University of Oulu

Stephen, R., Liu, Y., Ngandu, T. et al. Brain volumes and cortical thickness on MRI in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). Alz Res Therapy 11, 53 (2019).

Brain volumes and cortical thickness on MRI in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER)

Saved in:
Author: Stephen, Ruth1; Liu, Yawu1,2; Ngandu, Tiia3,4;
Organizations: 1Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
2Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland
3Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland
4Division of Clinical Geriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden
5Center for Life Course Health Research/Geriatrics, University of Oulu, Oulu, Finland
6Medical Research Center Oulu, Oulu University Hospital and Oulu City Hospital, Oulu, Finland
7Combinostics, Tampere, Finland
8Turku University Hospital, Turku, Finland
9Turku PET Centre, University of Turku, Turku, Finland
10Seinäjoki City Hospital, Seinäjoki, Finland
11University of Helsinki, Clinicum, and Helsinki University Hospital, Helsinki, Finland
12Department of Public Health, University of Helsinki, Helsinki, Finland
13South Ostrobothnia Central Hospital, Seinäjoki, Finland
14Department of Neurosciences and Preventive Medicine, Danube-University Krems, Krems an der Donau, Austria
15Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
16Dasman Diabetes Institute, Dasman, Kuwait
17Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK
18Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.8 MB)
Persistent link:
Language: English
Published: Springer Nature, 2019
Publish Date: 2020-04-16


Background: The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) was a multicenter randomized controlled trial that reported beneficial effects on cognition for a 2-year multimodal intervention (diet, exercise, cognitive training, vascular risk monitoring) versus control (general health advice). This study reports exploratory analyses of brain MRI measures.

Methods: FINGER targeted 1260 older individuals from the general Finnish population. Participants were 60–77 years old, at increased risk for dementia but without dementia/substantial cognitive impairment. Brain MRI scans were available for 132 participants (68 intervention, 64 control) at baseline and 112 participants (59 intervention, 53 control) at 2 years. MRI measures included regional brain volumes, cortical thickness, and white matter lesion (WML) volume. Cognition was assessed at baseline and 1- and 2-year visits using a comprehensive neuropsychological test battery. We investigated the (1) differences between the intervention and control groups in change in MRI outcomes (FreeSurfer 5.3) and (2) post hoc sub-group analyses of intervention effects on cognition in participants with more versus less pronounced structural brain changes at baseline (mixed-effects regression models, Stata 12).

Results: No significant differences between the intervention and control groups were found on the changes in MRI measures. Beneficial intervention effects on processing speed were more pronounced in individuals with higher baseline cortical thickness in Alzheimer’s disease signature areas (composite measure of entorhinal, inferior and middle temporal, and fusiform regions). The randomization group × time × cortical thickness interaction coefficient was 0.198 (p = 0.021). A similar trend was observed for higher hippocampal volume (group × time × hippocampus volume interaction coefficient 0.1149, p = 0.085).

Conclusions: The FINGER MRI exploratory sub-study did not show significant differences between the intervention and control groups on changes in regional brain volumes, regional cortical thicknesses, or WML volume after 2 years in at-risk elderly without substantial impairment. The cognitive benefits on processing speed of the FINGER intervention may be more pronounced in individuals with fewer structural brain changes on MRI at baseline. This suggests that preventive strategies may be more effective if started early, before the occurrence of more pronounced structural brain changes.

see all

Series: Alzheimers research & therapy
ISSN: 1758-9193
ISSN-E: 1758-9193
ISSN-L: 1758-9193
Volume: 11
Article number: 53
DOI: 10.1186/s13195-019-0506-z
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
3124 Neurology and psychiatry
Funding: This study was funded by the Joint Program of Neurodegenerative Disorders – prevention (MIND-AD), Academy of Finland 278457, 287490, 294061, and 319318 projects; EVO/VTR funding from Kuopio University Hospital, Turku University Hospital, Oulu University Hospital, Oulu City, and South Ostrobothnia Central Hospital; UEF Strategic funding for UEFBRAIN; Swedish Research Council; Knut and Alice Wallenberg Foundation Sweden; Alzheimerfonden Sweden; Stockholm County Council (ALF); Alzheimer’s Research & Prevention Foundation, USA; Center for Innovative Medicine (CIMED) at Karolinska Institutet Sweden; Stiftelsen Stockholms sjukhem Sweden; Konung Gustaf V:s och Drottning Victorias Frimurarstiftelse Sweden; Finnish Cultural Foundation North Savo Regional Fund; Orion Research Foundation; Suomen Aivosäätiö; and European Research Council grant 804371. The funding sources had no involvement in the study design; in the collection, analysis, and interpretation of the data; in the writing of the report; and in the decision to submit the article for publication.
Copyright information: © The Author(s). 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.