111 results on '"Levälahti E"'
Search Results
2. Overweight and Obesity in Finnish Children by Parents’ Socioeconomic Position—A Registry-Based Study
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Mäki, P., Levälahti, E., Lehtinen-Jacks, Susanna, Laatikainen, T., Mäki, P., Levälahti, E., Lehtinen-Jacks, Susanna, and Laatikainen, T.
- Abstract
Objectives: To examine associations between parents’ socioeconomic position (SEP) and child overweight and obesity, using registry data. Methods: Data (final n = 194,423) on children’s height, weight and parents’ SEP were drawn from the national Register of Primary Health Care Visits (Avohilmo) and Statistics Finland. Risk ratios for bernoulli-distributed overweight (RROW) and obesity (RROB) according to SEP were estimated using generalized linear models and using a log -link. Results: The risk for obesity was lower in boys from high-income families (RROB 0.76), for overweight and obesity was lower in boys (RROW 0.72, RROB 0.58) and girls (RROW 0.72, RROB 0.54) with highly educated fathers, in boys (RROW 0.79, RROB 0.58) and girls (RROW 0.78, RROB 0.56) with high-educated mothers and in boys (RROW 0.85, RROB 0.77) and girls (RROW 0.80, RROB 0.69) living in urban areas, as compared to low-income families, low-educated parents, and rural residence, respectively. Conclusion: The risk of overweight and obesity was increased in children with low SEP or rural residence. Administrative registers are a valid approach to monitor childhood obesity by parents’ SEP.
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- 2023
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3. Impact of socioeconomic position on childhood obesity in Finland based on register data from 2018
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Paalanen, L, primary, Levälahti, E, additional, Mäki, P, additional, Tolonen, H, additional, and Laatikainen, T, additional
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- 2022
- Full Text
- View/download PDF
4. Occupational complexity and cognition in the FINGER multidomain intervention trial
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Rydström, A. (Anders), Darin-Mattsson, A. (Alexander), Kåreholt, I. (Ingemar), Ngandu, T. (Tiia), Lehtisalo, J. (Jenni), Solomon, A. (Alina), Antikainen, R. (Riitta), Bäckman, L. (Lars), Hänninen, T. (Tuomo), Laatikainen, T. (Tiina), Levälahti, E. (Esko), Lindström, J. (Jaana), Paajanen, T. (Teemu), Havulinna, S. (Satu), Peltonen, M. (Markku), Sindi, S. (Shireen), Soininen, H. (Hilkka), Neely, A. S. (Anna Stigsdotter), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), Mangialasche, F. (Francesca), Rydström, A. (Anders), Darin-Mattsson, A. (Alexander), Kåreholt, I. (Ingemar), Ngandu, T. (Tiia), Lehtisalo, J. (Jenni), Solomon, A. (Alina), Antikainen, R. (Riitta), Bäckman, L. (Lars), Hänninen, T. (Tuomo), Laatikainen, T. (Tiina), Levälahti, E. (Esko), Lindström, J. (Jaana), Paajanen, T. (Teemu), Havulinna, S. (Satu), Peltonen, M. (Markku), Sindi, S. (Shireen), Soininen, H. (Hilkka), Neely, A. S. (Anna Stigsdotter), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), and Mangialasche, F. (Francesca)
- Abstract
Introduction: Lifetime exposure to occupational complexity is linked to late-life cognition, and may affect benefits of preventive interventions. Methods: In the 2-year multidomain Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), we investigated, through post hoc analyses (N = 1026), the association of occupational complexity with cognition. Occupational complexity with data, people, and substantive complexity were classified through the Dictionary of Occupational Titles. Results: Higher levels of occupational complexity were associated with better baseline cognition. Measures of occupational complexity had no association with intervention effects on cognition, except for occupational complexity with data, which was associated with the degree of intervention-related gains for executive function. Discussion: In older adults at increased risk for dementia, higher occupational complexity is associated with better cognition. The cognitive benefit of the FINGER intervention did not vary significantly among participants with different levels of occupational complexity. These exploratory findings require further testing in larger studies.
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- 2022
5. Associations of depressive symptoms and cognition in the FINGER trial:a secondary analysis of a randomised clinical trial
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Neuvonen, E. (Elisa), Lehtisalo, J. (Jenni), Ngandu, T. (Tiia), Levälahti, E. (Esko), Antikainen, R. (Riitta), Hänninen, T. (Tuomo), Laatikainen, T. (Tiina), Lindström, J. (Jaana), Paajanen, T. (Teemu), Soininen, H. (Hilkka), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), Solomon, A. (Alina), Neuvonen, E. (Elisa), Lehtisalo, J. (Jenni), Ngandu, T. (Tiia), Levälahti, E. (Esko), Antikainen, R. (Riitta), Hänninen, T. (Tuomo), Laatikainen, T. (Tiina), Lindström, J. (Jaana), Paajanen, T. (Teemu), Soininen, H. (Hilkka), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), and Solomon, A. (Alina)
- Abstract
Depression and cognition are associated, but the role of depressive symptoms in lifestyle interventions to prevent dementia needs further study. We investigated the intervention effect on depressive symptoms and their associations with cognition in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER; NCT01041989), a two-year multidomain lifestyle trial. One thousand two-hundred and sixty individuals (60–77 years) at risk for dementia were randomised into a multidomain intervention (diet, exercise, cognitive training, and vascular/metabolic risk monitoring) or control group (regular health advice). Depressive symptoms (Zung scale) and cognition (modified Neuropsychological Test Battery) were evaluated at baseline, 12, and 24 months. One thousand one-hundred and twenty-five participants had baseline Zung data. Mean Zung score decreased 0.73 (SD 5.6) points in the intervention and 0.36 (5.6) points in the control group, with nonsignificant between-group difference (group × time coefficient −0.006, 95% CI −0.019 to 0.007). Overall, higher baseline Zung score was associated with less improvement in global cognition (−0.140, p = 0.005) and memory (−0.231, p = 0.005). Participants with clinically significant baseline depressive symptoms (Zung ≥ 40 points) had less intervention benefit to executive functioning (group × time × Zung −0.096, 95% CI −0.163 to −0.028). Change in Zung score was not associated with change in cognition. Clinically significant depressive symptoms warrant more attention when designing dementia-prevention interventions.
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- 2022
6. Telomere length change in a multidomain lifestyle intervention to prevent cognitive decline:a randomized clinical trial
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Sindi, S. (Shireen), Solomon, A. (Alina), Kåreholt, I. (Ingemar), Hovatta, I. (Iiris), Antikainen, R. (Riitta), Hänninen, T. (Tuomo), Levälahti, E. (Esko), Laatikainen, T. (Tiina), Lehtisalo, J. (Jenni), Lindström, J. (Jaana), Paajanen, T. (Teemu), Peltonen, M. (Markku), Singh Khalsa, D. (Dharma), Wolozin, B. (Benjamin), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Soininen, H. (Hilkka), Ngandu, T. (Tiia), Kivipelto, M. (Miia), and F. S. (FINGER Study Group)
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behavioural intervention ,dementia prevention ,telomeres ,older adults - 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
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- 2021
7. Step Count Associations between Adults at Risk of Developing Diabetes and Their Children: The Feel4Diabetes Study
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Flores-Barrantes, P. Cardon, G. Iglesia, I. Moreno, L.A. Androutsos, O. Manios, Y. Kivelä, J. Lindström, J. De Craemer, M. Schwarz, P. Makrilakis, K. Annemans, L. Ko, W. Karatzi, K. Moschonis, G. Kanellakis, S. Mavrogianni, C. Tsoutsoulopoulou, K. Katsarou, C. Karaglani, E. Qira, I. Skoufas, E. Maragkopoulou, K. Tsiafitsa, A. Sotiropoulou, I. Tsolakos, M. Argyri, E. Nikolaou, M. Vampouli, E.-A. Filippou, C. Apergi, K. Filippou, A. Katerina, G. Dimitriadis, E. Laatikainen, T. Wikström, K. Valve, P. Levälahti, E. Virtanen, E. Pennanen, T. Olli, S. Nelimarkka, K. Van Stappen, V. Huys, N. Willems, R. Shadid, S. Timpel, P. Liatis, S. Dafoulas, G. Lambrinou, C.-P. Giannopoulou, A. Karuranga, E. Civeira, F. Bueno, G. De Miguel-Etayo, P. González-Gil, E.M. Miguel-Berges, M.L. Giménez-Legarre, N. Ayala-Marín, A.M. Seral-Cortés, M. Baila-Rueda, L. Cenarro, A. Jarauta, E. Mateo-Gallego, R. Iotova, V. Tankova, T. Usheva, N. Tsochev, K. Chakarova, N. Galcheva, S. Dimova, R. Bocheva, Y. Radkova, Z. Marinova, V. Bazdarska, Y. Stefanova, T. Rurik, I. Ungvari, T. Jancsó, Z. Nánási, A. Kolozsvári, L. Semánova, C. Bíró, É. Antal, E. Radó, S. Martinez, R. Tong, M. Feel4Diabetes Study Group
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education - Abstract
Background: Shared risk factors of type 2 diabetes mellitus (T2DM) between parents at risk and their children, such as low physical activity levels, should be addressed to prevent the development of the disease. The aim of this study was to determine the association of objectively measured step counts per day between parents at risk of developing T2DM and their 6- to 10-year-old children. Methods: The baseline data from the Feel4Diabetes study were analyzed. Dyads of children and one parent (n = 250, 54.4% girls and 77.6% mothers) from Belgium were included. Step counts per day during 5 consecutive days from parents and their children were objectively measured with ActiGraph accelerometers. Results: Adjusted linear regression models indicated that parents’ and children’s step counts were significantly associated during all days (β = 0.245), weekdays (β = 0.205), and weekend days (β = 0.316) (P ≤ .002 in all cases). Specifically, mother–daughter associations during all days and weekend days and father–son step counts during weekdays and when considering all days were significant. Conclusion: There is a positive association between step counts from adults at risk of developing T2DM and their children, especially in the mother–daughter and father–son dyads. © 2021 Human Kinetics, Inc.
