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1. Author Correction: Common variants in Alzheimer’s disease and risk stratification by polygenic risk scores

Author

de Rojas, Itziar, Moreno-Grau, Sonia, Tesi, Niccolo, Grenier-Boley, Benjamin, Andrade, Victor, Jansen, Iris E., Pedersen, Nancy L., Stringa, Najada, Zettergren, Anna, Hernández, Isabel, Montrreal, Laura, Antúnez, Carmen, Antonell, Anna, Tankard, Rick M., Bis, Joshua C., Sims, Rebecca, Bellenguez, Céline, Quintela, Inés, González-Perez, Antonio, Calero, Miguel, Franco-Macías, Emilio, Macías, Juan, Blesa, Rafael, Cervera-Carles, Laura, Menéndez-González, Manuel, Frank-García, Ana, Royo, Jose Luís, Moreno, Fermin, Huerto Vilas, Raquel, Baquero, Miquel, Diez-Fairen, Mónica, Lage, Carmen, García-Madrona, Sebastián, García-González, Pablo, Alarcón-Martín, Emilio, Valero, Sergi, Sotolongo-Grau, Oscar, Ullgren, Abbe, Naj, Adam C., Lemstra, Afina W., Benaque, Alba, Pérez-Cordón, Alba, Benussi, Alberto, Rábano, Alberto, Padovani, Alessandro, Squassina, Alessio, de Mendonça, Alexandre, Arias Pastor, Alfonso, Kok, Almar A. L., Meggy, Alun, Pastor, Ana Belén, Espinosa, Ana, Corma-Gómez, Anaïs, Martín Montes, Angel, Sanabria, Ángela, DeStefano, Anita L., Schneider, Anja, Haapasalo, Annakaisa, Kinhult Ståhlbom, Anne, Tybjærg-Hansen, Anne, Hartmann, Annette M., Spottke, Annika, Corbatón-Anchuelo, Arturo, Rongve, Arvid, Borroni, Barbara, Arosio, Beatrice, Nacmias, Benedetta, Nordestgaard, Børge G., Kunkle, Brian W., Charbonnier, Camille, Abdelnour, Carla, Masullo, Carlo, Martínez Rodríguez, Carmen, Muñoz-Fernandez, Carmen, Dufouil, Carole, Graff, Caroline, Ferreira, Catarina B., Chillotti, Caterina, Reynolds, Chandra A., Fenoglio, Chiara, Van Broeckhoven, Christine, Clark, Christopher, Pisanu, Claudia, Satizabal, Claudia L., Holmes, Clive, Buiza-Rueda, Dolores, Aarsland, Dag, Rujescu, Dan, Alcolea, Daniel, Galimberti, Daniela, Wallon, David, Seripa, Davide, Grünblatt, Edna, Dardiotis, Efthimios, Düzel, Emrah, Scarpini, Elio, Conti, Elisa, Rubino, Elisa, Gelpi, Ellen, Rodriguez-Rodriguez, Eloy, Duron, Emmanuelle, Boerwinkle, Eric, Ferri, Evelyn, Tagliavini, Fabrizio, Küçükali, Fahri, Pasquier, Florence, Sanchez-Garcia, Florentino, Mangialasche, Francesca, Jessen, Frank, Nicolas, Gaël, Selbæk, Geir, Ortega, Gemma, Chêne, Geneviève, Hadjigeorgiou, Georgios, Rossi, Giacomina, Spalletta, Gianfranco, Giaccone, Giorgio, Grande, Giulia, Binetti, Giuliano, Papenberg, Goran, Hampel, Harald, Bailly, Henri, Zetterberg, Henrik, Soininen, Hilkka, Karlsson, Ida K., Alvarez, Ignacio, Appollonio, Ildebrando, Giegling, Ina, Skoog, Ingmar, Saltvedt, Ingvild, Rainero, Innocenzo, Rosas Allende, Irene, Hort, Jakub, Diehl-Schmid, Janine, Van Dongen, Jasper, Vidal, Jean-Sebastien, Lehtisalo, Jenni, Wiltfang, Jens, Thomassen, Jesper Qvist, Kornhuber, Johannes, Haines, Jonathan L., Vogelgsang, Jonathan, Pineda, Juan A., Fortea, Juan, Popp, Julius, Deckert, Jürgen, Buerger, Katharina, Morgan, Kevin, Fließbach, Klaus, Sleegers, Kristel, Molina-Porcel, Laura, Kilander, Lena, Weinhold, Leonie, Farrer, Lindsay A., Wang, Li-San, Kleineidam, Luca, Farotti, Lucia, Parnetti, Lucilla, Tremolizzo, Lucio, Hausner, Lucrezia, Benussi, Luisa, Froelich, Lutz, Ikram, M. Arfan, Deniz-Naranjo, M. Candida, Tsolaki, Magda, Rosende-Roca, Maitée, Löwenmark, Malin, Hulsman, Marc, Spallazzi, Marco, Pericak-Vance, Margaret A., Esiri, Margaret, Bernal Sánchez-Arjona, María, Dalmasso, Maria Carolina, Martínez-Larrad, María Teresa, Arcaro, Marina, Nöthen, Markus M., Fernández-Fuertes, Marta, Dichgans, Martin, Ingelsson, Martin, Herrmann, Martin J., Scherer, Martin, Vyhnalek, Martin, Kosmidis, Mary H., Yannakoulia, Mary, Schmid, Matthias, Ewers, Michael, Heneka, Michael T., Wagner, Michael, Scamosci, Michela, Kivipelto, Miia, Hiltunen, Mikko, Zulaica, Miren, Alegret, Montserrat, Fornage, Myriam, Roberto, Natalia, van Schoor, Natasja M., Seidu, Nazib M., Banaj, Nerisa, Armstrong, Nicola J., Scarmeas, Nikolaos, Scherbaum, Norbert, Goldhardt, Oliver, Hanon, Oliver, Peters, Oliver, Skrobot, Olivia Anna, Quenez, Olivier, Lerch, Ondrej, Bossù, Paola, Caffarra, Paolo, Dionigi Rossi, Paolo, Sakka, Paraskevi, Mecocci, Patrizia, Hoffmann, Per, Holmans, Peter A., Fischer, Peter, Riederer, Peter, Yang, Qiong, Marshall, Rachel, Kalaria, Rajesh N., Mayeux, Richard, Vandenberghe, Rik, Cecchetti, Roberta, Ghidoni, Roberta, Frikke-Schmidt, Ruth, Sorbi, Sandro, Hägg, Sara, Engelborghs, Sebastiaan, Helisalmi, Seppo, Botne Sando, Sigrid, Kern, Silke, Archetti, Silvana, Boschi, Silvia, Fostinelli, Silvia, Gil, Silvia, Mendoza, Silvia, Mead, Simon, Ciccone, Simona, Djurovic, Srdjan, Heilmann-Heimbach, Stefanie, Riedel-Heller, Steffi, Kuulasmaa, Teemu, del Ser, Teodoro, Lebouvier, Thibaud, Polak, Thomas, Ngandu, Tiia, Grimmer, Timo, Bessi, Valentina, Escott-Price, Valentina, Giedraitis, Vilmantas, Deramecourt, Vincent, Maier, Wolfgang, Jian, Xueqiu, Pijnenburg, Yolande A. L., Kehoe, Patrick Gavin, Garcia-Ribas, Guillermo, Sánchez-Juan, Pascual, Pastor, Pau, Pérez-Tur, Jordi, Piñol-Ripoll, Gerard, Lopez de Munain, Adolfo, García-Alberca, Jose María, Bullido, María J., Álvarez, Victoria, Lleó, Alberto, Real, Luis M., Mir, Pablo, Medina, Miguel, Scheltens, Philip, Holstege, Henne, Marquié, Marta, Sáez, María Eugenia, Carracedo, Ángel, Amouyel, Philippe, Schellenberg, Gerard D., Williams, Julie, Seshadri, Sudha, van Duijn, Cornelia M., Mather, Karen A., Sánchez-Valle, Raquel, Serrano-Ríos, Manuel, Orellana, Adelina, Tárraga, Lluís, Blennow, Kaj, Huisman, Martijn, Andreassen, Ole A., Posthuma, Danielle, Clarimón, Jordi, Boada, Mercè, van der Flier, Wiesje M., Ramirez, Alfredo, Lambert, Jean-Charles, van der Lee, Sven J., and Ruiz, Agustín

Published
2023
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3. New insights into the genetic etiology of Alzheimer’s disease and related dementias

