University of Oulu

Neuvonen, E., Lehtisalo, J., Solomon, A. et al. Psychosocial determinants for adherence to a healthy lifestyle and intervention participation in the FINGER trial: an exploratory analysis of a randomised clinical trial. Aging Clin Exp Res 34, 1793–1805 (2022).

Psychosocial determinants for adherence to a healthy lifestyle and intervention participation in the FINGER trial : an exploratory analysis of a randomised clinical trial

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Author: Neuvonen, Elisa1; Lehtisalo, Jenni1,2; Solomon, Alina1,3,4;
Organizations: 1School of Medicine, Institute of Clinical Medicine/Neurology, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
2Population Health Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
3Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Solnavägen 1, 171 77, Solna, Sweden
4Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, St Dunstan’s Road, London, W6 8RP, UK
5Center for Life Course Health Research/Geriatrics, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland
6Medical Research Center Oulu, Oulu University Hospital, P.O. Box 10, 90029 OYS, Oulu, Finland
7Ageing, Disability and Functioning Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
8Department of Neurology, Neurocenter, Kuopio University Hospital, P.O. Box 100, 70029 KYS, Kuopio, Finland
9Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
10Joint Municipal Authority for North Karelia Social and Health Services (Siun Sote), Tikkamäentie 16, 80210, Joensuu, Finland
11University of Helsinki and Helsinki University Hospital, P.O. Box 340, 00029 HUS, Helsinki, Finland
12Department of Public Health, University of Helsinki, P.O. Box 20, 00014, Helsinki, Finland
13South Ostrobothnia Central Hospital, Hanneksenrinne 7, 60220, Seinäjoki, Finland
14National School of Public Health, Carlos III Health Institute, Monforte de Lemos 5, 28029, Madrid, Spain
15Diabetes Research Group, King Abdulaziz University, P.O. Box 80215, Jiddah, 21589, Saudi Arabia
16Theme Aging, Karolinska University Hospital, Karolinska Vägen 22, 171 64, Solna, Sweden
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
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Language: English
Published: Springer Nature, 2022
Publish Date: 2022-09-05


Background and aims: Psychosocial factors may affect adherence to lifestyle interventions and lifestyle changes. The role of psychosocial factors in dementia prevention needs more research. We aimed at clarify the issue in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER).

Methods: The population included 1260 participants aged 60–77 years at risk for cognitive decline, randomised to a multidomain lifestyle intervention or regular health advice for 2 years. Adherence was evaluated as participation in the provided activities and actual lifestyle changes, separately for each domain (diet, exercise, social/cognitive activity, vascular risk management) and combined into multidomain. Psychosocial factors were measured at trial baseline (depressive symptoms; study perception; health-related quality of life, HRQoL) and earlier life (hopelessness; satisfaction with family life, achievements, and financial situation).

Results: Depressive symptoms, hopelessness, and nonpositive study perception were negatively and HRQoL positively associated with participation in the multidomain intervention. Depressive symptoms, lower HRQoL, hopelessness and dissatisfaction with financial situation were associated with unhealthier lifestyles at baseline. Baseline depressive symptoms and lower HRQoL predicted less improvement in lifestyle, but did not modify the intervention effect on lifestyle change.

Discussion and conclusions: Several psychosocial factors were associated with participation in lifestyle intervention, while fewer of them contributed to lifestyle changes. Although the intervention was beneficial for lifestyle changes independent of psychosocial factors, those most in need of lifestyle improvement were less likely to be active. Tailoring lifestyle-modifying strategies based on the need for psychosocial support may add efficacy in future trials.

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Series: Aging clinical and experimental research
ISSN: 1594-0667
ISSN-E: 1720-8319
ISSN-L: 1594-0667
Volume: 34
Issue: 8
Pages: 1793 - 1805
DOI: 10.1007/s40520-022-02088-x
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Funding: Open access funding provided by University of Eastern Finland (UEF) including Kuopio University Hospital. This study was supported by the Academy of Finland (Grant Nos. 287490, 294061, 319318, and 317465), Alzheimer’s Research and Prevention Foundation, Juho Vainio Foundation, Finnish Social Insurance Institution, Ministry of Education and Culture Research Grant, Salama bint Hamdan Al Nahyan Foundation, Axa Research Grant, EVO/VTR grants of University Hospitals of Kuopio, Oulu, and Turku, Seinäjoki Central Hospital, and Oulu City Hospital, European Research Council (Grant No. 804371), Finnish Cultural Foundation, Yrjö Jahnsson Foundation, Alzheimerfonden, Region Stockholm ALF, Saastamoinen Foundation, Loo och Hans Osterman Foundation, Stiftelsen Dementia, EU Joint Programme—Neurodegenerative Disease Research for MIND-AD and EURO-FINGERS, EU 7th framework collaborative project grant for HATICE, UEF Strategic funding for UEFBRAIN, Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse, Swedish Research Council, Center for Innovative Medicine (CIMED) at Karolinska Institutet, Knut and Alice Wallenberg Foundation, Stiftelsen Stockholms sjukhem, Jalmari and Rauha Ahokas Foundation, Swedish Society for Medical Research, Orion Research Foundation, and Finnish Medical Foundation. The blood pressure monitoring devices were provided by Microlife (Vilnius, Lithuania). The views expressed are those of the authors and do not necessarily represent those of the funding sources.
Dataset Reference: The online version contains supplementary material available at
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