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- 2021
8. Effect of a multidomain lifestyle intervention on estimated dementia risk
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Solomon, A. (Alina), Handels, R. (Ron), Wimo, A. (Anders), Antikainen, R. (Riitta), Laatikainen, T. (Tiina), Levälahti, E. (Esko), Peltonen, M. (Markku), Soininen, H. (Hilkka), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), Ngandu, T. (Tiia), Solomon, A. (Alina), Handels, R. (Ron), Wimo, A. (Anders), Antikainen, R. (Riitta), Laatikainen, T. (Tiina), Levälahti, E. (Esko), Peltonen, M. (Markku), Soininen, H. (Hilkka), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), and Ngandu, T. (Tiia)
- Abstract
We investigated the effect of a multidomain lifestyle intervention on the risk of dementia estimated using the validated CAIDE risk score (post-hoc analysis). The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) is a 2-year randomized controlled trial among 1,260 at-risk older adults (60–77 years). Difference in the estimated mean change in CAIDE score at 2 years in the intervention compared to the control group was –0.16 (95 %CI –0.31 to 0.00) (p = 0.013), corresponding to a relative dementia risk reduction between 6.04–6.50%. This could be interpreted as a reflection of the prevention potential of the intervention.
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- 2021
9. Feel4Diabetes healthy diet score: Development and evaluation of clinical validity
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Virtanen, E. Kivelä, J. Wikström, K. Lambrinou, C.-P. De Miguel-Etayo, P. Huys, N. Vraukó-Tóth, K. Moreno, L.A. Usheva, N. Chakarova, N. Rado, S.A. Iotova, V. Makrilakis, K. Cardon, G. Liatis, S. Manios, Y. Lindström, J. Manios, Y. Cardon, G. Lindström, J. Schwarz, P. Makrilakis, K. Annemans, L. Garamendi, I. Karatzi, K. Androutsos, O. Moschonis, G. Kanellakis, S. Mavrogianni, C. Tsoutsoulopoulou, K. Katsarou, C. Karaglani, E. Qira, I. Skoufas, E. Maragkopoulou, K. Tsiafitsa, A. Sotiropoulou, I. Tsolakos, M. Argyri, E. Nikolaou, M. Vampouli, E.-A. Filippou, C. Apergi, K. Filippou, A. Katerina, G. Dimitriadis, E. Laatikainen, T. Wikström, K. Kivelä, J. Valve, P. Levälahti, E. Virtanen, E. Pennanen, T. Olli, S. Nelimarkka, K. Van Stappen, V. Huys, N. Willems, R. Shadid, S. Timpel, P. Liatis, S. Dafoulas, G. Lambrinou, C.-P. Giannopoulou, A. Rabemananjara, L. De Sabata, M.S. Ko, W. Civeira, F. Bueno, G. De Miguel-Etayo, P. Gonzalez-Gil, E.Mª. Miguel-Berges, M.L. Giménez-Legarre, N. Flores-Barrantes, P. Ayala-Marín, A.M. Seral-Cortés, M. Baila-Rueda, L. Cenarro, A. Jarauta, E. Mateo-Gallego, R. Iotova, V. Tankova, T. Usheva, N. Tsochev, K. Chakarova, N. Galcheva, S. Dimova, R. Bocheva, Y. Radkova, Z. Marinova, V. Bazdarska, Y. Stefanova, T. Rurik, I. Ungvari, T. Jancsó, Z. Nánási, A. Kolozsvári, L. Semánova, C. Bíró, É. Antal, E. Radó, S. Martinez, R. Tong, M. Feel4Diabetes research group
- Abstract
Background: The aim of this paper is to present the development of the Feel4Diabetes Healthy Diet Score and to evaluate its clinical validity. Methods: Study population consisted of 3268 adults (63% women) from high diabetes risk families living in 6 European countries. Participants filled in questionnaires at baseline and after 1 year, reflecting the dietary goals of the Feel4Diabetes intervention. Based on these questions the Healthy Diet Score was constructed, consisting of the following components: breakfast, vegetables, fruit and berries, sugary drinks, whole-grain cereals, nuts and seeds, low-fat dairy products, oils and fats, red meat, sweet snacks, salty snacks, and family meals. Maximum score for each component was set based on its estimated relative importance regarding T2DM risk, higher score indicating better quality of diet. Clinical measurements included height, weight, waist circumference, heart rate, blood pressure, and fasting blood sampling, with analyses of glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides. Analysis of (co) variance was used to compare the Healthy Diet Score and its components between countries and sexes using baseline data, and to test differences in clinical characteristics between score categories, adjusted for age, sex and country. Pearson's correlations were used to study the association between changes from baseline to year 1 in the Healthy Diet Score and clinical markers. To estimate reproducibility, Pearson's correlations were studied between baseline and 1 year score, within the control group only. Results: The mean total score was 52.8 ± 12.8 among women and 46.6 ± 12.8 among men (p < 0.001). The total score and its components differed between countries. The change in the Healthy Diet Score was significantly correlated with changes in BMI, waist circumference, and total and LDL cholesterol. The Healthy Diet Score as well as its components at baseline were significantly correlated with the values at year 1, in the control group participants. Conclusion: The Feel4Diabetes Healthy Diet Score is a reproducible method to capture the dietary information collected with the Feel4Diabetes questionnaire and measure the level of and changes in the adherence to the dietary goals of the intervention. It gives a simple parameter that associates with clinical risk factors in a meaningful manner. Trial registration: Clinicaltrials.gov NCT02393872. Registered March 20, 2015. © 2020 The Author(s).
- Published
- 2020
10. Feel4Diabetes healthy diet score: Development and evaluation of clinical validity
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Virtanen, E., Kivelä, J., Wikström, K., Lambrinou, C.P., De Miguel-Etayo, P., Huys, N., Vraukó-Tóth, K., Moreno, L.A., Usheva, N., Chakarova, N., Rado, S.A., Iotova, V., Makrilakis, K., Cardon, G., Liatis, S., Manios, Y., Lindström, J., Schwarz, P., Annemans, L., Garamendi, I., Karatzi, K., Androutsos, O., Moschonis, G., Kanellakis, S., Mavrogianni, C., Tsoutsoulopoulou, K., Katsarou, C., Karaglani, E., Qira, I., Skoufas, E., Maragkopoulou, K., Tsiafitsa, A., Sotiropoulou, I., Tsolakos, M., Argyri, E., Nikolaou, M., Vampouli, E.A., Filippou, C., Apergi, K., Filippou, A., Katerina, G., Dimitriadis, E., Laatikainen, T., Valve, P., Levälahti, E., Pennanen, T., Olli, S., Nelimarkka, K., Van Stappen, V., Willems, R., Shadid, S., Timpel, P., Dafoulas, G., Giannopoulou, A., Rabemananjara, L., De Sabata, M.S., Ko, W., Moreno, L., Civeira, F., Bueno, G., Gonzalez-Gil, E.Mª., Miguel-Berges, M.L., Giménez-Legarre, N., Flores-Barrantes, P., Ayala-Marín, A.M., Seral-Cortés, M., Baila-Rueda, L., Cenarro, A., Jarauta, E., Mateo-Gallego, R., Tankova, T., Tsochev, K., Galcheva, S., Dimova, R., Bocheva, Y., Radkova, Z., Marinova, V., Bazdarska, Y., Stefanova, T., Rurik, I., Ungvari, T., Jancsó, Z., Nánási, A., Kolozsvári, L., Semánova, C., Bíró, É., Antal, E., Radó, S., Martinez, R., Tong, M., and Feel4Diabetes, research, group
- Abstract
Background: The aim of this paper is to present the development of the Feel4Diabetes Healthy Diet Score and to evaluate its clinical validity. Methods: Study population consisted of 3268 adults (63% women) from high diabetes risk families living in 6 European countries. Participants filled in questionnaires at baseline and after 1 year, reflecting the dietary goals of the Feel4Diabetes intervention. Based on these questions the Healthy Diet Score was constructed, consisting of the following components: breakfast, vegetables, fruit and berries, sugary drinks, whole-grain cereals, nuts and seeds, low-fat dairy products, oils and fats, red meat, sweet snacks, salty snacks, and family meals. Maximum score for each component was set based on its estimated relative importance regarding T2DM risk, higher score indicating better quality of diet. Clinical measurements included height, weight, waist circumference, heart rate, blood pressure, and fasting blood sampling, with analyses of glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides. Analysis of (co) variance was used to compare the Healthy Diet Score and its components between countries and sexes using baseline data, and to test differences in clinical characteristics between score categories, adjusted for age, sex and country. Pearson''s correlations were used to study the association between changes from baseline to year 1 in the Healthy Diet Score and clinical markers. To estimate reproducibility, Pearson''s correlations were studied between baseline and 1 year score, within the control group only. Results: The mean total score was 52.8 ± 12.8 among women and 46.6 ± 12.8 among men (p < 0.001). The total score and its components differed between countries. The change in the Healthy Diet Score was significantly correlated with changes in BMI, waist circumference, and total and LDL cholesterol. The Healthy Diet Score as well as its components at baseline were significantly correlated with the values at year 1, in the control group participants. Conclusion: The Feel4Diabetes Healthy Diet Score is a reproducible method to capture the dietary information collected with the Feel4Diabetes questionnaire and measure the level of and changes in the adherence to the dietary goals of the intervention. It gives a simple parameter that associates with clinical risk factors in a meaningful manner.