Author

Bellenguez, Céline, Küçükali, Fahri, Jansen, Iris E., Kleineidam, Luca, Moreno-Grau, Sonia, Amin, Najaf, Naj, Adam C., Campos-Martin, Rafael, Grenier-Boley, Benjamin, Andrade, Victor, Holmans, Peter A., Boland, Anne, Damotte, Vincent, van der Lee, Sven J., Costa, Marcos R., Kuulasmaa, Teemu, Yang, Qiong, de Rojas, Itziar, Bis, Joshua C., Yaqub, Amber, Prokic, Ivana, Chapuis, Julien, Ahmad, Shahzad, Giedraitis, Vilmantas, Aarsland, Dag, Garcia-Gonzalez, Pablo, Abdelnour, Carla, Alarcón-Martín, Emilio, Alcolea, Daniel, Alegret, Montserrat, Alvarez, Ignacio, Álvarez, Victoria, Armstrong, Nicola J., Tsolaki, Anthoula, Antúnez, Carmen, Appollonio, Ildebrando, Arcaro, Marina, Archetti, Silvana, Pastor, Alfonso Arias, Arosio, Beatrice, Athanasiu, Lavinia, Bailly, Henri, Banaj, Nerisa, Baquero, Miquel, Barral, Sandra, Beiser, Alexa, Pastor, Ana Belén, Below, Jennifer E., Benchek, Penelope, Benussi, Luisa, Berr, Claudine, Besse, Céline, Bessi, Valentina, Binetti, Giuliano, Bizarro, Alessandra, Blesa, Rafael, Boada, Mercè, Boerwinkle, Eric, Borroni, Barbara, Boschi, Silvia, Bossù, Paola, Bråthen, Geir, Bressler, Jan, Bresner, Catherine, Brodaty, Henry, Brookes, Keeley J., Brusco, Luis Ignacio, Buiza-Rueda, Dolores, Bûrger, Katharina, Burholt, Vanessa, Bush, William S., Calero, Miguel, Cantwell, Laura B., Chene, Geneviève, Chung, Jaeyoon, Cuccaro, Michael L., Carracedo, Ángel, Cecchetti, Roberta, Cervera-Carles, Laura, Charbonnier, Camille, Chen, Hung-Hsin, Chillotti, Caterina, Ciccone, Simona, Claassen, Jurgen A. H. R., Clark, Christopher, Conti, Elisa, Corma-Gómez, Anaïs, Costantini, Emanuele, Custodero, Carlo, Daian, Delphine, Dalmasso, Maria Carolina, Daniele, Antonio, Dardiotis, Efthimios, Dartigues, Jean-François, de Deyn, Peter Paul, de Paiva Lopes, Katia, de Witte, Lot D., Debette, Stéphanie, Deckert, Jürgen, del Ser, Teodoro, Denning, Nicola, DeStefano, Anita, Dichgans, Martin, Diehl-Schmid, Janine, Diez-Fairen, Mónica, Rossi, Paolo Dionigi, Djurovic, Srdjan, Duron, Emmanuelle, Düzel, Emrah, Dufouil, Carole, Eiriksdottir, Gudny, Engelborghs, Sebastiaan, Escott-Price, Valentina, Espinosa, Ana, Ewers, Michael, Faber, Kelley M., Fabrizio, Tagliavini, Nielsen, Sune Fallgaard, Fardo, David W., Farotti, Lucia, Fenoglio, Chiara, Fernández-Fuertes, Marta, Ferrari, Raffaele, Ferreira, Catarina B., Ferri, Evelyn, Fin, Bertrand, Fischer, Peter, Fladby, Tormod, Fließbach, Klaus, Fongang, Bernard, Fornage, Myriam, Fortea, Juan, Foroud, Tatiana M., Fostinelli, Silvia, Fox, Nick C., Franco-Macías, Emlio, Bullido, María J., Frank-García, Ana, Froelich, Lutz, Fulton-Howard, Brian, Galimberti, Daniela, García-Alberca, Jose Maria, García-González, Pablo, Garcia-Madrona, Sebastian, Garcia-Ribas, Guillermo, Ghidoni, Roberta, Giegling, Ina, Giorgio, Giaccone, Goate, Alison M., Goldhardt, Oliver, Gomez-Fonseca, Duber, González-Pérez, Antonio, Graff, Caroline, Grande, Giulia, Green, Emma, Grimmer, Timo, Grünblatt, Edna, Grunin, Michelle, Gudnason, Vilmundur, Guetta-Baranes, Tamar, Haapasalo, Annakaisa, Hadjigeorgiou, Georgios, Haines, Jonathan L., Hamilton-Nelson, Kara L., Hampel, Harald, Hanon, Olivier, Hardy, John, Hartmann, Annette M., Hausner, Lucrezia, Harwood, Janet, Heilmann-Heimbach, Stefanie, Helisalmi, Seppo, Heneka, Michael T., Hernández, Isabel, Herrmann, Martin J., Hoffmann, Per, Holmes, Clive, Holstege, Henne, Vilas, Raquel Huerto, Hulsman, Marc, Humphrey, Jack, Biessels, Geert Jan, Jian, Xueqiu, Johansson, Charlotte, Jun, Gyungah R., Kastumata, Yuriko, Kauwe, John, Kehoe, Patrick G., Kilander, Lena, Ståhlbom, Anne Kinhult, Kivipelto, Miia, Koivisto, Anne, Kornhuber, Johannes, Kosmidis, Mary H., Kukull, Walter A., Kuksa, Pavel P., Kunkle, Brian W., Kuzma, Amanda B., Lage, Carmen, Laukka, Erika J., Launer, Lenore, Lauria, Alessandra, Lee, Chien-Yueh, Lehtisalo, Jenni, Lerch, Ondrej, Lleó, Alberto, Longstreth, Jr, William, Lopez, Oscar, de Munain, Adolfo Lopez, Love, Seth, Löwemark, Malin, Luckcuck, Lauren, Lunetta, Kathryn L., Ma, Yiyi, Macías, Juan, MacLeod, Catherine A., Maier, Wolfgang, Mangialasche, Francesca, Spallazzi, Marco, Marquié, Marta, Marshall, Rachel, Martin, Eden R., Montes, Angel Martín, Rodríguez, Carmen Martínez, Masullo, Carlo, Mayeux, Richard, Mead, Simon, Mecocci, Patrizia, Medina, Miguel, Meggy, Alun, Mehrabian, Shima, Mendoza, Silvia, Menéndez-González, Manuel, Mir, Pablo, Moebus, Susanne, Mol, Merel, Molina-Porcel, Laura, Montrreal, Laura, Morelli, Laura, Moreno, Fermin, Morgan, Kevin, Mosley, Thomas, Nöthen, Markus M., Muchnik, Carolina, Mukherjee, Shubhabrata, Nacmias, Benedetta, Ngandu, Tiia, Nicolas, Gael, Nordestgaard, Børge G., Olaso, Robert, Orellana, Adelina, Orsini, Michela, Ortega, Gemma, Padovani, Alessandro, Paolo, Caffarra, Papenberg, Goran, Parnetti, Lucilla, Pasquier, Florence, Pastor, Pau, Peloso, Gina, Pérez-Cordón, Alba, Pérez-Tur, Jordi, Pericard, Pierre, Peters, Oliver, Pijnenburg, Yolande A. L., Pineda, Juan A., Piñol-Ripoll, Gerard, Pisanu, Claudia, Polak, Thomas, Popp, Julius, Posthuma, Danielle, Priller, Josef, Puerta, Raquel, Quenez, Olivier, Quintela, Inés, Thomassen, Jesper Qvist, Rábano, Alberto, Rainero, Innocenzo, Rajabli, Farid, Ramakers, Inez, Real, Luis M., Reinders, Marcel J. T., Reitz, Christiane, Reyes-Dumeyer, Dolly, Ridge, Perry, Riedel-Heller, Steffi, Riederer, Peter, Roberto, Natalia, Rodriguez-Rodriguez, Eloy, Rongve, Arvid, Allende, Irene Rosas, Rosende-Roca, Maitée, Royo, Jose Luis, Rubino, Elisa, Rujescu, Dan, Sáez, María Eugenia, Sakka, Paraskevi, Saltvedt, Ingvild, Sanabria, Ángela, Sánchez-Arjona, María Bernal, Sanchez-Garcia, Florentino, Juan, Pascual Sánchez, Sánchez-Valle, Raquel, Sando, Sigrid B., Sarnowski, Chloé, Satizabal, Claudia L., Scamosci, Michela, Scarmeas, Nikolaos, Scarpini, Elio, Scheltens, Philip, Scherbaum, Norbert, Scherer, Martin, Schmid, Matthias, Schneider, Anja, Schott, Jonathan M., Selbæk, Geir, Seripa, Davide, Serrano, Manuel, Sha, Jin, Shadrin, Alexey A., Skrobot, Olivia, Slifer, Susan, Snijders, Gijsje J. L., Soininen, Hilkka, Solfrizzi, Vincenzo, Solomon, Alina, Song, Yeunjoo, Sorbi, Sandro, Sotolongo-Grau, Oscar, Spalletta, Gianfranco, Spottke, Annika, Squassina, Alessio, Stordal, Eystein, Tartan, Juan Pablo, Tárraga, Lluís, Tesí, Niccolo, Thalamuthu, Anbupalam, Thomas, Tegos, Tosto, Giuseppe, Traykov, Latchezar, Tremolizzo, Lucio, Tybjærg-Hansen, Anne, Uitterlinden, Andre, Ullgren, Abbe, Ulstein, Ingun, Valero, Sergi, Valladares, Otto, Broeckhoven, Christine Van, Vance, Jeffery, Vardarajan, Badri N., van der Lugt, Aad, Dongen, Jasper Van, van Rooij, Jeroen, van Swieten, John, Vandenberghe, Rik, Verhey, Frans, Vidal, Jean-Sébastien, Vogelgsang, Jonathan, Vyhnalek, Martin, Wagner, Michael, Wallon, David, Wang, Li-San, Wang, Ruiqi, Weinhold, Leonie, Wiltfang, Jens, Windle, Gill, Woods, Bob, Yannakoulia, Mary, Zare, Habil, Zhao, Yi, Zhang, Xiaoling, Zhu, Congcong, Zulaica, Miren, Farrer, Lindsay A., Psaty, Bruce M., Ghanbari, Mohsen, Raj, Towfique, Sachdev, Perminder, Mather, Karen, Jessen, Frank, Ikram, M. Arfan, de Mendonça, Alexandre, Hort, Jakub, Tsolaki, Magda, Pericak-Vance, Margaret A., Amouyel, Philippe, Williams, Julie, Frikke-Schmidt, Ruth, Clarimon, Jordi, Deleuze, Jean-François, Rossi, Giacomina, Seshadri, Sudha, Andreassen, Ole A., Ingelsson, Martin, Hiltunen, Mikko, Sleegers, Kristel, Schellenberg, Gerard D., van Duijn, Cornelia M., Sims, Rebecca, van der Flier, Wiesje M., Ruiz, Agustín, Ramirez, Alfredo, and Lambert, Jean-Charles

Published
2022
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5. Integrating a multimodal lifestyle intervention with medical food in prodromal Alzheimer's disease: the MIND-ADmini randomized controlled trial.

Author

Thunborg, Charlotta, Wang, Rui, Rosenberg, Anna, Sindi, Shireen, Andersen, Pia, Andrieu, Sandrine, Broersen, Laus M., Coley, Nicola, Couderc, Celine, Duval, Celine Z., Faxen-Irving, Gerd, Hagman, Göran, Hallikainen, Merja, Håkansson, Krister, Kekkonen, Eija, Lehtisalo, Jenni, Levak, Nicholas, Mangialasche, Francesca, Pantel, Johannes, and Rydström, Anders

Subjects
ALZHEIMER'S disease, COGNITIVE training, OLDER people, RANDOMIZED controlled trials, FOOD combining, MEDITERRANEAN diet
Abstract

Background: The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) showed cognitive benefits from a multidomain lifestyle intervention in at-risk older people. The LipiDiDiet trial highlighted benefits of medical food in prodromal Alzheimer's disease (AD). However, the feasibility and impact of multimodal interventions combining lifestyle with medical food in prodromal AD is unclear. Methods: MIND-ADmini was a 6-month multinational (Sweden, Finland, Germany, France) proof-of-concept randomized controlled trial (RCT). Participants were 60–85 years old, had prodromal AD (International Working Group-1 criteria), and vascular/lifestyle risk factors. The parallel-group RCT had three arms: multimodal lifestyle intervention (nutritional guidance, exercise, cognitive training, vascular/metabolic risk management and social stimulation); multimodal lifestyle intervention + medical food (Fortasyn Connect); and regular health advice/care (control). Participants were randomized 1:1:1 (computer-generated allocation at each site). Outcome evaluators were blinded to randomization. Primary outcome was feasibility of the multimodal intervention, evaluated by recruitment rate during a 6-month recruitment phase, overall adherence in each intervention arm, and 6-month retention rate. Successful adherence was pre-specified as attending ≥ 40% of sessions/domain in ≥ 2/4 domains (lifestyle intervention), and consuming ≥ 60% of the medical food (lifestyle intervention + medical food). The secondary outcomes included adherence/participation to each intervention component and overall adherence to healthy lifestyle changes, measured using a composite score for healthy lifestyle. Cognitive assessments were included as exploratory outcomes, e.g. Clinical Dementia Rating scale. Results: During September 2017-May 2019, 93 individuals were randomized (32 lifestyle intervention, 31 lifestyle + medical food, and 30 control group). Overall recruitment rate was 76.2% (64.8% during the first 6 months). Overall 6-month retention rate was 91.4% (lifestyle intervention 87.5%; lifestyle + medical food 90.3%; control 96.7%). Domain-specific adherence in the lifestyle intervention group was 71.9% to cognitive training, 78.1% exercise, 68.8% nutritional guidance, and 81.3% vascular risk management; and in the lifestyle + medical food group, 90.3% to cognitive training, 87.1% exercise, 80.7% nutritional guidance, 87.1% vascular risk management, and 87.1% medical food. Compared with control, both intervention arms showed healthy diet improvements (βLifestyle×Time = 1.11, P = 0.038; βLifestyle+medical food×Time = 1.43, P = 0.007); the lifestyle + medical food group also showed vascular risk reduction (P = 0.043) and less cognitive-functional decline (P < 0.05, exploratory analysis). There were 5 serious adverse events (control group: 1; lifestyle intervention: 3; lifestyle + medical food: 1) unrelated to interventions. Conclusions: The multidomain lifestyle intervention, alone or combined with medical food, had good feasibility and adherence in prodromal AD. Longer-term cognitive and other health benefits should be further investigated in a larger-scale trial. Trial registration: ClinicalTrials.gov NCT03249688. [ABSTRACT FROM AUTHOR]

Published
2024
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6. The Australian National University Alzheimer's Disease Risk Index (ANU‐ADRI) score as a predictor for cognitive decline and potential surrogate outcome in the FINGER lifestyle randomized controlled trial.

Author

Hall, Anette, Barbera, Mariagnese, Lehtisalo, Jenni, Antikainen, Riitta, Huque, Hamidul, Laatikainen, Tiina, Ngandu, Tiia, Soininen, Hilkka, Stephen, Ruth, Strandberg, Timo, Kivipelto, Miia, Anstey, Kaarin J., and Solomon, Alina

Subjects
DISEASE risk factors, COGNITION disorders, MAXIMUM likelihood statistics, ALZHEIMER'S disease
Abstract

Background and purpose: The complex aetiology of Alzheimer's disease suggests prevention potential. Risk scores have potential as risk stratification tools and surrogate outcomes in multimodal interventions targeting specific at‐risk populations. The Australian National University Alzheimer's Disease Risk Index (ANU‐ADRI) was tested in relation to cognition and its suitability as a surrogate outcome in a multidomain lifestyle randomized controlled trial, in older adults at risk of dementia. Methods: In this post hoc analysis of the Finnish Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), ANU‐ADRI was calculated at baseline, 12, and 24 months (n = 1174). The association between ANU‐ADRI and cognition (at baseline and over time), the intervention effect on changes in ANU‐ADRI, and the potential impact of baseline ANU‐ADRI on the intervention effect on changes in cognition were assessed using linear mixed models with maximum likelihood estimation. Results: A higher ANU‐ADRI was significantly related to worse cognition, at baseline (e.g., estimate for global cognition [95% confidence interval] was −0.028 [−0.032 to −0.025]) and over the 2‐year study (e.g., estimate for 2‐year changes in ANU‐ADRI and per‐year changes in global cognition [95% confidence interval] was −0.068 [−0.026 to −0.108]). No significant beneficial intervention effect was reported for ANU‐ADRI, and baseline ANU‐ADRI did not significantly affect the response to the intervention on changes in cognition. Conclusions: The ANU‐ADRI was effective for the risk prediction of cognitive decline. Risk scores may be crucial for the success of novel dementia prevention strategies, but their algorithm, the target population, and the intervention design should be carefully considered when choosing the appropriate tool for each context. [ABSTRACT FROM AUTHOR]

Published
2024
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8. Common variants in Alzheimer’s disease and risk stratification by polygenic risk scores

