University of Oulu

Ruth Stephen, PhD, Tiia Ngandu, MD, PhD, Yawu Liu, MD, PhD, Markku Peltonen, PhD, Riitta Antikainen, MD, PhD, Nina Kemppainen, MD, PhD, Tiina Laatikainen, MD, PhD, Jyrki Lötjönen, PhD, Juha Rinne, MD, PhD, Timo Strandberg, MD, PhD, Jaakko Tuomilehto, MD, PhD, Ritva Vanninen, MD, PhD, Hilkka Soininen, MD, PhD, Miia Kivipelto, MD, PhD, Alina Solomon, MD, PhD, FINGER Study Group, Change in CAIDE Dementia Risk Score and Neuroimaging Biomarkers During a 2-Year Multidomain Lifestyle Randomized Controlled Trial: Results of a Post-Hoc Subgroup Analysis, The Journals of Gerontology: Series A, Volume 76, Issue 8, August 2021, Pages 1407–1414,

Change in CAIDE dementia risk score and neuroimaging biomarkers during a 2-year multidomain lifestyle randomized controlled trial : results of a post-hoc subgroup analysis

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Author: Stephen, Ruth1; Ngandu, Tiia2,3; Liu, Yawu1,4;
Organizations: 1Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
2Public Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
3Division of Clinical Geriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden
4Department of Clinical Radiology, Kuopio University Hospital, Finland
5Center for Life Course Health Research/Geriatrics, University of Oulu, Finland
6Medical Research Center Oulu, Oulu University Hospital and Oulu City Hospital, Finland
7Division of Clinical Neurosciences, Turku University Hospital, Finland
8Turku PET Centre, University of Turku, Finland
9Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
10Joint Municipal Authority for North Karelia Social and Health Services, Joensuu, Finland
11Department of Public Health Solutions, National Institute for Health and Welfare Helsinki, Finland
12Combinostics Tampere, Finland
13University of Helsinki, Clinicum, and Helsinki University Hospital, Finland
14Department of Public Health, University of Helsinki, Finland
15South Ostrobothnia Central Hospital, Seinäjoki, Finland
16Department of Neurosciences and Preventive Medicine, Danube-University Krems, Austria
17Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
18Neurocenter, Neurology, Kuopio University Hospital, Finland
19Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, UK
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
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Language: English
Published: Oxford University Press, 2021
Publish Date: 2021-10-21


The CAIDE (Cardiovascular Risk Factors, Aging and Dementia) Risk Score is a validated tool estimating dementia risk. It was previously associated with imaging biomarkers. However, associations between dementia risk scores (including CAIDE) and dementia-related biomarkers have not been studied in the context of an intervention. This study investigated associations between change in CAIDE score and change in neuroimaging biomarkers (brain magnetic resonance imaging [MRI] and Pittsburgh Compound B-positron emission tomography [PiB-PET] measures) during the 2-year Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) (post-hoc analyses). FINGER targeted at-risk older adults, aged 60–77 years, from the general population. Participants were randomized to either multidomain intervention (diet, exercise, cognitive training, and vascular risk management) or control group (general health advice). Neuroimaging (MRI and PiB-PET) data from baseline and 2-year visits were used. A toal of 112 participants had repeated brain MRI measures (hippocampal, total gray matter, and white matter lesion volumes, and Alzheimer’s disease signature cortical thickness). Repeated PiB-PET scans were available for 39 participants. Reduction in CAIDE score (indicating lower dementia risk) during the intervention was associated with less decline in hippocampus volume in the intervention group, but not the control group (Randomization group × CAIDE change interaction β coefficient = −0.40, p = .02). Associations for other neuroimaging measures were not significant. The intervention may have benefits on hippocampal volume in individuals who succeed in improving their overall risk level as indicated by a reduction in CAIDE score. This exploratory finding requires further testing and validation in larger studies.

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Series: Journals of gerontology. A, Biological sciences and medical sciences
ISSN: 1079-5006
ISSN-E: 1758-535X
ISSN-L: 1079-5006
Volume: 76
Issue: 8
Pages: 1407 - 1414
DOI: 10.1093/gerona/glab130
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: This work was supported by the Academy of Finland (312703, 310962, SALVE and 278457, 305810, 317465, 287490, 294061, 319318), EU 7th Framework Collaborative Project grant (HATICE), European Research Council grant 804371, EU Joint Program of Neurodegenerative Disorders—Prevention (MIND-AD and EURO-FINGERS); EVO grants of Oulu University Hospital and Oulu City Hospital, Finnish Cultural Foundation, Finnish Ministry of Education and Culture, Finnish Social Insurance Institution, Finnish State Research Funding, Juho Vainio Foundation, Sigrid Juselius Foundation, UEF Strategic funding for UEFBRAIN, and EVO/VTR funding from Kuopio University Hospital, and Yrjö Jahnsson Foundation (Finland); Alzheimerfonden, Center for Innovative Medicine (CIMED) at Karolinska Institutet, Konung Gustaf V:s och Drottning Victorias Frimurarstiftelse, Knut and Alice Wallenberg Foundation, Region Stockholm (ALF, NSV), Stiftelsen Stockholms sjukhem, and Swedish Research Council (Sweden).
Copyright information: © The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.