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- 2020
11. Effective strategies for childhood obesity prevention via school based, family involved interventions: A critical review for the development of the Feel4Diabetes-study school based component
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Lambrinou, C.-P. Androutsos, O. Karaglani, E. Cardon, G. Huys, N. Wikström, K. Kivelä, J. Ko, W. Karuranga, E. Tsochev, K. Iotova, V. Dimova, R. De Miguel-Etayo, P. M. González-Gil, E. Tamás, H. Jancsó, Z. Liatis, S. Makrilakis, K. Manios, Y. Cardon, G. Lindström, J. Schwarz, P. Makrilakis, K. Annemans, L. Garamendi, I. Karatzi, K. Androutsos, O. Moschonis, G. Kanellakis, S. Mavrogianni, C. Tsoutsoulopoulou, K. Katsarou, C. Karaglani, E. Qira, I. Skoufas, E. Maragkopoulou, K. Tsiafitsa, A. Sotiropoulou, I. Tsolakos, M. Argyri, E. Nikolaou, M. Vampouli, E.-A. Filippou, C. Apergi, K. Filippou, A. Katerina, G. Dimitriadis, E. Lindström, J. Laatikainen, T. Wikström, K. Hovi, P. Kivelä, J. Valve, P. Levälahti, E. Virtanen, E. Cardon, G. Van Stappen, V. Huys, N. Annemans, L. Willems, R. Shadid, S. Schwarz, P. Timpel, P. Makrilakis, K. Liatis, S. Dafoulas, G. Lambrinou, C.-P. Giannopoulou, A. Rabemananjara, L. De Sabata, M.S. Ko, W. Garamendi, I. Moreno, L. Civeira, F. Bueno, G. De Miguel-Etayo, P. Gonzalez-Gil, E.Mª. Miguel-Berges, M.L. Giménez-Legarre, N. Flores-Barrantes, P. Ayala-Marín, A.M. Seral-Cortés, M. Baila-Rueda, L. Cenarro, A. Jarauta, E. Mateo-Gallego, R. Iotova, V. Tankova, T. Usheva, N. Tsochev, K. Chakarova, N. Galcheva, S. Dimova, R. Bocheva, Y. Radkova, Z. Marinova, V. Bazdarska, Y. Stefanova, T. Rurik, I. Ungvari, T. Jancsó, Z. Nánási, A. Kolozsvári, L. Semánova, C. Bíró, É. Antal, E. Radó, S. Martinez, R. Tong, M.
- Abstract
Background: Although there are many interventions targeting childhood obesity prevention, only few have demonstrated positive results. The current review aimed to gather and evaluate available school-based intervention studies with family involvement targeting dietary, physical activity and sedentary behaviors among primary schoolchildren and their families, in order to identify the most effective strategies. Methods: Studies published between 2000 and January 2015 were retrieved from scientific electronic databases and grey literature. The databases used included MEDLINE/PubMed, Web-of-Science, CINAHL and Scopus. Included studies had to be experimental controlled studies and had duration over 1 school year, had family involvement, combined PA and dietary behaviors and were implemented in school setting. A complementary search was executed to update the review to cover the period from February 2015 to January 2019. Results: From the studies examined (n = 425), 27 intervention programs (33 publications) fulfilled the inclusion criteria. Among these, 15 presented significant effect on weight status and/ or overweight/ obesity or clinical indices, 3 presented significant effect on most energy balance-related behaviors (EBRBs) while 9 presented significant effect on some/few EBRBs or determinants. Strategies implemented in effective interventions were: teachers acting as role-models and being actively involved in the delivery of the intervention, school policies supporting the availability of healthy food and beverage choices and limiting unhealthy snacks, changes in the schoolyard, in the recess rules and in the physical education classes to increase physical activity, and involving parents in the intervention via assignments, meetings, informative material and encouraging them to improve the home environment. Use of incentives for children, social marketing techniques, collaboration with local stakeholders were found to increase effectiveness. Programs that focused only on educational sessions and material for parents, without promoting relevant environmental and policy changes, were found to be less effective. Cultural adaptations have been suggested to increase the intervention's acceptance in specific or vulnerable population groups. Conclusions: Several effective strategies were identified in the reviewed programs. Outcomes of the current review were taken into account in developing the Feel4Diabetes-intervention and summed up as recommendations in the current work in order to facilitate other researchers designing similar childhood obesity prevention initiatives. © 2020 The Author(s).
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- 2020
12. White matter changes on diffusion tensor imaging in the FINGER randomized controlled trial
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Stephen, R. (Ruth), Solomon, A. (Alina), Ngandu, T. (Tiia), Levälahti, E. (Esko), Rinne, J. O. (Juha O.), Kemppainen, N. (Nina), Parkkola, R. (Riitta), Antikainen, R. (Riitta), Strandberg, T. (Timo), Kivipelto, M. (Miia), Soininen, H. (Hilkka), Liu, Y. (Yawu), Stephen, R. (Ruth), Solomon, A. (Alina), Ngandu, T. (Tiia), Levälahti, E. (Esko), Rinne, J. O. (Juha O.), Kemppainen, N. (Nina), Parkkola, R. (Riitta), Antikainen, R. (Riitta), Strandberg, T. (Timo), Kivipelto, M. (Miia), Soininen, H. (Hilkka), and Liu, Y. (Yawu)
- Abstract
Background: Early pathological changes in white matter microstructure can be studied using the diffusion tensor imaging (DTI). It is not only important to study these subtle pathological changes leading to cognitive decline, but also to ascertain how an intervention would impact the white matter microstructure and cognition in persons at-risk of dementia. Objectives: To study the impact of a multidomain lifestyle intervention on white matter and cognitive changes during the 2-year Finnish Geriatric Intervention Study to prevent Cognitive Impairment and Disability (FINGER), a randomized controlled trial in at-risk older individuals (age 60–77 years) from the general population. Methods: This exploratory study consisted of a subsample of 60 FINGER participants. Participants were randomized to either a multidomain intervention (diet, exercise, cognitive training, and vascular risk management, n = 34) or control group (general health advice, n = 26). All underwent baseline and 2-year brain DTI. Changes in fractional anisotropy (FA), diffusivity along domain (F1) and non-domain (F2) diffusion orientations, mean diffusivity (MD), axial diffusivity (AxD), radial diffusivity (RD), and their correlations with cognitive changes during the 2-year multidomain intervention were analyzed. Results: FA decreased, and cognition improved more in the intervention group compared to the control group (p < 0.05), with no significant intergroup differences for changes in F1, F2, MD, AxD, or RD. The cognitive changes were significantly positively related to FA change, and negatively related to RD change in the control group, but not in the intervention group. Conclusion: The 2-year multidomain FINGER intervention may modulate white matter microstructural alterations.
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- 2020
13. The effect of multidomain lifestyle intervention on daily functioning in older people
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Kulmala, J. (Jenni), Ngandu, T. (Tiia), Havulinna, S. (Satu), Levälahti, E. (Esko), Lehtisalo, J. (Jenni), Solomon, A. (Alina), Antikainen, R. (Riitta), Laatikainen, T. (Tiina), Pippola, P. (Pauliina), Peltonen, M. (Markku), Rauramaa, R. (Rainer), Soininen, H. (Hilkka), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), Kulmala, J. (Jenni), Ngandu, T. (Tiia), Havulinna, S. (Satu), Levälahti, E. (Esko), Lehtisalo, J. (Jenni), Solomon, A. (Alina), Antikainen, R. (Riitta), Laatikainen, T. (Tiina), Pippola, P. (Pauliina), Peltonen, M. (Markku), Rauramaa, R. (Rainer), Soininen, H. (Hilkka), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), and Kivipelto, M. (Miia)
- 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. Conclusions: 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
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- 2019
14. Brain volumes and cortical thickness on MRI in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER)
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Stephen, R. (Ruth), Liu, Y. (Yawu), Ngandu, T. (Tiia), Antikainen, R. (Riitta), Hulkkonen, J. (Juha), Koikkalainen, J. (Juha), Kemppainen, N. (Nina), Lötjönen, J. (Jyrki), Levälahti, E. (Esko), Parkkola, R. (Riitta), Pippola, P. (Pauliina), Rinne, J. (Juha), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Vanninen, R. (Ritva), Kivipelto, M. (Miia), Soininen, H. (Hilkka), Solomon, A. (Alina), f. t. (for the FINGER study group), Stephen, R. (Ruth), Liu, Y. (Yawu), Ngandu, T. (Tiia), Antikainen, R. (Riitta), Hulkkonen, J. (Juha), Koikkalainen, J. (Juha), Kemppainen, N. (Nina), Lötjönen, J. (Jyrki), Levälahti, E. (Esko), Parkkola, R. (Riitta), Pippola, P. (Pauliina), Rinne, J. (Juha), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Vanninen, R. (Ritva), Kivipelto, M. (Miia), Soininen, H. (Hilkka), Solomon, A. (Alina), and f. t. (for the FINGER study group)
- Abstract
Background: The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) was a multicenter randomized controlled trial that reported beneficial effects on cognition for a 2-year multimodal intervention (diet, exercise, cognitive training, vascular risk monitoring) versus control (general health advice). This study reports exploratory analyses of brain MRI measures. Methods: FINGER targeted 1260 older individuals from the general Finnish population. Participants were 60–77 years old, at increased risk for dementia but without dementia/substantial cognitive impairment. Brain MRI scans were available for 132 participants (68 intervention, 64 control) at baseline and 112 participants (59 intervention, 53 control) at 2 years. MRI measures included regional brain volumes, cortical thickness, and white matter lesion (WML) volume. Cognition was assessed at baseline and 1- and 2-year visits using a comprehensive neuropsychological test battery. We investigated the (1) differences between the intervention and control groups in change in MRI outcomes (FreeSurfer 5.3) and (2) post hoc sub-group analyses of intervention effects on cognition in participants with more versus less pronounced structural brain changes at baseline (mixed-effects regression models, Stata 12). Results: No significant differences between the intervention and control groups were found on the changes in MRI measures. Beneficial intervention effects on processing speed were more pronounced in individuals with higher baseline cortical thickness in Alzheimer’s disease signature areas (composite measure of entorhinal, inferior and middle temporal, and fusiform regions). The randomization group × time × cortical thickness interaction coefficient was 0.198 (p = 0.021). A similar trend was observed for higher hippocampal volume (group × time × hippocampus volume interaction coefficient 0.1149, p = 0.085). Conclusions: The FINGER MRI exploratory sub-study did not show s
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- 2019
15. Dietary changes and cognition over 2 years within a multidomain intervention trial:the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER)
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Lehtisalo, J. (Jenni), Levälahti, E. (Esko), Lindström, J. (Jaana), Hänninen, T. (Tuomo), Paajanen, T. (Teemu), Peltonen, M. (Markku), Antikainen, R. (Riitta), Laatikainen, T. (Tiina), Strandberg, T. (Timo), Soininen, H. (Hilkka), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), Ngandu, T. (Tiia), Lehtisalo, J. (Jenni), Levälahti, E. (Esko), Lindström, J. (Jaana), Hänninen, T. (Tuomo), Paajanen, T. (Teemu), Peltonen, M. (Markku), Antikainen, R. (Riitta), Laatikainen, T. (Tiina), Strandberg, T. (Timo), Soininen, H. (Hilkka), Tuomilehto, J. (Jaakko), Kivipelto, M. (Miia), and Ngandu, T. (Tiia)
- Abstract
Introduction: Association between healthy diet and better cognition is well established, but evidence is limited to evaluate the effect of dietary changes adopted in older age. Methods: We investigated the role of dietary changes in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) with 1260 at-risk participants (60–77 years) who were randomized to intensive multidomain intervention (including dietary counseling) or regular health advice for 2 years. Parallel process latent growth curves of adherence to dietary recommendations and cognitive performance were analyzed. Results: Adherence to healthy diet at baseline predicted improvement in global cognition, regardless of intervention allocation (P = .003). Dietary improvement was associated with beneficial changes in executive function, especially in the intervention group (P = .008; P = .051 for groups combined). Discussion: Dietary changes initiated during the intervention were related to changes in executive function in 2 years. Long-term diet appeared more influential for global cognition.
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- 2019
16. THE ROLE OF GENETIC AND ENVIRONMENTAL INFLUENCES ON HEART RATE VARIABILITY
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Uusitalo, A L.T., Vanninen, E, Levälahti, E, Battié, M C., Videman, T, and Kaprio, J
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- 2002
17. Repeatability of lifetime exercise reporting
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Ropponen, A., Levälahti, E., Simonen, R., Videman, T., and Battié, M. C.
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- 2001
18. Multidomain lifestyle intervention benefits a large elderly population at risk for cognitive decline and dementia regardless of baseline characteristics:the FINGER trial
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Rosenberg, A. (Anna), Ngandu, T. (Tiia), Rusanen, M. (Minna), Antikainen, R. (Riitta), Bäckman, L. (Lars), Havulinna, S. (Satu), Hänninen, T. (Tuomo), Laatikainen, T. (Tiina), Lehtisalo, J. (Jenni), Levälahti, E. (Esko), Lindström, J. (Jaana), Paajanen, T. (Teemu), Peltonen, M. (Markku), Soininen, H. (Hilkka), Stigsdotter-Neely, A. (Anna), Strandberg, T. (Timo), Tuomilehto, J. (Jaakko), Solomon, A. (Alina), and Kivipelto, M. (Miia)
- Subjects
Cognitive impairment ,Randomized controlled trial ,Prevention ,Dementia ,Intervention ,Alzheimer's disease ,Lifestyle ,Multidomain - 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.
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- 2018
19. Tilastotietoa lasten ylipainoisuuden yleisyydestä saatavilla yhä useammasta kunnasta [Data on prevalence of overweight among Finnish children available in an increasing number of municipalities through the Avohilmo Register]
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Mäki, P., Lehtinen-Jacks, Susanna, Vuorela, N., Levälahti, E., Koskela, T., Saari, A., Mölläri, K., Mahkonen, R., Salo, J., Laatikainen, T., Mäki, P., Lehtinen-Jacks, Susanna, Vuorela, N., Levälahti, E., Koskela, T., Saari, A., Mölläri, K., Mahkonen, R., Salo, J., and Laatikainen, T.
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- 2018
20. Baseline telomere length and effects of a multidomain lifestyle intervention on cognition : The FINGER randomized controlled trial
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Sindi, S., Ngandu, T., Hovatta, I., Kåreholt, Ingemar, Antikainen, R., Hänninen, T., Levälahti, E., Laatikainend, T., Lindström, J., Paajanen, T., Peltonen, M., Khalsa, D. S., Wolozin, B., Strandberg, T., Tuomilehto, J., Soininen, H., Kivipelto, M., Solomon, A., Sindi, S., Ngandu, T., Hovatta, I., Kåreholt, Ingemar, Antikainen, R., Hänninen, T., Levälahti, E., Laatikainend, T., Lindström, J., Paajanen, T., Peltonen, M., Khalsa, D. S., Wolozin, B., Strandberg, T., Tuomilehto, J., Soininen, H., Kivipelto, M., and Solomon, A.