Author

de Rojas, Itziar, Moreno-Grau, Sonia, Tesi, Niccolo, Grenier-Boley, Benjamin, Andrade, Victor, Jansen, Iris E., Pedersen, Nancy L., Stringa, Najada, Zettergren, Anna, Hernández, Isabel, Montrreal, Laura, Antúnez, Carmen, Antonell, Anna, Tankard, Rick M., Bis, Joshua C., Sims, Rebecca, Bellenguez, Céline, Quintela, Inés, González-Perez, Antonio, Calero, Miguel, Franco-Macías, Emilio, Macías, Juan, Blesa, Rafael, Cervera-Carles, Laura, Menéndez-González, Manuel, Frank-García, Ana, Royo, Jose Luís, Moreno, Fermin, Huerto Vilas, Raquel, Baquero, Miquel, Diez-Fairen, Mónica, Lage, Carmen, García-Madrona, Sebastián, García-González, Pablo, Alarcón-Martín, Emilio, Valero, Sergi, Sotolongo-Grau, Oscar, Ullgren, Abbe, Naj, Adam C., Lemstra, Afina W., Benaque, Alba, Pérez-Cordón, Alba, Benussi, Alberto, Rábano, Alberto, Padovani, Alessandro, Squassina, Alessio, de Mendonça, Alexandre, Arias Pastor, Alfonso, Kok, Almar A. L., Meggy, Alun, Pastor, Ana Belén, Espinosa, Ana, Corma-Gómez, Anaïs, Martín Montes, Angel, Sanabria, Ángela, DeStefano, Anita L., Schneider, Anja, Haapasalo, Annakaisa, Kinhult Ståhlbom, Anne, Tybjærg-Hansen, Anne, Hartmann, Annette M., Spottke, Annika, Corbatón-Anchuelo, Arturo, Rongve, Arvid, Borroni, Barbara, Arosio, Beatrice, Nacmias, Benedetta, Nordestgaard, Børge G., Kunkle, Brian W., Charbonnier, Camille, Abdelnour, Carla, Masullo, Carlo, Martínez Rodríguez, Carmen, Muñoz-Fernandez, Carmen, Dufouil, Carole, Graff, Caroline, Ferreira, Catarina B., Chillotti, Caterina, Reynolds, Chandra A., Fenoglio, Chiara, Van Broeckhoven, Christine, Clark, Christopher, Pisanu, Claudia, Satizabal, Claudia L., Holmes, Clive, Buiza-Rueda, Dolores, Aarsland, Dag, Rujescu, Dan, Alcolea, Daniel, Galimberti, Daniela, Wallon, David, Seripa, Davide, Grünblatt, Edna, Dardiotis, Efthimios, Düzel, Emrah, Scarpini, Elio, Conti, Elisa, Rubino, Elisa, Gelpi, Ellen, Rodriguez-Rodriguez, Eloy, Duron, Emmanuelle, Boerwinkle, Eric, Ferri, Evelyn, Tagliavini, Fabrizio, Küçükali, Fahri, Pasquier, Florence, Sanchez-Garcia, Florentino, Mangialasche, Francesca, Jessen, Frank, Nicolas, Gaël, Selbæk, Geir, Ortega, Gemma, Chêne, Geneviève, Hadjigeorgiou, Georgios, Rossi, Giacomina, Spalletta, Gianfranco, Giaccone, Giorgio, Grande, Giulia, Binetti, Giuliano, Papenberg, Goran, Hampel, Harald, Bailly, Henri, Zetterberg, Henrik, Soininen, Hilkka, Karlsson, Ida K., Alvarez, Ignacio, Appollonio, Ildebrando, Giegling, Ina, Skoog, Ingmar, Saltvedt, Ingvild, Rainero, Innocenzo, Rosas Allende, Irene, Hort, Jakub, Diehl-Schmid, Janine, Van Dongen, Jasper, Vidal, Jean-Sebastien, Lehtisalo, Jenni, Wiltfang, Jens, Thomassen, Jesper Qvist, Kornhuber, Johannes, Haines, Jonathan L., Vogelgsang, Jonathan, Pineda, Juan A., Fortea, Juan, Popp, Julius, Deckert, Jürgen, Buerger, Katharina, Morgan, Kevin, Fließbach, Klaus, Sleegers, Kristel, Molina-Porcel, Laura, Kilander, Lena, Weinhold, Leonie, Farrer, Lindsay A., Wang, Li-San, Kleineidam, Luca, Farotti, Lucia, Parnetti, Lucilla, Tremolizzo, Lucio, Hausner, Lucrezia, Benussi, Luisa, Froelich, Lutz, Ikram, M. Arfan, Deniz-Naranjo, M. Candida, Tsolaki, Magda, Rosende-Roca, Maitée, Löwenmark, Malin, Hulsman, Marc, Spallazzi, Marco, Pericak-Vance, Margaret A., Esiri, Margaret, Bernal Sánchez-Arjona, María, Dalmasso, Maria Carolina, Martínez-Larrad, María Teresa, Arcaro, Marina, Nöthen, Markus M., Fernández-Fuertes, Marta, Dichgans, Martin, Ingelsson, Martin, Herrmann, Martin J., Scherer, Martin, Vyhnalek, Martin, Kosmidis, Mary H., Yannakoulia, Mary, Schmid, Matthias, Ewers, Michael, Heneka, Michael T., Wagner, Michael, Scamosci, Michela, Kivipelto, Miia, Hiltunen, Mikko, Zulaica, Miren, Alegret, Montserrat, Fornage, Myriam, Roberto, Natalia, van Schoor, Natasja M., Seidu, Nazib M., Banaj, Nerisa, Armstrong, Nicola J., Scarmeas, Nikolaos, Scherbaum, Norbert, Goldhardt, Oliver, Hanon, Oliver, Peters, Oliver, Skrobot, Olivia Anna, Quenez, Olivier, Lerch, Ondrej, Bossù, Paola, Caffarra, Paolo, Dionigi Rossi, Paolo, Sakka, Paraskevi, Mecocci, Patrizia, Hoffmann, Per, Holmans, Peter A., Fischer, Peter, Riederer, Peter, Yang, Qiong, Marshall, Rachel, Kalaria, Rajesh N., Mayeux, Richard, Vandenberghe, Rik, Cecchetti, Roberta, Ghidoni, Roberta, Frikke-Schmidt, Ruth, Sorbi, Sandro, Hägg, Sara, Engelborghs, Sebastiaan, Helisalmi, Seppo, Botne Sando, Sigrid, Kern, Silke, Archetti, Silvana, Boschi, Silvia, Fostinelli, Silvia, Gil, Silvia, Mendoza, Silvia, Mead, Simon, Ciccone, Simona, Djurovic, Srdjan, Heilmann-Heimbach, Stefanie, Riedel-Heller, Steffi, Kuulasmaa, Teemu, del Ser, Teodoro, Lebouvier, Thibaud, Polak, Thomas, Ngandu, Tiia, Grimmer, Timo, Bessi, Valentina, Escott-Price, Valentina, Giedraitis, Vilmantas, Deramecourt, Vincent, Maier, Wolfgang, Jian, Xueqiu, Pijnenburg, Yolande A. L., Kehoe, Patrick Gavin, Garcia-Ribas, Guillermo, Sánchez-Juan, Pascual, Pastor, Pau, Pérez-Tur, Jordi, Piñol-Ripoll, Gerard, Lopez de Munain, Adolfo, García-Alberca, Jose María, Bullido, María J., Álvarez, Victoria, Lleó, Alberto, Real, Luis M., Mir, Pablo, Medina, Miguel, Scheltens, Philip, Holstege, Henne, Marquié, Marta, Sáez, María Eugenia, Carracedo, Ángel, Amouyel, Philippe, Schellenberg, Gerard D., Williams, Julie, Seshadri, Sudha, van Duijn, Cornelia M., Mather, Karen A., Sánchez-Valle, Raquel, Serrano-Ríos, Manuel, Orellana, Adelina, Tárraga, Lluís, Blennow, Kaj, Huisman, Martijn, Andreassen, Ole A., Posthuma, Danielle, Clarimón, Jordi, Boada, Mercè, van der Flier, Wiesje M., Ramirez, Alfredo, Lambert, Jean-Charles, van der Lee, Sven J., and Ruiz, Agustín

Published
2021
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9. Adherence to multidomain interventions for dementia prevention: Data from the FINGER and MAPT trials

Author

Richard, Edo, van Gool, Pim, van Charante, Eric Moll, Beishuizen, Cathrien, Jongstra, Susan, van Middelaar, Tessa, van Wanrooij, Lennard, Hoevenaar-Blom, Marieke, Soininen, Hilkka, Ngandu, Tiia, Barbera, Mariagnese, Kivipelto, Miia, Mangiasche, Francesca, Andrieu, Sandrine, Coley, Nicola, Guillemont, Juliette, Meiller, Yannick, van de Groep, Bram, Brayne, Carol, Solomon, Alina, Laatikainen, Tiina, Strandberg, Timo, Tuomilehto, Jaakko, Antikainen, Riitta, Lindström, Jaana, Lehtisalo, Jenni, Havulinna, Satu, Rauramaa, Rainer, Hänninen, Tuomo, Bäckman, Lars, Stigsdotter-Neely, Anna, Jula, Antti, Peltonen, Markku, Levälahti, Esko, Grönholm, Marko, Hemiö, Katri, Vellas, Bruno, Guyonnet, Sophie, Carrié, Isabelle, Brigitte, Lauréane, Faisant, Catherine, Lala, Françoise, Delrieu, Julien, Villars, Hélène, Combrouze, Emeline, Badufle, Carole, Zueras, Audrey, Cantet, Christelle, Morin, Christophe, Van Kan, Gabor Abellan, Dupuy, Charlotte, Rolland, Yves, Caillaud, Céline, Ousset, Pierre-Jean, Fougère, Bertrand, Willis, Sherry, Belleville, Sylvie, Gilbert, Brigitte, Fontaine, Francine, Dartigues, Jean-François, Marcet, Isabelle, Delva, Fleur, Foubert, Alexandra, Cerda, Sandrine, Marie-Noëlle-Cuffi, Costes, Corinne, Rouaud, Olivier, Manckoundia, Patrick, Quipourt, Valérie, Marilier, Sophie, Franon, Evelyne, Bories, Lawrence, Pader, Marie-Laure, Basset, Marie-France, Lapoujade, Bruno, Faure, Valérie, Yung Tong, Michael Li, Malick-Loiseau, Christine, Cazaban-Campistron, Evelyne, Desclaux, Françoise, Blatge, Colette, Dantoine, Thierry, Laubarie-Mouret, Cécile, Saulnier, Isabelle, Clément, Jean-Pierre, Picat, Marie-Agnès, Bernard-Bourzeix, Laurence, Willebois, Stéphanie, Désormais, Iléana, Cardinaud, Noëlle, Bonnefoy, Marc, Livet, Pierre, Rebaudet, Pascale, Gédéon, Claire, Burdet, Catherine, Terracol, Flavien, Pesce, Alain, Roth, Stéphanie, Chaillou, Sylvie, Louchart, Sandrine, Sudres, Kristelle, Lebrun, Nicolas, Barro-Belaygues, Nadège, Touchon, Jacques, Bennys, Karim, Gabelle, Audrey, Romano, Aurélia, Touati, Lynda, Marelli, Cécilia, Pays, Cécile, Robert, Philippe, Le Duff, Franck, Gervais, Claire, Gonfrier, Sébastien, Gasnier, Yannick, Bordes, Serge, Begorre, Danièle, Carpuat, Christian, Khales, Khaled, Lefebvre, Jean-François, El Idrissi, Samira Misbah, Skolil, Pierre, Salles, Jean-Pierre, Dufouil, Carole, Lehéricy, Stéphane, Chupin, Marie, Mangin, Jean-François, Bouhayia, Ali, Allard, Michèle, Ricolfi, Frédéric, Dubois, Dominique, Bonceour Martel, Marie Paule, Cotton, François, Bonafé, Alain, Chanalet, Stéphane, Hugon, Françoise, Bonneville, Fabrice, Cognard, Christophe, Chollet, François, Payoux, Pierre, Voisin, Thierry, Peiffer, Sophie, Hitzel, Anne, Zanca, Michel, Monteil, Jacques, Darcourt, Jacques, Molinier, Laurent, Derumeaux, Hélène, Costa, Nadège, Vincent, Christian, Perret, Bertrand, Vinel, Claire, and Olivier-Abbal, Pascale

Published
2019
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11. A multimodal precision-prevention approach combining lifestyle intervention with metformin repurposing to prevent cognitive impairment and disability: the MET-FINGER randomised controlled trial protocol.

