University of Oulu

Neuvonen E, Lehtisalo J, Ngandu T, Levälahti E, Antikainen R, Hänninen T, Laatikainen T, Lindström J, Paajanen T, Soininen H, Strandberg T, Tuomilehto J, Kivipelto M, Solomon A. Associations of Depressive Symptoms and Cognition in the FINGER Trial: A Secondary Analysis of a Randomised Clinical Trial. Journal of Clinical Medicine. 2022; 11(5):1449.

Associations of depressive symptoms and cognition in the FINGER trial : a secondary analysis of a randomised clinical trial

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Author: Neuvonen, Elisa1; Lehtisalo, Jenni1,2; Ngandu, Tiia2,3;
Organizations: 1Institute of Clinical Medicine/Neurology, University of Eastern Finland, 70211 Kuopio, Finland
2Population Health Unit, Finnish Institute for Health and Welfare, 00271 Helsinki, Finland
3Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, 171 77 Stockholm, Sweden
4Center for Life Course Health Research, University of Oulu, 90014 Oulu, Finland
5Medical Research Center Oulu, Oulu University Hospital, 90029 Oulu, Finland
6Neurocenter, Department of Neurology, Kuopio University Hospital, 70029 Kuopio, Finland
7Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211 Kuopio, Finland
8Joint Municipal Authority for North Karelia Social and Health Services (Siun Sote), 80210 Joensuu, Finland
9Finnish Institute of Occupational Health, 00032 Helsinki, Finland
10Department of Medicine, University of Helsinki and Helsinki University Hospital, 00029 Helsinki, Finland
11Department of Public Health, University of Helsinki, 00014 Helsinki, Finland
12National School of Public Health, 28029 Madrid, Spain
13South Ostrobothnia Central Hospital, 60220 Seinäjoki, Finland
14Diabetes Research Group, King Abdulaziz University, Jeddah 21589, Saudi Arabia
15Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London W6 8RP, UK
16Center of Theme Aging, Karolinska University Hospital, 171 64 Stockholm, Sweden
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
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Language: English
Published: Multidisciplinary Digital Publishing Institute, 2022
Publish Date: 2022-05-10


Depression and cognition are associated, but the role of depressive symptoms in lifestyle interventions to prevent dementia needs further study. We investigated the intervention effect on depressive symptoms and their associations with cognition in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER; NCT01041989), a two-year multidomain lifestyle trial. One thousand two-hundred and sixty individuals (60–77 years) at risk for dementia were randomised into a multidomain intervention (diet, exercise, cognitive training, and vascular/metabolic risk monitoring) or control group (regular health advice). Depressive symptoms (Zung scale) and cognition (modified Neuropsychological Test Battery) were evaluated at baseline, 12, and 24 months. One thousand one-hundred and twenty-five participants had baseline Zung data. Mean Zung score decreased 0.73 (SD 5.6) points in the intervention and 0.36 (5.6) points in the control group, with nonsignificant between-group difference (group × time coefficient −0.006, 95% CI −0.019 to 0.007). Overall, higher baseline Zung score was associated with less improvement in global cognition (−0.140, p = 0.005) and memory (−0.231, p = 0.005). Participants with clinically significant baseline depressive symptoms (Zung ≥ 40 points) had less intervention benefit to executive functioning (group × time × Zung −0.096, 95% CI −0.163 to −0.028). Change in Zung score was not associated with change in cognition. Clinically significant depressive symptoms warrant more attention when designing dementia-prevention interventions.

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Series: Journal of clinical medicine
ISSN: 2077-0383
ISSN-E: 2077-0383
ISSN-L: 2077-0383
Volume: 11
Issue: 5
Article number: 1449
DOI: 10.3390/jcm11051449
Type of Publication: A1 Journal article – refereed
Field of Science: 3124 Neurology and psychiatry
Funding: This research was funded by Orion Research Foundation (Finland); Finnish Medical Foundation; Finnish Cultural Foundation; Juho Vainio Foundation (Finland); Jalmari and Rauha Ahokas Foundation (Finland); State research funding (EVO/VTR grants) from Oulu City Hospital and Kuopio University Hospital (Finland); Academy of Finland, grants 317465, 287490, 294061, and 319318; Finnish Social Insurance Institution; Finnish Ministry of Education and Culture; Alzheimer’s Research and Prevention Foundation (US); Alzheimerfonden (Sweden); Center for Innovative Medicine (CIMED) at Karolinska Institutet (Sweden); Region Stockholm ALF (Sweden); Knut and Alice Wallenberg Foundation (Sweden); Stiftelsen Stockholms Sjukhem (Sweden); Konung Gustaf V:s och Drottning Victorias Frimurarstiftelse (Sweden); Swedish Research Council for Health, Working Life, and Welfare; European Research Council, grant 804371; EU Joint Programme - Neurodegenerative Disease Research; and Yrjö Jahnsson Foundation (Finland).
Copyright information: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (