University of Oulu

Ngandu, T., Lehtisalo, J., Korkki, S., Solomon, A., Coley, N., Antikainen, R., Bäckman, L., Hänninen, T., Lindström, J., Laatikainen, T., Paajanen, T., Havulinna, S., Peltonen, M., Neely, A. S., Strandberg, T., Tuomilehto, J., Soininen, H., & Kivipelto, M. (2022). The effect of adherence on cognition in a multidomain lifestyle intervention (Finger). Alzheimer’s & Dementia, 18(7), 1325–1334.

The effect of adherence on cognition in a multidomain lifestyle intervention (FINGER)

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Author: Ngandu, Tiia1,2; Lehtisalo, Jenni1,3; Korkki, Saana4,5;
Organizations: 1Department of Public Health and Welfare, Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
2Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Stockholm, Sweden
3Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
4Department of Psychology, University of Cambridge, Cambridge, UK
5Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
6Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
7Faculté de Médecine, INSERM-University of Toulouse UMR1295 (CERPOP), Toulouse, France
8Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
9Center for Life Course Health Research, University of Oulu, Oulu, Finland
10Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
11Neurocenter, Department of Neurology, Kuopio University Hospital, Kuopio, Finland
12Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
13Joint municipal authority for North Karelia social and health services (Siun sote), Joensuu, Finland
14Finnish Institute of Occupational Health, Helsinki, Finland
15Department of Public Health and Welfare, Functioning and Service Needs Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
16Department of Social Psychological Sciences, Karlstad University, Karlstad, Sweden
17Engineering Psychology, Luleå University of Technology, Luleå, Sweden
18Department of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
19Department of Public Health, University of Helsinki, Helsinki, Finland
20Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
21South Ostrobothnia Central Hospital, Seinäjoki, Finland
22Theme Aging, Karolinska University Hospital, Solna, Sweden
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
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Language: English
Published: Elsevier, 2022
Publish Date: 2022-11-16


Introduction: Lifestyle interventions may prevent cognitive decline, but the sufficient dose of intervention activities and lifestyle changes is unknown. We investigated how intervention adherence affects cognition in the FINGER trial (pre-specified subgroup analyses).

Methods: FINGER is a multicenter randomized controlled trial examining the efficacy of multidomain lifestyle intervention ( NCT01041989). A total of 1260 participants aged 60 to 77 with increased dementia risk were randomized to a lifestyle intervention and control groups. Percentage of completed intervention sessions, and change in multidomain lifestyle score (self-reported diet; physical, cognitive, and social activity; vascular risk) were examined in relation to change in Neuropsychological Test Battery (NTB) scores.

Results: Active participation was associated with better trajectories in NTB total and all cognitive subdomains. Improvement in lifestyle was associated with improvement in NTB total and executive function.

Discussion: Multidomain lifestyle changes are beneficial for cognitive functioning, but future interventions should be intensive enough, and supporting adherence is essential.

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Series: Alzheimer's & dementia. The journal of the Alzheimer's Association
ISSN: 1552-5260
ISSN-E: 1552-5279
ISSN-L: 1552-5260
Volume: 18
Issue: 7
Pages: 1325 - 1334
DOI: 10.1002/alz.12492
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: This study was supported by the Academy of Finland (317465, 287490, 294061 [AS]; 319318 [MK]), Finnish Social Insurance Institution (MK), Finnish Ministry of Education and Culture (MK), Juho Vainio Foundation, Finland (TN, MK), EU Joint Programme - Neurodegenerative Disease Research (MIND-AD [MK] and EURO-FINGERS [TN, MK]), Alzheimer's Research and Prevention Foundation, US (MK), Alzheimerfonden, Sweden (AS, MK), Hjärnfonden, Sweden (MK), Swedish Research Council (LB, MK), Center for Innovative Medicine (CIMED) at Karolinska Institutet, Sweden (MK), Region Stockholm (ALF, NSV), Sweden (AS, MK), Knut and Alice Wallenberg Foundation, Sweden (MK), Stiftelsen Stockholms sjukhem, Sweden (MK), Konung Gustaf V:s och Drottning Victorias Frimurarstiftelse, Sweden (MK), Finnish Cultural Foundation (TN, AS), Jalmari and Rauha Ahokas Foundation, Finland (TN), Yrjö Jahnsson Foundation, Finland (AS,MK), State research funding (EVO/VTR grants) of Oulu University Hospital and Oulu City Hospital, Finland (RA) and Kuopio University Hospital, Finland (HS), UEF Strategic funding for UEFBRAIN, Finland (HS), European Research Council (grant 804371) (AS), Swedish Research Council for Health, Working Life and Welfare (ASN, MK), The Heart Disease Foundation, Finland (TL), Umeå University (ASN). Study funders had no role in study design; in the collection, analysis, interpretation of data; or in the writing of the report. We sincerely thank all participants of the FINGER study and all people involved in the data collection, particularly the nurses, psychologists, physicians, nutritionists and physiotherapists conducting the field work.
Copyright information: © 2021 The Authors. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.