The randomized clinical FINGER-study (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) was carried out under the direction of Professor Miia Kivipelto and was published in the internationally recognized journal The Lancet in 2015 (Lancet, 2015, 385: 2255-63). The study has rapidly gained a large international recognition and has been called “a rare success against Alzheimer´s”.
The FINGER-study constitutes a paradigm shift in the area of brain health, as it shows that it is possible to prevent cognitive impairment and dementia through changes of several lifestyle factors in different risk groups. “Prevention interventions have the potential to slow down the development of the disease and possibly give people additional years without dementia”, says Miia Kivipelto. She believes that more than 30 per cent of all cases of Alzheimer´s disease is related to factors that can be influenced.
The first FINGER-study was carried out as a randomized study in Finland during 2009-2011 with 1260 participants, both men and women, who at that time were between 60 and 77 years old. The objective of the study was to assess how cognition was affected by an improved diet, physical activity and cognitive training.
Fifty per cent of the participants were randomly assigned to the control group and the other fifty percent of the participants were assigned to the treatment group. Everyone recruited to the study had a slightly higher risk for dementia, based on several strict criteria for recruitment. Those included in the treatment group were during a period of two years subjected to a specific diet in accordance with recommendations by Finland´s National Nutrition Council, a physical exercise program consisting of both muscle-strength training, aerobic exercise and postural balance and cognitive training using a computer program. The cognitive training was done to enhance executive function (planning and organizing), memory improvement and mental speed.
Those in the treatment group received nurse visits at set intervals and visited physicians five times during the two-year course of the trial to assess how well they were following the recommendations. The participants in the control group received only basic health advice at two physician visits during the two-year period.
The results from the two-year study showed a clear improvement of cognition and other positive effects were also seen in the treatment group. Overall cognitive performance improved by 25 per cent in the treatment group compared to the control group. The risk of waning cognitive performance was 30 per cent higher in the control group compared to the treatment group. In more detail, the treatment group showed a 40 per cent performance increase over the control group in complex memory tasks, such as remembering long lists, an 83 per cent improvement in executive function and a 150 per cent better score in speed of processing, i.e. time required to perform mental tasks. It was also found that participants in the treatment group with a specific gene variant (APOE e4) that increases the risk for Alzheimer´s disease, gained more benefit from the intervention than others without the gene variant. This constitutes additional proof of the effectiveness of the intervention. In addition to the cognitive improvements, the risk of acquiring additional chronic diseases in the treatment group decreased by 60 per cent.
The FINGER-study going forward
What we have learned from the initial FINGER-study will also be applied in future clinical studies at FINGERS Brain Health Institute. The FINGER-study has the potential to transform how we treat and look upon different forms of dementia, which potentially can decrease the number of new cases of dementia and give patients better a better basis to lead a good life. Provided that we can secure financing for the Institute, we are planning to initiate new FINGER-based trials at the Institute during 2020. The Institute could play an important role through the planned FINGER-based studies, which can lead to new insights with the potential to change people´s lives through early personalized preventive interventions to maintain brain health and to prevent cognitive impairment and dementia.
Fingers Brain Health Institute
c/o Stockholms Sjukhem
102 26 Stockholm