University of Oulu

Jenni Lehtisalo and others, Effect of a multi-domain lifestyle intervention on cardiovascular risk in older people: the FINGER trial, European Heart Journal, Volume 43, Issue 21, 1 June 2022, Pages 2054–2061,

Effect of a multi-domain lifestyle intervention on cardiovascular risk in older people : the FINGER trial

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Author: Lehtisalo, Jenni1,2; Rusanen, Minna1,2,3; Solomon, Alina1,4,5;
Organizations: 1Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
2Department of Public Health and Welfare, Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
3Department of Neurology, Kuopio University Hospital, KYS Kuopio, Finland
4Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
5Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
6Center for Life Course Health Research, University of Oulu, Oulu, Finland
7Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
8Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
9Joint municipal authority for North Karelia Social and Health Services (Siun sote), Development Unit, Joensuu, Finland
10Department of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
11Department of Public Health, University of Helsinki, Helsinki, Finland
12Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
13South Ostrobothnia Central Hospital, Seinäjoki, Finland
14Theme Aging, Karolinska University Hospital, Solna, Sweden
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
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Language: English
Published: Oxford University Press, 2022
Publish Date: 2023-07-07


Aims: Joint prevention of cardiovascular disease (CVD) and dementia could reduce the burden of both conditions. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) demonstrated a beneficial effect on cognition (primary outcome) and we assessed the effect of this lifestyle intervention on incident CVD (pre-specified secondary outcome).

Methods and results: FINGER enrolled 1259 individuals aged 60–77 years ( NCT01041989). They were randomized (1:1) to a 2-year multi-domain intervention with diet, physical and cognitive activity, and vascular monitoring (n = 631), or general health advice (n = 628). National registries provided data on CVD including stroke, transient ischaemic attack (TIA), or coronary heart event. During an average of 7.4 years, 229 participants (18%) had at least one CVD diagnosis: 107 in the intervention group and 122 in the control group. The incidence of cerebrovascular events was lower in the intervention than the control group: hazard ratio (HR) for combined stroke/TIA was 0.71 [95% confidence interval (CI): 0.51–0.99] after adjusting for background characteristics. Hazard ratio for coronary events was 0.84 (CI: 0.56–1.26) and total CVD events 0.80 (95% CI: 0.61–1.04). Among those with history of CVD (n = 145), the incidence of both total CVD events (HR: 0.50, 95% CI: 0.28–0.90) and stroke/TIA (HR: 0.40, 95% CI: 0.20–0.81) was lower in the intervention than the control group.

Conclusion: A 2-year multi-domain lifestyle intervention among older adults was effective in preventing cerebrovascular events and also total CVD events among those who had history of CVD.

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Series: European heart journal
ISSN: 0195-668X
ISSN-E: 1522-9645
ISSN-L: 0195-668X
Volume: 43
Issue: 21
Pages: 2054 - 2061
DOI: 10.1093/eurheartj/ehab922
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Funding: This study was supported by the Academy of Finland (A.S.,M.K., H.S.); the Finnish Social Insurance Institution (M.K.); the Finnish Ministry of Education and Culture (M.K.); the Juho Vainio Foundation (T.N.); the EU Joint Programme—Neurodegenerative Disease Research (EURO-FINGERS) (T.N.); the Alzheimer’s Research and Prevention Foundation (M.K.); the Alzheimerfonden (A.S.); the Region Stockholm ALF (A.S.); the Finnish Cultural Foundation (T.N.); the Jalmari and Rauha Ahokas Foundation (T.N.); the State Research Funding (EVO/VTR grants) of Oulu City Hospital (R.A.), and the Kuopio University Hospital (H.S.); the European Research Council (A.S.); the Finnish Foundation for Cardiovascular Research (T.L.); and the Finnish Medical Foundation (M.R.).
Copyright information: © The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (, which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact