information

• Verified date: April 2023
• Source: Finnish Institute for Health and Welfare
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This multi-center (6 sites: Helsinki, Kuopio, Oulu, Seinäjoki, Turku, Vantaa) intervention study aims to prevent cognitive impairment, dementia and disability in 60-77 year old persons at an increased dementia risk. The 2-year multi-domain life-style intervention includes nutritional guidance, exercise, cognitive training, increased social activity, and intensive monitoring and management of metabolic and vascular risk factors. The primary outcome is cognitive impairment measured by a sensitive Neuropsychological Test Battery (NTB), and Stroop and Trail Making tests to capture early cognitive impairment typical for both Alzheimer's disease and vascular dementia. We hypothesize that the multi-domain intervention will reduce cognitive impairment in the study group compared to the control group during the initial 2-year intervention period and reduce dementia incidence after the extended follow-up (until at least 300 participants have developed dementia).

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 1200
• Est. completion date: December 2025
• Est. primary completion date: December 2013
• Accepts healthy volunteers: No
• Gender: All
• Age group: 60 Years to 77 Years

Eligibility

Inclusion Criteria:

• aged 60-77 years

• dementia Risk Score 6 points or more

• fulfillment of at least one of the following CERAD criteria: i) MMSE: 20-26 points ii) word list memory task (3x10 words): 19 words or less iii) delayed recall: 75% or less

Exclusion Criteria:

• malignant diseases

• dementia

• substantial cognitive decline

• major depression

• symptomatic cardiovascular disease

• revascularisation within 1 year

• severe loss of vision, hearing or communicative ability

• other conditions inhibiting from safe engagement in the prescribed intervention as judged by the study physician

• other conditions preventing from cooperation as judged by the study physician

Related Conditions & MeSH terms

• Cognitive Dysfunction
• Cognitive Impairment
• Dementia

Intervention

Behavioral:
• Nutritional guidance
Individual counseling sessions and group meetings will be organized.
• Exercise
Guided muscle strength training and aerobic exercise.
• Cognitive training
Cognitive training will be implemented through 8 group sessions lead by a psychologist and a computer-based cognitive training program available to participants via the internet.

Other:
• Reduction of vascular risk factors
Monitoring and maintenance of metabolic and vascular risk factors

Locations

Country	Name	City	State
Finland	Finnish Institute for Health and Welfare	Helsinki
Finland	University of Eastern Finland	Kuopio
Finland	University of Oulu	Oulu
Finland	Research Center Mediwest	Seinajoki
Finland	Finnish Institute for Health and Welfare	Turku

Sponsors (9)

Lead Sponsor	Collaborator
Finnish Institute for Health and Welfare	Academy of Finland, Karolinska Institutet, Kuopio Research Institute of Exercise Medicine, Umeå University, University of Eastern Finland, University of Helsinki, University of Oulu, Western University, Canada

Country where clinical trial is conducted

Finland, 

References & Publications (18)

Kivipelto M, Helkala EL, Hanninen T, Laakso MP, Hallikainen M, Alhainen K, Soininen H, Tuomilehto J, Nissinen A. Midlife vascular risk factors and late-life mild cognitive impairment: A population-based study. Neurology. 2001 Jun 26;56(12):1683-9. doi: 10.1212/wnl.56.12.1683. — View Citation

Kivipelto M, Helkala EL, Laakso MP, Hanninen T, Hallikainen M, Alhainen K, Iivonen S, Mannermaa A, Tuomilehto J, Nissinen A, Soininen H. Apolipoprotein E epsilon4 allele, elevated midlife total cholesterol level, and high midlife systolic blood pressure are independent risk factors for late-life Alzheimer disease. Ann Intern Med. 2002 Aug 6;137(3):149-55. doi: 10.7326/0003-4819-137-3-200208060-00006. — View Citation

Kivipelto M, Helkala EL, Laakso MP, Hanninen T, Hallikainen M, Alhainen K, Soininen H, Tuomilehto J, Nissinen A. Midlife vascular risk factors and Alzheimer's disease in later life: longitudinal, population based study. BMJ. 2001 Jun 16;322(7300):1447-51. doi: 10.1136/bmj.322.7300.1447. — View Citation

Kivipelto M, Ngandu T, Fratiglioni L, Viitanen M, Kareholt I, Winblad B, Helkala EL, Tuomilehto J, Soininen H, Nissinen A. Obesity and vascular risk factors at midlife and the risk of dementia and Alzheimer disease. Arch Neurol. 2005 Oct;62(10):1556-60. doi: 10.1001/archneur.62.10.1556. — View Citation

Kivipelto M, Ngandu T, Laatikainen T, Winblad B, Soininen H, Tuomilehto J. Risk score for the prediction of dementia risk in 20 years among middle aged people: a longitudinal, population-based study. Lancet Neurol. 2006 Sep;5(9):735-41. doi: 10.1016/S1474-4422(06)70537-3. — View Citation

Kivipelto M, Rovio S, Ngandu T, Kareholt I, Eskelinen M, Winblad B, Hachinski V, Cedazo-Minguez A, Soininen H, Tuomilehto J, Nissinen A. Apolipoprotein E epsilon4 magnifies lifestyle risks for dementia: a population-based study. J Cell Mol Med. 2008 Dec;12(6B):2762-71. doi: 10.1111/j.1582-4934.2008.00296.x. Epub 2008 Feb 8. — View Citation