Author

Barbera, Mariagnese, Lehtisalo, Jenni, Perera, Dinithi, Aspö, Malin, Cross, Mary, De Jager Loots, Celeste A., Falaschetti, Emanuela, Friel, Naomi, Luchsinger, José A., Gavelin, Hanna Malmberg, Peltonen, Markku, Price, Geraint, Neely, Anna Stigsdotter, Thunborg, Charlotta, Tuomilehto, Jaakko, Mangialasche, Francesca, Middleton, Lefkos, Ngandu, Tiia, Solomon, Alina, and Kivipelto, Miia

Subjects
*COGNITION disorders, *METFORMIN, *ALZHEIMER'S disease, *TYPE 2 diabetes, *HEALTH behavior, *PEOPLE with disabilities, *DISEASE risk factors, *SELF-monitoring (Psychology)
Abstract

Background: Combining multimodal lifestyle interventions and disease-modifying drugs (novel or repurposed) could provide novel precision approaches to prevent cognitive impairment. Metformin is a promising candidate in view of the well-established link between type 2 diabetes (T2D) and Alzheimer's Disease and emerging evidence of its potential neuro-protective effects (e.g. vascular, metabolic, anti-senescence). MET-FINGER aims to test a FINGER 2.0 multimodal intervention, combining an updated FINGER multidomain lifestyle intervention with metformin, where appropriate, in an APOE ε4-enriched population of older adults (60–79 years) at increased risk of dementia. Methods: MET-FINGER is an international randomised, controlled, parallel-group, phase-IIb proof-of-concept clinical trial, where metformin is included through a trial-within-trial design. 600 participants will be recruited at three sites (UK, Finland, Sweden). Participants at increased risk of dementia based on vascular risk factors and cognitive screening, will be first randomised to the FINGER 2.0 intervention (lifestyle + metformin if eligible; active arm) or to receive regular health advice (control arm). Participants allocated to the FINGER 2.0 intervention group at risk indicators of T2D will be additionally randomised to receive metformin (2000 mg/day or 1000 mg/day) or placebo. The study duration is 2 years. The changes in global cognition (primary outcome, using a Neuropsychological Test Battery), memory, executive function, and processing speed cognitive domains; functional status; lifestyle, vascular, metabolic, and other dementia-related risk factors (secondary outcomes), will be compared between the FINGER 2.0 intervention and the control arm. The feasibility, potential interaction (between-groups differences in healthy lifestyle changes), and disease-modifying effects of the lifestyle-metformin combination will be exploratory outcomes. The lifestyle intervention is adapted from the original FINGER trial (diet, physical activity, cognitive training, monitoring of cardiovascular/metabolic risk factors, social interaction) to be consistently delivered in three countries. Metformin is administered as Glucophage®XR/SR 500, (500 mg oral tablets). The metformin/placebo treatment will be double blinded. Conclusion: MET-FINGER is the first trial combining a multimodal lifestyle intervention with a putative repurposed disease-modifying drug for cognitive impairment prevention. Although preliminary, its findings will provide crucial information for innovative precision prevention strategies and form the basis for a larger phase-III trial design and future research in this field. Trial registration: ClinicalTrials.gov (NCT05109169). [ABSTRACT FROM AUTHOR]

Published
2024
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14. Multidomain lifestyle intervention benefits a large elderly population at risk for cognitive decline and dementia regardless of baseline characteristics: The FINGER trial

Author

Rosenberg, Anna, Ngandu, Tiia, Rusanen, Minna, Antikainen, Riitta, Bäckman, Lars, Havulinna, Satu, Hänninen, Tuomo, Laatikainen, Tiina, Lehtisalo, Jenni, Levälahti, Esko, Lindström, Jaana, Paajanen, Teemu, Peltonen, Markku, Soininen, Hilkka, Stigsdotter-Neely, Anna, Strandberg, Timo, Tuomilehto, Jaakko, Solomon, Alina, and Kivipelto, Miia

Published
2018
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15. Third follow-up of the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) cohort investigating determinants of cognitive, physical, and psychosocial wellbeing among the oldest old: the CAIDE85+ study protocol

Author

Barbera, Mariagnese, Kulmala, Jenni, Lisko, Inna, Pietilä, Eija, Rosenberg, Anna, Hallikainen, Ilona, Hallikainen, Merja, Laatikainen, Tiina, Lehtisalo, Jenni, Neuvonen, Elisa, Rusanen, Minna, Soininen, Hilkka, Tuomilehto, Jaakko, Ngandu, Tiia, Solomon, Alina, and Kivipelto, Miia

Published
2020
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17. The Role of Brain Integrity in the Association between Occupational Complexity and Cognitive Performance in Subjects with Increased Risk of Dementia.

Author

Rydström, Anders, Stephen, Ruth, Kåreholt, Ingemar, Darin Mattsson, Alexander, Ngandu, Tiia, Lehtisalo, Jenni, Bäckman, Lars, Kemppainen, Nina, Rinne, Juha, Sindi, Shireen, Soininen, Hilkka, Vanninen, Ritva, Solomon, Alina, and Mangialasche, Francesca

Subjects
COGNITIVE ability, DISEASE risk factors, MAGNETIC resonance imaging, COGNITION, ALZHEIMER'S disease, EXECUTIVE function
Abstract

Introduction: Mechanisms underlying the positive association between occupational mental demands and late-life cognition are poorly understood. The objective of this study was to assess whether the association between occupational complexity and cognition is related to and moderated by brain integrity in individuals at risk for dementia. Brain integrity was appraised throughout structural measures (magnetic resonance imaging, MRI) and amyloid accumulation (Pittsburgh compound B (PiB)-positron emission tomography, PiB-PET). Methods: Participants from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) neuroimaging sample – MRI (N = 126), PiB-PET (N = 41) – were included in a post hoc cross-sectional analysis. Neuroimaging parameters comprised the Alzheimer's disease signature (ADS) cortical thickness (FreeSurfer 5.3), medial temporal atrophy (MTA), and amyloid accumulation (PiB-PET). Cognition was assessed using the neuropsychological test battery. Occupational complexity with data, people, and substantive complexity were classified through the Dictionary of Occupational Titles. Linear regression models included cognition as dependent variable, and occupational complexity, measures of brain integrity, and their interaction terms as predictors. Results: Occupational complexity with data and substantive complexity were associated with better cognition (overall cognition, executive function) when adjusting for ADS and MTA (independent association). Significant interaction effects between occupational complexity and brain integrity were also found, indicating that, for some indicators of brain integrity and cognition (e.g., overall cognition, processing speed), the positive association between occupational complexity and cognition occurred only among persons with higher brain integrity (moderated association). Conclusions: Among individuals at risk for dementia, occupational complexity does not seem to contribute toward resilience against neuropathology. These exploratory findings require validation in larger populations. [ABSTRACT FROM AUTHOR]

Published
2023
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18. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial

Author

Ngandu, Tiia, Lehtisalo, Jenni, Solomon, Alina, Levälahti, Esko, Ahtiluoto, Satu, Antikainen, Riitta, Bäckman, Lars, Hänninen, Tuomo, Jula, Antti, Laatikainen, Tiina, Lindström, Jaana, Mangialasche, Francesca, Paajanen, Teemu, Pajala, Satu, Peltonen, Markku, Rauramaa, Rainer, Stigsdotter-Neely, Anna, Strandberg, Timo, Tuomilehto, Jaakko, Soininen, Hilkka, and Kivipelto, Miia

Published
2015
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21. Occupational complexity and cognition in the FINGER multidomain intervention trial.

Author

Rydström, Anders, Darin‐Mattsson, Alexander, Kåreholt, Ingemar, Ngandu, Tiia, Lehtisalo, Jenni, Solomon, Alina, Antikainen, Riitta, Bäckman, Lars, Hänninen, Tuomo, Laatikainen, Tiina, Levälahti, Esko, Lindström, Jaana, Paajanen, Teemu, Havulinna, Satu, Peltonen, Markku, Sindi, Shireen, Soininen, Hilkka, Neely, Anna Stigsdotter, Strandberg, Timo, and Tuomilehto, Jaakko

Published
2022
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22. Development of the First WHO Guidelines for Risk Reduction of Cognitive Decline and Dementia : Lessons Learned and Future Directions

Author

Stephen, Ruth, Barbera, Mariagnese, Peters, Ruth, Ee, Nicole, Zheng, Lidan, Lehtisalo, Jenni, Kulmala, Jenni, Håkansson, Krister, Chowdhary, Neerja, Dua, Tarun, Solomon, Alina, Anstey, Kaarin J., Kivipelto, Miia, Tampere University, and Health Sciences

Subjects
3141 Health care science
Abstract

The first WHO guidelines for risk reduction of cognitive decline and dementia marked an important milestone in the field of dementia prevention. In this paper, we discuss the evidence reviewed as part of the guidelines development and present the main themes emerged from its synthesis, to inform future research and policies on dementia risk reduction. The role of intervention effect-size; the mismatch between observational and intervention-based evidence; the heterogeneity of evidence among intervention trials; the importance of intervention duration; the role of timing of exposure to a certain risk factor and interventions; the relationship between intervention intensity and response; the link between individual risk factors and specific dementia pathologies; and the need for tailored interventions emerged as the main themes. The interaction and clustering of individual risk factors, including genetics, was identified as the overarching theme. The evidence collected indicates that multidomain approaches targeting simultaneously multiple risk factors and tailored at both individual and population level, are likely to be most effective and feasible in dementia risk reduction. The current status of multidomain intervention trials aimed to cognitive impairment/dementia prevention was also briefly reviewed. Primary results were presented focusing on methodological differences and the potential of design harmonization for improving evidence quality. Since multidomain intervention trials address a condition with slow clinical manifestation—like dementia—in a relatively short time frame, the need for surrogate outcomes was also discussed, with a specific focus on the potential utility of dementia risk scores. Finally, we considered how multidomain intervention could be most effectively implemented in a public health context and the implications world-wide for other non-communicable diseases targeting common risk factors, taking into account the limited evidence in low-middle income countries. In conclusion, the evidence from the first WHO guidelines for risk reduction of cognitive decline and dementia indicated that “one size does not fit all,” and multidomain approaches adaptable to different populations and individuals are likely to be the most effective. Harmonization in trial design, the use of appropriate outcome measures, and sustainability in large at-risk populations in the context of other chronic disorders also emerged as key elements. publishedVersion

Published
2021

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

Author

Lehtisalo, Jenni, Rusanen, Minna, Solomon, Alina, Antikainen, Riitta, Laatikainen, Tiina, Peltonen, Markku, Strandberg, Timo, Tuomilehto, Jaakko, Soininen, Hilkka, Kivipelto, Miia, and Ngandu, Tiia

Subjects
TRANSIENT ischemic attack, OLDER people, CARDIOVASCULAR diseases risk factors, AT-risk people, FINGERS, COGNITION disorders
Abstract

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 (ClinicalTrials.gov 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. [ABSTRACT FROM AUTHOR]

Published
2022
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26. Rapid Absorption of Naloxone from Eye Drops.