- Abstract
Leukocyte telomere length (LTL) is a biomarker of aging, and it is associated with lifestyle. It is currently unknown whether LTL is associated with the response to lifestyle interventions. The goal is to assess whether baseline LTL modified the cognitive benefits of a 2-year multidomain lifestyle intervention (exploratory analyses). The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) was a 2-year randomized controlled trial including 1,260 people at risk of cognitive decline, aged 60-77 years identified from the general population. Participants were randomly assigned to the lifestyle intervention (diet, exercise, cognitive training, and vascular risk management) and control (general health advice) groups. Primary outcome was change in cognition (comprehensive neuropsychological test battery). Secondary outcomes were changes in cognitive domains: Memory, executive functioning, and processing speed. 775 participants (392 control, 383 intervention) had baseline LTL (peripheral blood DNA). Mixed effects regression models with maximum likelihood estimation were used to analyze change in cognition as a function of randomization group, time, baseline LTL, and their interaction. Intervention and control groups did not significantly differ at baseline. Shorter LTL was related to less healthy baseline lifestyle. Intervention benefits on executive functioning were more pronounced among those with shorter baseline LTL (p-value for interaction was 0.010 adjusted for age and sex, and 0.007 additionally adjusted for baseline lifestyle factors). The FINGER intervention cognitive benefits were more pronounced with shorter baseline LTL, particularly for executive functioning, indicating that the multidomain lifestyle intervention was especially beneficial among higher-risk individuals.
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- 2017
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21. Health-related quality of life in a multidomain intervention trial to prevent cognitive decline (FINGER)
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Strandberg, T. E., Levälahti, E., Ngandu, T., Solomon, A., Kivipelto, M., Strandberg, T. E., Levälahti, E., Ngandu, T., Solomon, A., and Kivipelto, M.
- Abstract
Introduction: The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) successfully demonstrated that multidomain lifestyle intervention can improve or maintain cognitive functioning in at-risk individuals. Health-related quality of life (HRQoL) was a secondary endpoint. Methods: The intervention (n = 631) aimed at healthy diet, increased physical activity, cognitive training, and vascular risk management. The control group (n = 629) was given general health advice. HRQoL was assessed at baseline, 12, and 24 months using validated RAND-36 (SF-36) instrument with 8 scales. Results: During the 2-year intervention period, mean scores in all scales decreased in the control group, but increased in the intervention group for vitality (12 months), social function (12 months), and especially general health at both 12 and 24 months. There was a statistically significant beneficial effect of intervention on the change in general health and physical function at 12 and 24 months. Conclusion: Multidomain lifestyle intervention improved also important dimensions of HRQoL., For the FINGER Study Group.
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- 2017
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22. Neonatal nutrition predicts energy balance in young adults born preterm at very low birth weight
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Matinolli, H.-M. (Hanna-Maria), Hovi, P. (Petteri), Levälahti, E. (Esko), Kaseva, N. (Nina), Silveira, P. P. (Patricia P.), Hemiö, K. (Katri), Järvenpää, A.-L. (Anna-Liisa), Eriksson, J. G. (Johan G.), Andersson, S. (Sture), Lindström, J. (Jaana), Männistö, S. (Satu), Kajantie, E. (Eero), Matinolli, H.-M. (Hanna-Maria), Hovi, P. (Petteri), Levälahti, E. (Esko), Kaseva, N. (Nina), Silveira, P. P. (Patricia P.), Hemiö, K. (Katri), Järvenpää, A.-L. (Anna-Liisa), Eriksson, J. G. (Johan G.), Andersson, S. (Sture), Lindström, J. (Jaana), Männistö, S. (Satu), and Kajantie, E. (Eero)
- Abstract
Epidemiological studies and animal models suggest that early postnatal nutrition and growth can influence adult health. However, few human studies have objective recordings of early nutrient intake. We studied whether nutrient intake and growth during the first 9 weeks after preterm birth with very low birth weight (VLBW, <1500 g) predict total energy intake, resting energy expenditure (REE), physical activity and food preferences in young adulthood. We collected daily nutritional intakes and weights during the initial hospital stay from hospital records for 127 unimpaired VLBW participants. At an average age 22.5 years, they completed a three-day food record and a physical activity questionnaire and underwent measurements of body composition (dual X-ray absorptiometry; n = 115 with adequate data) and REE (n = 92 with adequate data). We used linear regression and path analysis to investigate associations between neonatal nutrient intake and adult outcomes. Higher energy, protein and fat intakes during the first three weeks of life predicted lower relative (=per unit lean body mass) energy intake and relative REE in adulthood, independent of other pre- and neonatal factors. In path analysis, total effects of early nutrition and growth on relative energy intake were mostly explained by direct effects of early life nutrition. A path mediated by early growth reached statistical significance only for protein intake. There were no associations of neonatal intakes with physical activity or food preferences in adulthood. As a conclusion, higher intake of energy and nutrients during first three weeks of life of VLBW infants predicts energy balance after 20 years. This association is partly mediated through postnatal growth.
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- 2017
23. Avohilmo-rekisteri tietolähteenä valtakunnallisessa lasten ylipainon yleisyyden seurannassa [Register of Primary Health Care Visits (Avohilmo) as data source for monitoring the prevalence of overweight among Finnish children]
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Mäki, P., Lehtinen-Jacks, Susanna, Levälahti, E., Koskela, T., Saari, A., Mölläri, K., Mahkonen, R., Salo, J., Laatikainen, T., Mäki, P., Lehtinen-Jacks, Susanna, Levälahti, E., Koskela, T., Saari, A., Mölläri, K., Mahkonen, R., Salo, J., and Laatikainen, T.
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- 2017
24. Register of primary health care visits (avohilmo) as data source for monitoring the prevalence of overweight among Finnish children
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Mäki, P., Lehtinen-Jacks, Susanna, Vuorela, N., Levälahti, E., Koskela, T., Saari, A., Mölleri, K., Mahkonen, R., Salo, J., Laatikainen, T., Mäki, P., Lehtinen-Jacks, Susanna, Vuorela, N., Levälahti, E., Koskela, T., Saari, A., Mölleri, K., Mahkonen, R., Salo, J., and Laatikainen, T.
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- 2017
25. Health-related quality of life in a multidomain intervention trial to prevent cognitive decline (FINGER)
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Strandberg, T.E., primary, Levälahti, E., additional, Ngandu, T., additional, Solomon, A., additional, Kivipelto, M., additional, Lehtisalo, J., additional, Laatikainen, T., additional, Soininen, H., additional, Strandberg, T., additional, Antikainen, R., additional, Jula, A., additional, Tuomilehto, J., additional, Peltonen, M., additional, Lindström, J., additional, Rauramaa, R., additional, Pajala, S., additional, Hänninen, T., additional, Paajanen, T., additional, and Mangialasche, F., additional
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- 2017
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26. P110: Walking difficulties predict mortality among Finnish war veterans. Results from the Veteran Project 1992 survey
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Leskinen, R., primary, Laatikainen, T., additional, Levälahti, E., additional, Peltonen, M., additional, and Antikainen, R.L., additional
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- 2014
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27. Maternal and paternal education is both directly and through the parent’s own BMI indirectly associated with overweight in children.
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Mäki, P., Parikka, S., Levälahti, E., Lehtinen-Jacks, Susanna, Martelin, T., Laatikainen, T., Mäki, P., Parikka, S., Levälahti, E., Lehtinen-Jacks, Susanna, Martelin, T., and Laatikainen, T.
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- 2013
28. Externalizing Behaviors and Cigarette Smoking as Predictors for Use of Illicit Drugs: A Longitudinal Study Among Finnish Adolescent Twins
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Korhonen, T., Levälahti, E., Dick, D.M., Pulkkinen, L., Rose, R.J., Kaprio, J., Huizink, A.C., Korhonen, T., Levälahti, E., Dick, D.M., Pulkkinen, L., Rose, R.J., Kaprio, J., and Huizink, A.C.
- Abstract
Item does not contain fulltext, We examined whether externalizing problem behaviors (hyperactivity-impulsivity, aggressiveness, and inattention) predict illicit drug use independently, or whether their associations with drug use are mediated through cigarette smoking. We used a prospective longitudinal design within the FinnTwin12-17 study among Finnish adolescents with baseline at age 12 and follow-up surveys at ages 14 and 17. Path models were conducted with Mplus and included 1992 boys and 2123 girls. The outcome was self-reported ever use of cannabis or other illicit drugs at age 17. The predictors were: externalizing behaviors (hyperactivity-impulsivity, aggressiveness, and inattention) assessed by teachers and parents (age 12) and self-reported cigarette smoking (age 14). The findings differed across behavior studied. The association of hyperactivity-impulsivity with drug use was mostly mediated through earlier cigarette smoking. Concerning aggressiveness and inattention, the results were different among girls than boys. Among girls no significant mediation occurred, whereas among boys more consistent evidence on mediation was seen. Consistently in all models, the direct association of early cigarette smoking on drug use was strong and highly significant. We conclude that the associations of externalizing problem behaviors with illicit drug use are partially mediated through cigarette smoking. Although interventions targeting externalizing problem behaviors may protect adolescents from early onset smoking and subsequently experimenting with drugs, interventions to prevent cigarette smoking initiation are also important in reducing risk of later drug use.
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- 2010
29. Tobacco, Cannabis, and Other Illicit Drug Use Among Finnish Adolescent Twins: Causal Relationship or Correlated Liabilities?
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Huizink, A.C., Levälahti, E., Korhonen, T., Dick, D.M., Rose, R.J., Kaprio, J., Huizink, A.C., Levälahti, E., Korhonen, T., Dick, D.M., Rose, R.J., and Kaprio, J.