Kivipelto M, Solomon A, Ahtiluoto S, Ngandu T, Lehtisalo J, Antikainen R, Backman L, Hanninen T, Jula A, Laatikainen T, Lindstrom J, Mangialasche F, Nissinen A, Paajanen T, Pajala S, Peltonen M, Rauramaa R, Stigsdotter-Neely A, Strandberg T, Tuomilehto J, — View Citation

Kulmala J, Ngandu T, Pajala S, Lehtisalo J, Levalahti E, Antikainen R, Laatikainen T, Oksa H, Peltonen M, Rauramaa R, Soininen H, Strandberg T, Tuomilehto J, Kivipelto M. Leisure-Time and Occupational Physical Activity in Early and Late Adulthood in Relat — View Citation

Lehtisalo J, Ngandu T, Valve P, Antikainen R, Laatikainen T, Strandberg T, Soininen H, Tuomilehto J, Kivipelto M, Lindstrom J. Nutrient intake and dietary changes during a 2-year multi-domain lifestyle intervention among older adults: secondary analysis o — View Citation

Lehtisalo J, Rusanen M, Solomon A, Antikainen R, Laatikainen T, Peltonen M, Strandberg T, Tuomilehto J, Soininen H, Kivipelto M, Ngandu T. Effect of a multi-domain lifestyle intervention on cardiovascular risk in older people: the FINGER trial. Eur Heart — View Citation

Lindstrom J, Ilanne-Parikka P, Peltonen M, Aunola S, Eriksson JG, Hemio K, Hamalainen H, Harkonen P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Mannelin M, Paturi M, Sundvall J, Valle TT, Uusitupa M, Tuomilehto J; Finnish Diabetes Prevention Study Group. Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet. 2006 Nov 11;368(9548):1673-9. doi: 10.1016/S0140-6736(06)69701-8. — View Citation

Marengoni A, Rizzuto D, Fratiglioni L, Antikainen R, Laatikainen T, Lehtisalo J, Peltonen M, Soininen H, Strandberg T, Tuomilehto J, Kivipelto M, Ngandu T. The Effect of a 2-Year Intervention Consisting of Diet, Physical Exercise, Cognitive Training, and — View Citation

Ngandu T, Lehtisalo J, Levalahti E, Laatikainen T, Lindstrom J, Peltonen M, Solomon A, Ahtiluoto S, Antikainen R, Hanninen T, Jula A, Mangialasche F, Paajanen T, Pajala S, Rauramaa R, Strandberg T, Tuomilehto J, Soininen H, Kivipelto M. Recruitment and ba — View Citation

Ngandu T, Lehtisalo J, Solomon A, Levalahti E, Ahtiluoto S, Antikainen R, Backman L, Hanninen T, Jula A, Laatikainen T, Lindstrom J, Mangialasche F, Paajanen T, Pajala S, Peltonen M, Rauramaa R, Stigsdotter-Neely A, Strandberg T, Tuomilehto J, Soininen H, — View Citation

Rovio S, Kareholt I, Helkala EL, Viitanen M, Winblad B, Tuomilehto J, Soininen H, Nissinen A, Kivipelto M. Leisure-time physical activity at midlife and the risk of dementia and Alzheimer's disease. Lancet Neurol. 2005 Nov;4(11):705-11. doi: 10.1016/S1474-4422(05)70198-8. — View Citation

Solomon A, Handels R, Wimo A, Antikainen R, Laatikainen T, Levalahti E, Peltonen M, Soininen H, Strandberg T, Tuomilehto J, Kivipelto M, Ngandu T. Effect of a Multidomain Lifestyle Intervention on Estimated Dementia Risk. J Alzheimers Dis. 2021;82(4):1461 — View Citation

Strandberg TE, Levälahti E, Ngandu T, Solomon A, M Kivipelto for FINGER Study Group. Health-Related Quality of Life in a Multidomain Intervention Trial to Prevent Cognitive Decline (FINGER). Eur Ger Med. 2017; 8: 164-167.

Wimo A, Handels R, Antikainen R, Eriksdotter M, Jonsson L, Knapp M, Kulmala J, Laatikainen T, Lehtisalo J, Peltonen M, Skoldunger A, Soininen H, Solomon A, Strandberg T, Tuomilehto J, Ngandu T, Kivipelto M. Dementia prevention: The potential long-term cos — View Citation

* Note: There are 18 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Cognitive impairment assessed with a Neuropsychological Test Battery, and Stroop and Trail Making tests.		2 years
Secondary	Depressive symptoms will be assessed using the Zung depression scale.		2 years
Secondary	Disability will be assessed using the ADCS-ADL scale		2 years
Secondary	Quality of Life will be assessed using the RAND-36 and 15D questionnaires.		2 years
Secondary	Utilization of health resources will be assessed using questionnaire and register data.		2 years
Secondary	Vascular and metabolic risk factors will be assessed with blood pressure and anthropometric measurements, and laboratory analyses of metabolic biomarkers.		2 years
Secondary	Vascular and metabolic morbidity and mortality will be assessed through questionnaire and register data.		2 years
Secondary	Changes in dietary biomarker levels will be assessed through laboratory testing.		2 years