Author

Tuunainen, Johanna, Saloranta, Lasse, Levijoki, Jouko, Lindstedt, Jenni, Lehtisalo, Jenni, Pappinen, Sari, Ramela, Meri, Virtanen, Sami, and Joensuu, Heikki

Subjects
NALOXONE, EYE drops, BIOAVAILABILITY, INTRAOCULAR drug administration, BEAGLE (Dog breed), INTRAOCULAR pressure, DRUG administration
Abstract

Naloxone as emergency treatment for opioid overdosing can be administered via several routes. However, the available administration methods are invasive or may be associated with incomplete or slow naloxone absorption. We evaluated pharmacokinetics and local tolerance of naloxone ocular drops in healthy beagle dogs. Naloxone administration as eye drops produced fast absorption with time to maximum plasma concentration (tmax) achieved in 14 to 28 min, high plasma exposure (Cmax 10.3 ng/mL to 12.7 ng/mL), and good bioavailability (41% to 56%). No signs of ocular irritability were observed in the scored ocular tolerability parameters, and the reactions of dogs suggesting immediate ocular discomfort after the dosing were sporadic and short lasting. Slight and transient increase in the intraocular pressure and transient decrease in the tear production were recorded. The results suggest that eye drops may provide a fast and an effective non-invasive route for naloxone administration to reverse opioid overdosing, and clinical studies in the human are warranted. [ABSTRACT FROM AUTHOR]

Published
2022
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29. Digitally supported lifestyle program to promote brain health among older adults (LETHE pilot trial) – Study design and progress.

Author

Rosenberg, Anna, Untersteiner, Helena, Guazzarini, Anna Giulia, Lehtisalo, Jenni, Thunborg, Charlotta, Bruinsma, Jeroen, Colombo, Matteo, Crutzen, Rik, Diaz, Ana, Fotiadis, Dimitrios, Hilberger, Hannes, Huber, Simone, Kivipelto, Miia, Loukas, Vassilis, Lötjönen, Jyrki, Pirani, Mattia, Schnalzer, Bianca, Hanke, Sten, Mangialasche, Francesca, and Mecocci, Patrizia

Published
2023
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32. Leisure-Time and Occupational Physical Activity in Early and Late Adulthood in Relation to Later Life Physical Functioning.

Author

Kulmala, Jenni, Ngandu, Tiia, Pajala, Satu, Lehtisalo, Jenni, Levälahti, Esko, Antikainen, Riitta, Laatikainen, Tiina, Oksa, Heikki, Peltonen, Markku, Rauramaa, Rainer, Soininen, Hilkka, Strandberg, Timo, Tuomilehto, Jaakko, and Kivipelto, Miia

Subjects
HEALTH of older people, PHYSICAL activity, LEISURE, OLD age, AGING
Abstract

Background: Physical activity (PA) has beneficial effects on older age physical functioning, but longitudinal studies with follow-ups extending up to decades are few. We investigated the association between leisure-time PA (LTPA) and occupational PA (OPA) from early to late adulthood in relation to later life performance-based physical functioning. Methods: The study involved 1260 people aged 60 to 79 years who took part in assessments of physical functioning (Short Physical Performance Battery [SPPB] test, 10-m maximal walking test, and grip strength test). Participants' data on earlier life LTPA/OPA (age range 25 to 74 years) were received from the previous studies (average follow-up 13.4 years). Logistic, linear, and censored regression models were used to assess the associations between LTPA/OPA earlier in life and subsequent physical functioning. Results: A high level of LTPA earlier in life was associated with a lower risk of having difficulties on the SPPB test (odds ratio [OR]: 0.37; 95% confidence interval [CI], 0.24-0.58) and especially on the chair rise test (OR: 0.42; 95% CI, 0.27-0.64) in old age. Heavy manual work predicted difficulties on SPPB (OR: 1.91; 95% CI, 1.22-2.98) and the chair rise test (OR: 1.75; 95% CI, 1.14-2.69) and poorer walking speed (β= .10, P = .005). Conclusions: This study highlights the importance of LTPA on later life functioning, but also indicates the inverse effects that may be caused by heavy manual work. [ABSTRACT FROM AUTHOR]

Published
2016
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33. Diet, diabetes, and prevention of cognitive decline : Focus on lifestyle intervention

Author

Lehtisalo, Jenni, University of Helsinki, Faculty of Medicine, Doctoral Program in Population Health, Public Health Promotion Unit, National Institute for Health and Welfare (THL), Helsingin yliopisto, lääketieteellinen tiedekunta, Väestön terveyden tohtoriohjelma, Helsingfors universitet, medicinska fakulteten, Doktorandprogrammet i befolkningshälsan, Scarmeas, Nikolaos, Kivipelto, Miia, Lindström, Jaana, and Ngandu, Tiia

Subjects
Kansanterveystiede
Abstract

Late-life cognitive impairment and dementia are more common among individuals with type 2 diabetes, and these disorders also share risk factors, such as obesity, as well as protective factors, such as healthy diet. Diabetes prevention could improve cognitive performance later in life, and improvement in diet may potentially prevent cognitive impairment through several pathways. This study aimed to examine the role of dietary intervention within a diabetes prevention study in midlife in relation to subsequent cognitive performance; and as a part of a multidomain lifestyle intervention in older adulthood in relation to simultaneous cognitive performance. The study comprised data from two pioneering randomized, controlled lifestyle intervention trials. The Finnish Diabetes Prevention Study included middle-aged participants at high risk for type 2 diabetes, who participated in an ancillary cognition assessment at 9 years after the lifestyle guidance. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability included older adults at elevated risk for dementia, who were offered a two-year multidomain lifestyle intervention with dietary guidance, exercise, cognitive training, and management of cardiovascular risk factors. Cognitive performance was assessed with neuropsychological test batteries. These results showed that better midlife glycaemic control, healthier diet, and lower BMI may protect from cognitive decline, even among those who meet the criteria for impaired glucose tolerance, highlighting the importance of healthy lifestyle in high-risk groups. Cognitive performance was worse among those who lost weight prior to cognition assessment, which could be explained by reverse causation, i.e. preclinical memory disorder may cause weight loss. Among older adults, targeted dietary counselling improved dietary quality and may prevent age-related decline in dietary intake, thus possibly preventing cognitive decline. For global cognition, baseline diet appeared more influential than dietary changes in two years, emphasizing the role of long-term healthy diet in supporting healthy brain ageing. Dietary changes in two years were nevertheless reflected in changes in executive function, indicating that cognitive benefits with dietary changes can be achieved in older age. These findings support the concept that diet has an important role in maintaining cognitive function in different phases of life. Muisti- ja ajattelutoimintojen heikentyminen ja muistisairaudet ovat yleisempiä tyypin 2 diabetesta sairastavilla, joten diabeteksen ehkäisy voisi vähentää myös muistitoimintojen heikentymistä. Samat taustatekijät, kuten lihavuus tai ruokavalion laatu, vaikuttavat sekä diabeteksen syntyyn että muistitoimintojen heikentymiseen. Ruokavaliomuutosten vaikutuksesta muistitoimintoihin ei kuitenkaan ole juurikaan tutkimustietoa. Tässä tutkimuksessa tutkittiin keski-iän elintapojen muutoksen sekä myöhemmän iän ruokavaliomuutosten mahdollisuuksia muistitoimintojen heikentymisen ehkäisyssä. Aineistona toimivat kaksi tutkimusta, jossa kohonneessa sairastumisriskissä olevat tutkittavat osallistuivat ravitsemusneuvontaa sisältävään elintapaohjelmaan. Diabeteksen ehkäisytutkimuksen osallistujat olivat keski-ikäisiä ja heidät kutsuttiin muistitutkimukseen 9 vuotta alkuperäisen elintapaneuvonnan jälkeen. Muistitoimintojen heikentymisen ehkäisytutkimukseen kutsuttiin ikääntyneitä, ja muistitoimintoja tutkittiin kaksivuotisen elintapaohjelman aikana. Tulokset osoittavat, että normaali glukoosiaineenvaihdunnan säätely, terveellinen ruokavalio ja pienempi painoindeksi keski-iässä voivat suojata myöhemmältä muistitoimintojen heikentymiseltä. Diabeteksen kehittyminen ei kuitenkaan vaikuttanut myöhempiin muistitoimintoihin. Painonlasku juuri ennen muistitutkimusta ennusti huonompaa suoriutumista, mikä voi selittyä alkavaan muistisairauteen liittyvällä painon putoamisella. Myöhemmällä iällä ravitsemussuosituksiin perustuva ruokavalioneuvonta paransi ruokavalion laatua ja ehkäisi iän myötä tapahtuvaa ravintoaineiden saannin vähenemistä, ja voi siten auttaa vähentämään muistitoimintojen heikentymistä. Ikääntyneillä havaittiin, että aloitusvaiheen terveellinen ruokavalio vaikutti muistitoimintojen muutokseen enemmän kuin ruokavalion muutokset kahden vuoden tutkimusaikana, mikä korostaa pitkän aikavälin ruokavalintojen tärkeyttä aivoterveyden ylläpitämisessä. Ruokavaliomuutokset heijastuivat kuitenkin toiminnanohjauksen muutoksiin, joten myös korkeammalla iällä tehdyt muutokset voivat ehkäistä muisti- ja ajattelutoimintojen heikentymistä. Tulokset tukevat ajatusta siitä, että ruokavaliolla on tärkeä rooli muisti- ja ajattelutoimintojen toimintojen ylläpitämisessä eri ikävaiheissa. Terveellisten elintapojen ylläpitäminen on tärkeää myös niillä, joilla sairastumisen todennäköisyys on kohonnut.