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Contains fulltext : 90566.pdf (publisher's version ) (Open Access), Objective: Among Finnish adolescent twins, we compared (a) a model that describes a direct impact of liability to tobacco use on cannabis and other illicit drug use with (b) a model that included a shared underlying liability for these substances. Furthermore, the extent to which genetic and environmental influences contribute to the covariation between liabilities to use these substances was examined. Method: Tobacco and illicit drug use were assessed at age 17.5 years. Twin data on 3,744 individuals were analyzed using standard biometrical methods. Two alternative multivariate models were fit and compared with Mx, a statistical program for genetic model fitting. Results: The multivariate model, including a direct impact of the initiation of tobacco use on illicit drug use, provided the best fit to the data. In this model, the total variation in the initiation of illicit drugs was decomposed to genetic factors (32%), common environmental factors (20%), unique environmental factors (8%), and a component due to initiation of smoking (40%). Most variation in the progression of illicit drug use was the result of initiation of smoking and illicit drug use (83%). Conclusions: Liability to initiate smoking directly affects illicit drug use in our best-fitting model. Our findings suggest that several common genetic influences may be related to tobacco use and illicit drugs but that a search for specific genes underlying illicit drug use is justified as well. Such specific genes may hold a key to understanding biological vulnerabilities that lead to illicit drug use, which could aid in the development of targeted interventions.
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- 2010
30. Testing the gateway model in Finnish adolescent twins: Progression from cigarette smoking to cannabis use
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Huizink, A.C., Korhonen, T., Levälahti, E., Dick, D.M., Rose, Richard, Pulkkinen, L., Kaprio, J., Huizink, A.C., Korhonen, T., Levälahti, E., Dick, D.M., Rose, Richard, Pulkkinen, L., and Kaprio, J.
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- 2007
31. Evidence that BMI and type 2 diabetes share only a minor fraction of genetic variance: a follow-up study of 23,585 monozygotic and dizygotic twins from the Finnish Twin Cohort Study
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Lehtovirta, M., primary, Pietiläinen, K. H., additional, Levälahti, E., additional, Heikkilä, K., additional, Groop, L., additional, Silventoinen, K., additional, Koskenvuo, M., additional, and Kaprio, J., additional
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- 2010
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32. Role of genetic and environmental influences on heart rate variability in middle-aged men
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Uusitalo, A. L. T., primary, Vanninen, E., additional, Levälahti, E., additional, Battié, M. C., additional, Videman, T., additional, and Kaprio, J., additional
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- 2007
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33. Genetic and environmental effects on disc degeneration by phenotype and spinal level: a multivariate twin study.
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Battié MC, Videman T, Levälahti E, Gill K, and Kaprio J
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- 2008
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34. The effects of anthropometrics, lifting strength, and physical activities in disc degeneration.
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Videman T, Levälahti E, and Battié MC
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STUDY DESIGN: A cross-sectional study design was used. OBJECTIVE: The objective was to examine the influences of body anthropometrics, axial disc area, and lifting strength on disc degeneration and to compare these with the effects of lifetime physical demands and age. SUMMARY OF BACKGROUND DATA: Although recent studies have shown that heredity is a dominant factor in disc degeneration, the common notion that occupational physical loading is the major risk factor persists. However, substantial variations in disc degeneration, particularly at the lowest lumbar levels, remain unexplained by heredity or occupational physical demands. METHODS: Univariate methods and stepwise multiple regression modeling were used to estimate associations of body height, weight, fat content, axial disc area, isokinetic lifting performance, and lifetime routine physical activities at work and leisure with disc height narrowing and disc signal (in T2 images) based on lumbar MRIs. These data were available from a population sample of 600 men, 35 to 70 years of age. RESULTS: Lower disc signal, representing disc desiccation, was associated with higher age, lower body mass and lifting strength, and larger axial disc area. Of the variance in disc signal, age explained 8.0% (P < 0.001) and body weight/axial disc area, isokinetic lifting strength, and occupational lifting history added 3.9%, 2.3%, and 1.3%, respectively. Greater disc narrowing was associated with higher age, larger axial disc area, and higher occupational physical loading. Of the variance in disc narrowing, age accounted for 3.8% (P < 0.001); axial disc area and occupational loading added 1.9% (P < 0.004) and 1.3% (P < 0.007), respectively. CONCLUSIONS: Body weight, lifting strength, and axial disc area were more highly associated with disc degeneration than occupational and leisure physical activity histories, although all had modest influences. Furthermore, higher body mass, greater lifting strength, and heavier work were all associated with more disc height narrowing but less disc desiccation contrary to current views. Smaller discs appeared to have beneficial effects. [ABSTRACT FROM AUTHOR]
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- 2007
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35. Multivariate genetic analysis of lifetime exercise and environmental factors.
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Simonen R, Levälahti E, Kaprio J, Videman T, and Battié MC
- Abstract
PURPOSE: We investigated whether the association between exercise and individual-specific factors that correlate with exercise may be explained by genetic or common environmental factors. METHODS: Lifetime exercise data were available from 147 MZ and 153 DZ adult male twin pairs with a mean age of 50 yr (SD = 8 yr). RESULTS: The best-fitting quantitative genetic model for adulthood exercise level consisted of additive genetic effects, genetic effects due to dominance and unique environment effects, with genetic effects explaining 51% (95% CI = 29-63%) of the variance. Factors associated with adulthood exercise level were adolescent exercise, participation in competitive sports, perceived health, smoking status, and percent body fat. In bivariate models, approximately half of the covariation between those factors and adulthood exercise level was accounted for by unique environmental effects (i.e., factors not shared by the co-twins). Additive genetic effects explained less (3-20%) than dominance genetic effects (23-53%) of the covariation between those factors and adulthood exercise. Shared environmental effects were present only in the bivariate model of adulthood and adolescent exercise, explaining 11% of the covariance. CONCLUSIONS:: The genetic component shared in common by exercise and factors associated with exercise suggests that there may be a complex pathway of genetic selection and predisposition for a physically active lifestyle. [ABSTRACT FROM AUTHOR]
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- 2004
36. Perceived sleep quality and its precursors in adolescents.
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Tynjälä, J, Kannas, L, Levälahti, E, and Välimaa, R
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AGE factors in sleep ,HEALTH promotion ,ADOLESCENT health - Abstract
Presents a study which investigated perceived sleep quality among Finnish adolescents. General sleep quality by age and sex; Factors associated with perceived sleep quality; Interpretation of the structural equation models used in the study; Practical considerations.
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- 1999
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37. Factors Associated with Exercise Lifestyle - A Study of Monozygotic Twins
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Simonen, R. L., Videman, T., Kaprio, J., Levälahti, E., and Battié, M. C.
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- 2003
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38. White Matter Changes on Diffusion Tensor Imaging in the FINGER Randomized Controlled Trial
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Stephen, R. (Ruth), Solomon, A. (Alina), Ngandu, T. (Tiia), Levälahti, E. (Esko), Rinne, J. O. (Juha O.), Kemppainen, N. (Nina), Parkkola, R. (Riitta), Antikainen, R. (Riitta), Strandberg, T. (Timo), Kivipelto, M. (Miia), Soininen, H. (Hilkka), and Liu, Y. (Yawu)
- Subjects
randomized controlled trial ,sense organs ,Alzheimer's disease ,diffusion tensor imaging ,dementia - Abstract
Background: Early pathological changes in white matter microstructure can be studied using the diffusion tensor imaging (DTI). It is not only important to study these subtle pathological changes leading to cognitive decline, but also to ascertain how an intervention would impact the white matter microstructure and cognition in persons at-risk of dementia. Objectives: To study the impact of a multidomain lifestyle intervention on white matter and cognitive changes during the 2-year Finnish Geriatric Intervention Study to prevent Cognitive Impairment and Disability (FINGER), a randomized controlled trial in at-risk older individuals (age 60–77 years) from the general population. Methods: This exploratory study consisted of a subsample of 60 FINGER participants. Participants were randomized to either a multidomain intervention (diet, exercise, cognitive training, and vascular risk management, n = 34) or control group (general health advice, n = 26). All underwent baseline and 2-year brain DTI. Changes in fractional anisotropy (FA), diffusivity along domain (F1) and non-domain (F2) diffusion orientations, mean diffusivity (MD), axial diffusivity (AxD), radial diffusivity (RD), and their correlations with cognitive changes during the 2-year multidomain intervention were analyzed. Results: FA decreased, and cognition improved more in the intervention group compared to the control group (p
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39. Subjective memory complaints and the effect of a multidomain lifestyle intervention on cognition - the FINGER trial.