Published
2018

34. Telomere Length Change in a Multidomain Lifestyle Intervention to Prevent Cognitive Decline: A Randomized Clinical Trial.

Author

Sindi, Shireen, Solomon, Alina, Kåreholt, Ingemar, Hovatta, Iiris, Antikainen, Riitta, Hänninen, Tuomo, Levälahti, Esko, Laatikainen, Tiina, Lehtisalo, Jenni, Lindström, Jaana, Paajanen, Teemu, Peltonen, Markku, Khalsa, Dharma Singh, Wolozin, Benjamin, Strandberg, Timo, Tuomilehto, Jaakko, Soininen, Hilkka, Ngandu, Tiia, Kivipelto, Miia, and Group, FINGER Study

Subjects
CLINICAL trials, TELOMERES, DEMENTIA, OLDER people, APOLIPOPROTEIN E
Abstract

Background: Shorter leukocyte telomere length (LTL) is associated with aging and dementia. Impact of lifestyle changes on LTL, and relation to cognition and genetic susceptibility for dementia, has not been investigated in randomized controlled trials (RCTs).Methods: Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability is a 2-year RCT enrolling 1260 participants at risk for dementia from the general population, aged 60-77 years, randomly assigned (1:1) to multidomain lifestyle intervention or control group. The primary outcome was cognitive change (Neuropsychological Test Battery z-score). Relative LTL was measured using quantitative real-time polymerase chain reaction (trial registration: NCT01041989).Results: This exploratory LTL substudy included 756 participants (377 intervention, 379 control) with baseline and 24-month LTL measurements. The mean annual LTL change (SD) was -0.016 (0.19) in the intervention group and -0.023 (0.17) in the control group. Between-group difference was nonsignificant (unstandardized β-coefficient 0.007, 95% CI -0.015 to 0.030). Interaction analyses indicated better LTL maintenance among apolipoprotein E (APOE)-ε4 carriers versus noncarriers: 0.054 (95% CI 0.007 to 0.102); younger versus older participants: -0.005 (95% CI -0.010 to -0.001); and those with more versus less healthy lifestyle changes: 0.047 (95% CI 0.005 to 0.089). Cognitive intervention benefits were more pronounced among participants with better LTL maintenance for executive functioning (0.227, 95% CI 0.057 to 0.396) and long-term memory (0.257, 95% CI 0.024 to 0.489), with a similar trend for Neuropsychological Test Battery total score (0.127, 95% CI -0.011 to 0.264).Conclusions: This is the first large RCT showing that a multidomain lifestyle intervention facilitated LTL maintenance among subgroups of older people at risk for dementia, including APOE-ε4 carriers. LTL maintenance was associated with more pronounced cognitive intervention benefits.Clinical Trials Registration Number: NCT01041989. [ABSTRACT FROM AUTHOR]

Published
2021
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35. Changes in Lifestyle, Behaviors, and Risk Factors for Cognitive Impairment in Older Persons During the First Wave of the Coronavirus Disease 2019 Pandemic in Finland: Results From the FINGER Study.

Author

Lehtisalo, Jenni, Palmer, Katie, Mangialasche, Francesca, Solomon, Alina, Kivipelto, Miia, and Ngandu, Tiia

Subjects
COVID-19, OLDER people, COVID-19 pandemic, LIVING alone, MEDICAL care, UNHEALTHY lifestyles, INTELLECTUAL disabilities
Abstract

Aims: This study aimed to describe how the first phase of the coronavirus disease 2019 (COVID-19) pandemic affected older persons from the general Finnish population who are at risk of developing or have cognitive impairment, specifically, to describe whether participants experienced a change in risk factors that are relevant for the prevention of cognitive decline including diet, physical activity, access to medical care, socially and cognitively stimulating activities, and emotional health and well-being. Method: A postal survey was sent in June 2020 to 859 participants from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), an ongoing longitudinal study. The survey was developed to assess the effect of the COVID-19 pandemic and related infection-control measures on daily life, specifically commitment to distancing measures, access to health care and social services, daily activities, and changes in cognitive and social activities. Results: By September 2020, 613 (71%) participants responded (mean age = 77.7 years, 32% lived alone, and 80% had at least one chronic condition). Three quarters adopted some distancing practices during the first months of the pandemic. Older participants were more likely to practice total isolation than younger ones (29 vs. 19%; p = 0.003). Non-acute health-care visits were canceled for 5% of the participants who needed appointments, but cancellations in dental health care (43%), home aid (30%), and rehabilitative services (53%) were more common. Pandemic-related changes were reported in social engagements, for example, less contact with friends (55%) and family (31%), or less frequent attendance in cultural events (38%) or associations (25%), although remote contact with others increased for 40%. Feelings of loneliness increased for 21%, particularly those who were older (p = 0.023) or living alone (p < 0.001). Physical activity reduced for 34%, but dietary habits remained stable or improved. Pandemic-related changes in lifestyle and activities were more evident among those living alone. Conclusions: Finnish older persons generally reported less negative changes in lifestyles and behaviors during the pandemic than expected. Older people and those living alone seemed more susceptible to negative changes. It is important to compare how coping strategies may compare with other European countries to identify factors that may help older individuals to maintain healthy lifestyles during future waves of COVID-19. [ABSTRACT FROM AUTHOR]

Published
2021
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37. Nutritional intake and adherence to dietary recommendation for patients with prodromal Alzheimers disease within a multimodal lifestyle trial.

Author

Levak, Nicholas, Lehtisalo, Jenni, Thunborg, Charlotta, Westman, Eric, Sindi, Shireen, Rosenberg, Anna, Andersen, Pia, Andrieu, Sandrine, Broersen, Laus M., Coley, Nicola, Irving, Gerd Faxén, Mangialasche, Francesca, Pantel, Johannes, Ngandu, Tiia, Soininen, Hilkka, Hartmann, Tobias, Solomon, Alina, and Kivipelto, Miia

Published
2023
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39. Multidomain lifestyle intervention benefits a large elderly population at risk for cognitive decline and dementia regardless of baseline characteristics: The FINGER trial

Author

Rosenberg, Anna, Ngandu, Tiia, Rusanen, Minna, Antikainen, Riitta, Backman, Lars, Havulinna, Satu, Hanninen, Tuomo, Laatikainen, Tiina, Lehtisalo, Jenni, Levalahti, Esko, Lindstrom, Jaana, Paajanen, Teemu, Peltonen, Markku, Soininen, Hilkka, Stigsdotter Neely, Anna, Strandberg, Timo, Tuomilehto, Jaakko, Solomon, Alina, Kivipelto, Miia, Clinicum, Department of Public Health, University of Helsinki, Timo Strandberg / Principal Investigator, Department of Medicine, Hjelt Institute (-2014), and HUS Internal Medicine and Rehabilitation

Subjects
PROTOCOL, Male, Geriatrik, Clinical Neurology, Intervention, EXERCISE, 3124 Neurology and psychiatry, Cognition, Risk Factors, COMPLAINTS, Humans, CORONARY-HEART-DISEASE, Cognitive Dysfunction, Healthy Lifestyle, OLDER-ADULTS, Aged, Science & Technology, Cognitive Behavioral Therapy, Prevention, 3112 Neurosciences, 1103 Clinical Sciences, Alzheimer's disease, RANDOMIZED CONTROLLED-TRIAL, IMPAIRMENT, Middle Aged, Lifestyle, Multidomain, Exercise Therapy, ALZHEIMERS-DISEASE, FINNISH GERIATRIC INTERVENTION, Cognitive impairment, Treatment Outcome, Socioeconomic Factors, Randomized controlled trial, Cardiovascular Diseases, Geriatrics, 3121 General medicine, internal medicine and other clinical medicine, Dementia, Female, Neurosciences & Neurology, PRIMARY PREVENTION, 1109 Neurosciences, Life Sciences & Biomedicine, DIABETES PREVENTION, CLINICAL-TRIALS, tervention
Abstract

Introduction: The 2-year Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) multidomain lifestyle intervention trial (NCT01041989) demonstrated beneficial effects on cognition. We investigated whether sociodemographics, socioeconomic status, baseline cognition, or cardiovascular factors influenced intervention effects on cognition. Methods: The FINGER recruited 1260 people from the general Finnish population (60-77 years, at risk for dementia). Participants were randomized 1: 1 to multidomain intervention (diet, exercise, cognition, and vascular risk management) and regular health advice. Primary outcome was change in cognition (Neuropsychological Test Battery z-score). Prespecified analyses to investigate whether participants' characteristics modified response to intervention were carried out using mixed-model repeated-measures analyses. Results: Sociodemographics (sex, age, and education), socioeconomic status (income), cognition (Mini-Mental State Examination), cardiovascular factors (body mass index, blood pressure, cholesterol, fasting glucose, and overall cardiovascular risk), and cardiovascular comorbidity did not modify response to intervention (P-values for interaction > .05). Conclusions: The FINGER intervention was beneficial regardless of participants' characteristics and can thus be implemented in a large elderly population at increased risk for dementia. (C) 2017 The Authors. Published by Elsevier Inc. on behalf of the Alzheimer's Association.