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Vaskivuo L, Hokkanen L, Levälahti E, Hänninen T, Antikainen R, Bäckman L, Laatikainen T, Paajanen T, Stigsdotter-Neely A, Strandberg T, Tuomilehto J, Soininen H, Kivipelto M, and Ngandu T
- Abstract
Objectives: Older people reporting subjective memory complaints (SMCs) may have greater risk of cognitive decline. Multidomain lifestyle interventions are a promising strategy for the prevention of cognitive decline. The aim of this study was to investigate whether the presence of SMCs affects the efficacy of a 2-year multidomain lifestyle intervention on cognition., Methods: This study is part of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) project. Participants (a sub-sample of 568 individuals, baseline age 60 to 77 years) were randomized (1:1) to receive a 2-year multidomain lifestyle intervention group including dietary advice, exercise, cognitive training, and vascular risk management, or regular health advice control group. Cognitive performance was assessed at baseline and at 1- and 2-year visits, using a neuropsychological test battery, including tests assessing memory, executive functions, and processing speed. Participants rated the frequency of SMCs using the Prospective and Retrospective Memory Questionnaire., Results: Having more retrospective SMCs was linked to a less favorable cognitive trajectory over 2 years. The difference between the intervention and control groups in annual change in tested memory performance was 0.077 (95 % CI 0.008-0.146) among those reporting more retrospective SMCs and -0.011 (-0.074-0.053) among those with less SMCs; interaction effect p=0.019. No other interactions between SMCs and intervention allocation were observed., Discussion: A lifestyle intervention may be beneficial for older adults with and without SMCs. Persons having more retrospective SMCs may benefit more from the intervention regarding memory functioning., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
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- 2024
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40. Overweight and Obesity in Finnish Children by Parents' Socioeconomic Position-A Registry-Based Study.
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Mäki P, Levälahti E, Lehtinen-Jacks S, and Laatikainen T
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- Child, Male, Female, Humans, Finland epidemiology, Parents, Poverty, Registries, Overweight epidemiology, Pediatric Obesity epidemiology
- Abstract
Objectives: To examine associations between parents' socioeconomic position (SEP) and child overweight and obesity, using registry data. Methods: Data (final n = 194,423) on children's height, weight and parents' SEP were drawn from the national Register of Primary Health Care Visits (Avohilmo) and Statistics Finland. Risk ratios for bernoulli-distributed overweight (RR
OW ) and obesity (RROB ) according to SEP were estimated using generalized linear models and using a log -link. Results: The risk for obesity was lower in boys from high-income families (RROB 0.76), for overweight and obesity was lower in boys (RROW 0.72, RROB 0.58) and girls (RROW 0.72, RROB 0.54) with highly educated fathers, in boys (RROW 0.79, RROB 0.58) and girls (RROW 0.78, RROB 0.56) with high-educated mothers and in boys (RROW 0.85, RROB 0.77) and girls (RROW 0.80, RROB 0.69) living in urban areas, as compared to low-income families, low-educated parents, and rural residence, respectively. Conclusion: The risk of overweight and obesity was increased in children with low SEP or rural residence. Administrative registers are a valid approach to monitor childhood obesity by parents' SEP., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2023 Mäki, Levälahti, Lehtinen-Jacks and Laatikainen.)- Published
- 2023
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41. Association of socioeconomic position and childhood obesity in Finland: a registry-based study.
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Paalanen L, Levälahti E, Mäki P, Tolonen H, Sassi F, Ezzati M, and Laatikainen T
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- Adult, Child, Humans, Finland epidemiology, Socioeconomic Factors, Income, Registries, Social Class, Pediatric Obesity epidemiology
- Abstract
Objective: To identify what dimensions of socioeconomic position (SEP) are most closely associated with childhood obesity in Finland, leveraging population-wide data among the whole child population aged 2-17 years in Finland., Design: Registry-based study., Setting: Data from several administrative registries linked on individual level covering the whole of Finland were used. Data on height and weight measurements in 2018 were obtained from the Register of Primary Health Care visits and data on sociodemographic and socioeconomic indicators (2014-2018) from Statistics Finland., Participants: Children aged 2-17 years with valid height and weight measurements performed at the child health clinic or school healthcare in 2018 (final n=194 423)., Main Outcome Measures: Obesity was defined according to WHO Growth Reference curves. Sociodemographic and socioeconomic indicators were linked on individual level for adults (both parents) who lived in the same household (42 predictors). Boosted regression model was used to analyse the contribution of SEP to obesity., Results: From socioeconomic indicators, annual household income (12.6%) and mother and father's educational level (12.6% and 8.1%, respectively) had the highest relative influence on obesity risk. The relative influence of a child's sex was 7.7%., Conclusions: The parents' SEP was inversely associated with obesity among the offspring. A remarkable number of objective SEP indicators were analysed with parents' education and household income finally being the indicators most strongly associated with obesity among children. In future research, more attention should be paid to reliable and objective ways of measuring educational status and income rather than on developing new SEP indicators. Administrative registries with information on both healthcare and socioeconomic indicators can in future provide better opportunities to assess the influence of SEP on various health risks., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2022
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42. Early childhood family background predicts meal frequency behaviour in children: Five-year follow-up study.
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Parikka S, Martelin T, Karvonen S, Levälahti E, Kestilä L, and Laatikainen T
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- Child, Male, Female, Child, Preschool, Humans, Follow-Up Studies, Socioeconomic Factors, Educational Status, Family, Feeding Behavior, Meals
- Abstract
Aims: Childhood nutrition patterns have an important role in later health. We studied the role of family type, other family background factors and their changes over a five-year follow-up with respect to meal frequency among children., Methods: Longitudinal data were collected in 2007-2009 and 2013-2014. A nationally representative sample of Finnish children ( n = 1822) aged 0.5-5 years at baseline and 5-10 years at follow-up and their families were used. The participation rate was 83% at baseline and 54% at follow-up. Meal frequency was defined as four to six meals per day. The associations of meal frequency with family background factors over a five-year follow-up period were examined by bivariate and multivariate regression analyses., Results: Eighty-nine per cent of the 5-10-year-old boys and girls had the recommended meal frequency at follow-up. Living in a single-parent family at baseline increased the risk of not eating the recommended number of meals compared with those living in intact families. After adjustments, a mother's low level of education (OR 0.51, CI 0.29-0.93) and a decrease in income sufficiency (OR 0.54, CI 0.35-0.84) during the follow-up period were unfavourably associated with the recommended meal frequency. The difference between children in stable single-parent, reconstituted or joint physical custody families and those living in stable intact families remained significant when controlling for other variables., Conclusions: Single-parent families with a low socioeconomic position represent important target groups for interventions designed to promote regular meal frequency .
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- 2022
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43. Occupational complexity and cognition in the FINGER multidomain intervention trial.
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Rydström A, Darin-Mattsson A, Kåreholt I, Ngandu T, Lehtisalo J, Solomon A, Antikainen R, Bäckman L, Hänninen T, Laatikainen T, Levälahti E, Lindström J, Paajanen T, Havulinna S, Peltonen M, Sindi S, Soininen H, Neely AS, Strandberg T, Tuomilehto J, Kivipelto M, and Mangialasche F
- Subjects
- Aged, Humans, Cognition, Executive Function, Research Design, Cognition Disorders etiology, Cognitive Dysfunction prevention & control, Cognitive Dysfunction complications
- Abstract
Introduction: Lifetime exposure to occupational complexity is linked to late-life cognition, and may affect benefits of preventive interventions., Methods: In the 2-year multidomain Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), we investigated, through post hoc analyses (N = 1026), the association of occupational complexity with cognition. Occupational complexity with data, people, and substantive complexity were classified through the Dictionary of Occupational Titles., Results: Higher levels of occupational complexity were associated with better baseline cognition. Measures of occupational complexity had no association with intervention effects on cognition, except for occupational complexity with data, which was associated with the degree of intervention-related gains for executive function., Discussion: In older adults at increased risk for dementia, higher occupational complexity is associated with better cognition. The cognitive benefit of the FINGER intervention did not vary significantly among participants with different levels of occupational complexity. These exploratory findings require further testing in larger studies., (© 2021 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)
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- 2022
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44. Associations of Depressive Symptoms and Cognition in the FINGER Trial: A Secondary Analysis of a Randomised Clinical Trial.
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Neuvonen E, Lehtisalo J, Ngandu T, Levälahti E, Antikainen R, Hänninen T, Laatikainen T, Lindström J, Paajanen T, Soininen H, Strandberg T, Tuomilehto J, Kivipelto M, and Solomon A
- Abstract
Depression and cognition are associated, but the role of depressive symptoms in lifestyle interventions to prevent dementia needs further study. We investigated the intervention effect on depressive symptoms and their associations with cognition in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER; NCT01041989), a two-year multidomain lifestyle trial. One thousand two-hundred and sixty individuals (60-77 years) at risk for dementia were randomised into a multidomain intervention (diet, exercise, cognitive training, and vascular/metabolic risk monitoring) or control group (regular health advice). Depressive symptoms (Zung scale) and cognition (modified Neuropsychological Test Battery) were evaluated at baseline, 12, and 24 months. One thousand one-hundred and twenty-five participants had baseline Zung data. Mean Zung score decreased 0.73 (SD 5.6) points in the intervention and 0.36 (5.6) points in the control group, with nonsignificant between-group difference (group × time coefficient -0.006, 95% CI -0.019 to 0.007). Overall, higher baseline Zung score was associated with less improvement in global cognition (-0.140, p = 0.005) and memory (-0.231, p = 0.005). Participants with clinically significant baseline depressive symptoms (Zung ≥ 40 points) had less intervention benefit to executive functioning (group × time × Zung -0.096, 95% CI -0.163 to -0.028). Change in Zung score was not associated with change in cognition. Clinically significant depressive symptoms warrant more attention when designing dementia-prevention interventions.
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- 2022
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45. Telomere Length Change in a Multidomain Lifestyle Intervention to Prevent Cognitive Decline: A Randomized Clinical Trial.
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Sindi S, Solomon A, Kåreholt I, Hovatta I, Antikainen R, Hänninen T, Levälahti E, Laatikainen T, Lehtisalo J, Lindström J, Paajanen T, Peltonen M, Singh Khalsa D, Wolozin B, Strandberg T, Tuomilehto J, Soininen H, Ngandu T, and Kivipelto M
- Subjects
- Aged, Cognitive Dysfunction diagnosis, Cognitive Dysfunction etiology, Exercise, Female, Finland, Health Behavior, Humans, Male, Middle Aged, Neuropsychological Tests, Patient Education as Topic, Cognitive Dysfunction prevention & control, Leukocytes physiology, Life Style, Telomere Homeostasis physiology
- 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., (© The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America.)
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- 2021
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46. Earlier life leisure-time physical activity in relation to age-related frailty syndrome.
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Kolehmainen L, Havulinna S, Ngandu T, Strandberg T, Levälahti E, Lehtisalo J, Antikainen R, Hietikko E, Peltonen M, Pölönen A, Soininen H, Tuomilehto J, Laatikainen T, Rauramaa R, Kivipelto M, and Kulmala J
- Subjects
- Aged, Exercise, Frail Elderly, Geriatric Assessment, Humans, Leisure Activities, Prospective Studies, Frailty diagnosis, Frailty epidemiology
- 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., (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2021
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47. Effect of a Multidomain Lifestyle Intervention on Estimated Dementia Risk.
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Solomon A, Handels R, Wimo A, Antikainen R, Laatikainen T, Levälahti E, Peltonen M, Soininen H, Strandberg T, Tuomilehto J, Kivipelto M, and Ngandu T
- Subjects
- Aged, Female, Finland, Humans, Male, Risk Factors, Cognitive Dysfunction prevention & control, Dementia prevention & control, Exercise physiology, Life Style, Nutrition Assessment, Risk Reduction Behavior
- Abstract
We investigated the effect of a multidomain lifestyle intervention on the risk of dementia estimated using the validated CAIDE risk score (post-hoc analysis). The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) is a 2-year randomized controlled trial among 1,260 at-risk older adults (60-77 years). Difference in the estimated mean change in CAIDE score at 2 years in the intervention compared to the control group was -0.16 (95 %CI -0.31 to 0.00) (p = 0.013), corresponding to a relative dementia risk reduction between 6.04-6.50%. This could be interpreted as a reflection of the prevention potential of the intervention.
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- 2021
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48. White Matter Changes on Diffusion Tensor Imaging in the FINGER Randomized Controlled Trial.
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Stephen R, Solomon A, Ngandu T, Levälahti E, Rinne JO, Kemppainen N, Parkkola R, Antikainen R, Strandberg T, Kivipelto M, Soininen H, and Liu Y
- Subjects
- Aged, Anisotropy, Cognitive Dysfunction diagnostic imaging, Female, Finland, Humans, Male, Diffusion Tensor Imaging, White Matter diagnostic imaging
- Abstract
Background: Early pathological changes in white matter microstructure can be studied using the diffusion tensor imaging (DTI). It is not only important to study these subtle pathological changes leading to cognitive decline, but also to ascertain how an intervention would impact the white matter microstructure and cognition in persons at-risk of dementia., Objectives: To study the impact of a multidomain lifestyle intervention on white matter and cognitive changes during the 2-year Finnish Geriatric Intervention Study to prevent Cognitive Impairment and Disability (FINGER), a randomized controlled trial in at-risk older individuals (age 60-77 years) from the general population., Methods: This exploratory study consisted of a subsample of 60 FINGER participants. Participants were randomized to either a multidomain intervention (diet, exercise, cognitive training, and vascular risk management, n = 34) or control group (general health advice, n = 26). All underwent baseline and 2-year brain DTI. Changes in fractional anisotropy (FA), diffusivity along domain (F1) and non-domain (F2) diffusion orientations, mean diffusivity (MD), axial diffusivity (AxD), radial diffusivity (RD), and their correlations with cognitive changes during the 2-year multidomain intervention were analyzed., Results: FA decreased, and cognition improved more in the intervention group compared to the control group (p < 0.05), with no significant intergroup differences for changes in F1, F2, MD, AxD, or RD. The cognitive changes were significantly positively related to FA change, and negatively related to RD change in the control group, but not in the intervention group., Conclusion: The 2-year multidomain FINGER intervention may modulate white matter microstructural alterations.
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- 2020
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49. Brain volumes and cortical thickness on MRI in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER).
- Author
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Stephen R, Liu Y, Ngandu T, Antikainen R, Hulkkonen J, Koikkalainen J, Kemppainen N, Lötjönen J, Levälahti E, Parkkola R, Pippola P, Rinne J, Strandberg T, Tuomilehto J, Vanninen R, Kivipelto M, Soininen H, and Solomon A
- Subjects
- Aged, Cognitive Dysfunction epidemiology, Female, Finland, Humans, Male, Middle Aged, Organ Size, Cerebral Cortex diagnostic imaging, Cognitive Dysfunction diagnostic imaging, Cognitive Dysfunction psychology, Disability Evaluation, Geriatric Assessment methods, Magnetic Resonance Imaging methods
- Abstract
Background: The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) was a multicenter randomized controlled trial that reported beneficial effects on cognition for a 2-year multimodal intervention (diet, exercise, cognitive training, vascular risk monitoring) versus control (general health advice). This study reports exploratory analyses of brain MRI measures., Methods: FINGER targeted 1260 older individuals from the general Finnish population. Participants were 60-77 years old, at increased risk for dementia but without dementia/substantial cognitive impairment. Brain MRI scans were available for 132 participants (68 intervention, 64 control) at baseline and 112 participants (59 intervention, 53 control) at 2 years. MRI measures included regional brain volumes, cortical thickness, and white matter lesion (WML) volume. Cognition was assessed at baseline and 1- and 2-year visits using a comprehensive neuropsychological test battery. We investigated the (1) differences between the intervention and control groups in change in MRI outcomes (FreeSurfer 5.3) and (2) post hoc sub-group analyses of intervention effects on cognition in participants with more versus less pronounced structural brain changes at baseline (mixed-effects regression models, Stata 12)., Results: No significant differences between the intervention and control groups were found on the changes in MRI measures. Beneficial intervention effects on processing speed were more pronounced in individuals with higher baseline cortical thickness in Alzheimer's disease signature areas (composite measure of entorhinal, inferior and middle temporal, and fusiform regions). The randomization group × time × cortical thickness interaction coefficient was 0.198 (p = 0.021). A similar trend was observed for higher hippocampal volume (group × time × hippocampus volume interaction coefficient 0.1149, p = 0.085)., Conclusions: The FINGER MRI exploratory sub-study did not show significant differences between the intervention and control groups on changes in regional brain volumes, regional cortical thicknesses, or WML volume after 2 years in at-risk elderly without substantial impairment. The cognitive benefits on processing speed of the FINGER intervention may be more pronounced in individuals with fewer structural brain changes on MRI at baseline. This suggests that preventive strategies may be more effective if started early, before the occurrence of more pronounced structural brain changes., Trial Registration: ClinicalTrials.gov, NCT01041989 . Registered January 5, 2010.
- Published
- 2019
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50. The Effect of Multidomain Lifestyle Intervention on Daily Functioning in Older People.
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Kulmala J, Ngandu T, Havulinna S, Levälahti E, Lehtisalo J, Solomon A, Antikainen R, Laatikainen T, Pippola P, Peltonen M, Rauramaa R, Soininen H, Strandberg T, Tuomilehto J, and Kivipelto M
- Subjects
- Aged, Diet, Female, Finland, Humans, Male, Surveys and Questionnaires, Activities of Daily Living, Cognitive Dysfunction prevention & control, Exercise physiology, Interpersonal Relations, Life Style
- 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., (© 2019 The American Geriatrics Society.)
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- 2019
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