Published
2017

40. Earlier life leisure-time physical activity in relation to age-related frailty syndrome.

Author

Kolehmainen, Laura, Havulinna, Satu, Ngandu, Tiia, Strandberg, Timo, Levälahti, Esko, Lehtisalo, Jenni, Antikainen, Riitta, Hietikko, Elina, Peltonen, Markku, Pölönen, Auli, Soininen, Hilkka, Tuomilehto, Jaakko, Laatikainen, Tiina, Rauramaa, Rainer, Kivipelto, Miia, and Kulmala, Jenni

Subjects
CONFIDENCE intervals, FRAIL elderly, LEISURE, PHENOTYPES, LOGISTIC regression analysis, PHYSICAL activity, ODDS ratio
Abstract

Background frailty syndrome is common amongst older people. Low physical activity is part of frailty, but long-term prospective studies investigating leisure-time physical activity (LTPA) during the life course as a predictor of frailty are still warranted. The aim of this study is to investigate whether earlier life LTPA predicts frailty in older age. Methods the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) included older adults (aged 60–77 years) from the general population who were at increased risk of cognitive decline. Frailty was assessed for 1,137 participants at a baseline visit using a modified version of Fried's phenotype, including five criteria: weight loss, exhaustion, weakness, slowness and low physical activity. Self-reported data on earlier life LTPA were available from previous population-based studies (average follow-up time 13.6 years). A binomial logistic regression analysis was used to investigate the association between earlier life LTPA and pre-frailty/frailty in older age. Results the prevalence of frailty and pre-frailty was 0.8% and 27.3%, respectively. In the analyses, pre-frail and frail groups were combined. People who had been physically very active (OR 0.37, 95% CI 0.23–0.60) or moderately active (OR 0.45, 95% CI 0.32–0.65) earlier in life had lower odds of becoming pre-frail/frail than individuals who had been sedentary. Conclusions frailty was rare in this relatively healthy study population, but almost a third of the participants were pre-frail. Earlier life LTPA was associated with lower levels of pre-frailty/frailty. The results highlight the importance of physical activity when aiming to promote healthy old age. [ABSTRACT FROM AUTHOR]

Published
2021
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42. Diabetes, glycaemia, and cognitiona secondary analysis of the Finnish Diabetes Prevention Study

Author

Lehtisalo, Jenni, Lindstrom, Jaana, Ngandu, Tiia, Kivipelto, Miia, Ahtiluoto, Satu, Ilanne-Parikka, Pirjo, Keinanen-Kiukaanniemi, Sirkka, Eriksson, Johan G., Uusitupa, Matti, Tuomilehto, Jaakko, Luchsinger, Jose A., Finnish Diabet Prevention Study DP, Clinicum, Department of Public Health, Johan Eriksson / Principal Investigator, and Department of General Practice and Primary Health Care

Subjects
dysglycaemia, cognition, DECLINE, DEMENTIA, WOMEN, DYSFUNCTION, 3142 Public health care science, environmental and occupational health, ALZHEIMERS-DISEASE, MELLITUS, IMPAIRED GLUCOSE-TOLERANCE, RISK-FACTOR, 3121 General medicine, internal medicine and other clinical medicine, LIFE-STYLE, type 2 diabetes, OLDER-ADULTS
Abstract

BackgroundType 2 diabetes is linked with cognitive dysfunction and dementia in epidemiological studies, but these observations are limited by lack of data on the exact timing of diabetes onset. We investigated diabetes, dysglycaemia, and cognition in the Finnish Diabetes Prevention Study, in which the timing and duration of diabetes are well documented. MethodsThe Finnish Diabetes Prevention Study comprised middle-aged, overweight participants with impaired glucose tolerance but no diabetes at baseline (n=522), randomized to lifestyle intervention or a control group. After an intervention period (mean duration 4years) and follow-up (additional 9years), cognitive assessment with the CERAD test battery and Trail Making Test A (TMT) was executed twice within a 2-year interval. Of the 364 (70%) participants with cognitive assessments, 171 (47%) had developed diabetes. ResultsCognitive function did not differ between those who developed diabetes and those who did not. Lower mean 2-h glucose at an oral glucose tolerance test (OGTT) and HbA(1C) during the intervention period predicted better performance in the TMT (p=0.012 and 0.024, respectively). Those without diabetes or with short duration of diabetes improved in CERAD total score between the two assessments (p=0.001) whereas those with long duration of diabetes did not (p=0.844). ConclusionsBetter glycemic control among persons with baseline impaired glucose tolerance predicted better cognitive performance 9years later in this secondary analysis of the Finnish Diabetes Prevention Study population. In addition, learning effects in cognitive testing were not evident in people with long diabetes duration. Copyright (c) 2015 John Wiley & Sons, Ltd.

Published
2016

47. The Effect of Multidomain Lifestyle Intervention on Daily Functioning in Older People.

Author

Kulmala, Jenni, Ngandu, Tiia, Havulinna, Satu, Levälahti, Esko, Lehtisalo, Jenni, Solomon, Alina, Antikainen, Riitta, Laatikainen, Tiina, Pippola, Pauliina, Peltonen, Markku, Rauramaa, Rainer, Soininen, Hilkka, Strandberg, Timo, Tuomilehto, Jaakko, and Kivipelto, Miia

Subjects
LIFESTYLES & health, GERIATRIC assessment, COGNITION in old age, PHYSICAL activity, GERIATRIC nutrition, VASCULAR diseases, SOCIAL conditions of older people, COGNITIVE training, NUTRITION counseling, COGNITION disorder risk factors, COGNITION disorders, ELDER care, CONFIDENCE intervals, EXERCISE therapy, HEALTH behavior, RISK assessment, VOCATIONAL rehabilitation, ACTIVITIES of daily living, BODY movement, LIFESTYLES, RANDOMIZED controlled trials, SOCIAL services case management, TREATMENT effectiveness, OLD age, DISEASE risk factors, PREVENTION
Abstract

OBJECTIVE: To investigate the effect of a 2‐year multidomain lifestyle intervention on daily functioning of older people. DESIGN: A 2‐year randomized controlled trial (ClinicalTrials.gov, NCT01041989). SETTING: Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability. PARTICIPANTS: A total of 1260 older adults, with a mean age of 69 years at the baseline, who were at risk of cognitive decline. INTERVENTION: A multidomain intervention, including simultaneous physical activity intervention, nutritional counseling, vascular risk monitoring and management, and cognitive training and social activity. MEASUREMENTS: The ability to perform daily activities (activities of daily living [ADLs] and instrumental ADLs) and physical performance (Short Physical Performance Battery). RESULTS: The mean baseline ADL score was 18.1 (SD = 2.6) points; the scale ranges from 17 (no difficulties) to 85 (total ADL dependence). During the 2‐year intervention, the ADL disability score slightly increased in the control group, while in the intervention group, it remained relatively stable. Based on the latent growth curve model, the difference in the change between the intervention and control groups was −0.95 (95% confidence interval [CI] = −1.61 to −0.28) after 1 year and −1.20 (95% CI = −2.02 to −0.38) after 2 years. In terms of physical performance, the intervention group had a slightly higher probability of improvement (from score 3 to score 4; P = .041) and a lower probability of decline (from score 3 to scores 0‐2; P = .043) for chair rise compared to the control group. CONCLUSION: A 2‐year lifestyle intervention was able to maintain the daily functioning of the at‐risk older population. The clinical significance of these results in this fairly well‐functioning population remains uncertain, but the study results hold promise that healthy eating, exercise, and cognitive and social activity may have favorable effects on functional independence in older people. [ABSTRACT FROM AUTHOR]

Published
2019
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48. Effect of the Apolipoprotein E Genotype on Cognitive Change During a Multidomain Lifestyle Intervention: A Subgroup Analysis of a Randomized Clinical Trial.

Author

Solomon, Alina, Turunen, Heidi, Ngandu, Tiia, Peltonen, Markku, Levälahti, Esko, Helisalmi, Seppo, Antikainen, Riitta, Bäckman, Lars, Hänninen, Tuomo, Jula, Antti, Laatikainen, Tiina, Lehtisalo, Jenni, Lindström, Jaana, Paajanen, Teemu, Pajala, Satu, Stigsdotter-Neely, Anna, Strandberg, Timo, Tuomilehto, Jaakko, Soininen, Hilkka, and Kivipelto, Miia

Published
2018
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49. Nutrient intake and dietary changes during a 2-year multi-domain lifestyle intervention among older adults: secondary analysis of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) randomised controlled trial.

Author

Lehtisalo, Jenni, Ngandu, Tiia, Valve, Päivi, Antikainen, Riitta, Laatikainen, Tiina, Strandberg, Timo, Soininen, Hilkka, Tuomilehto, Jaakko, Kivipelto, Miia, and Lindström, Jaana

Subjects
COGNITION disorders, CARDIOVASCULAR diseases risk factors, COMPARATIVE studies, DIET, EXERCISE, EXPERIMENTAL design, FOOD habits, INGESTION, MINERALS, MUSCLE strength, NUTRITION counseling, VITAMINS, DISEASE management, SECONDARY analysis, RANDOMIZED controlled trials, OLD age, PREVENTION
Abstract

Advancing age increases the risk for diseases and health concerns like cognitive decline, constituting a major public health challenge. Lifestyle, especially healthy diet, affects many risk factors related to chronic diseases, and thus lifestyle interventions among older adults may be beneficial in promoting successful ageing. We completed a randomised 2-year multi-domain lifestyle intervention trial aiming at prevention of cognitive decline among 631 participants in the intervention and 629 in the control group, aged 60-77 years at baseline. Dietary counselling was one of the intervention domains together with strength exercise, cognitive training and management of CVD risk factors. The aim of this paper was to describe success of the intervention -- that is, how an intervention based on national dietary recommendations affected dietary habits as a part of multi-intervention. Composite dietary intervention adherence score comprising nine distinct goals (range 0--9 points from none to achieving all goals) was 5·0 at baseline, and increased in the intervention group after the 1st (P<0⋅001) and 2nd (P =0⋅005) year. The difference in change compared with the control group was significant at both years (P <0⋅001 and P=0⋅018). Intake of several vitamins and minerals decreased in the control group but remained unchanged or increased in the intervention group during the 2 years. Well-targeted dietary counselling may prevent age-related decline in diet quality and help in preventing cognitive decline. [ABSTRACT FROM AUTHOR]

Published
2017
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