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Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER)

Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). Miia Kivipelto, MD, PhD Professor Karolinska Institutet Alzheimer Disease Research Center (KI-ADRC) and Aging Research Center, Sweden and University of Eastern Finland.

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Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER)

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  1. Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) Miia Kivipelto, MD, PhDProfessor Karolinska Institutet Alzheimer Disease Research Center (KI-ADRC) and Aging Research Center, Sweden and University of Eastern Finland

  2. …the ideal interventions should be multi-dimensional...

  3. Objective: To reduce cognitive impairment in an at risk population through a 2-year multi-domain life-style intervention • Target population: 60-77 year old persons (n= 1200) from previous population-based non-intervention studies (FINRISK, D2D) • Time schedule: Screening began in September 2009 and was completed in 2011. The intervention will be completed in 2013

  4. INCLUSION CRITERIA: persons at risk of cognitive decline/dementia Dementia Risk score > 6 Based on risk factors assessed in earlier population surveys: Age, Education, Sex, SBP, Cholesterol, BMI, Physical Activity (Kivipelto et al., Lancet Neurology 2006) AND Cognitive performance at mean level or slightly lower than expected for age (based on CERAD test battery)

  5. INTERVENTION SCHEDULE INTENSIVE INTERVENTION NUTRITION: 7 group sessions, 3 individual sessions EXERCISE: 1-2x/wk muscle 2-4x/wk aerobic EXERCISE: 2x/wk muscle 4-5x/vk aerobic EXERCISE: 2x/wk muscle strength training 5x/wk aerobic training COGNITIVE TRAINING: 9 group sessions Independent training COGNITIVE TRAINING: 2 group sessios Independent training INTERVENTION KICK-OFF RANDOMIZATION 2nd Baseline visit 1st Baseline visít MONITORING AND MANAGEMENT OF METABOLIC AND VASCULAR RISK FACTORS Nurse: Visit every 3 months, Physician: 3 additional visits Screening months 3 6 9 12 15 18 21 24 MINI- INTERVENTION REGULAR HEALTH ADVICE

  6. FINGER intervention

  7. Safety Committee Monitoring Committee FINLAND FINGER StudyPI: M. Kivipelto Coordination Group/THL:Heads: T. Laatikainen, J.Lindström,Coordinators: T. Ngandu, S. AhtiluotoField coordinator: J. LehtisaloData manager, Statistician, Administrator Oulu cohortT. Strandberg Kuopio cohort H.Soininen Supervision:Nutrition: J. Lindström Exercise: R. Rauramaa, S.PajalaCognitive&social activation: T.Hänninen, T.NganduVascular factors: J. Tuomilehto, T.Strandberg, R. Antikainen Seinäjoki cohort J. Tuomilehto Turku cohort A. Jula Volunteer organizations Practices in the community Vantaa cohort T. Laatikainen Helsinki cohortM. Kivipelto

  8. OUTCOMES • Primary: • Cognitive impairment (Neuropsychological Test Battery, Trail Making & Stroop tests) • Secondary: • Dementia (after 7 years) • Depressive symptoms (Zung scale) • Vascular risk factors, morbidity and mortality • Disability (questionnaire, ADL + IADL) • Quality of life (RAND-36, 15D) • Utilization of health resources • Blood markers (i.e. inflammation, redox status, lipid and glucose metabolism, NMR metabonomics) • Brain MRI measures (n=100) and PET (n=90)

  9. Current status (06.03.2012)

  10. Drop outs and refusals (06.03.2012)

  11. Demographic and baseline medical data of the first participants

  12. 1st year preliminary results

  13. 1st year preliminary results

  14. Experience of the participants ”I have friends who are jealous when they hear all that I have been offered to do at this course” ”Right amount of everything” ”Nice experience” ”Coming here has always given me reinforcement and strength to take care of myself and others” (participant from the control group)

  15. European Dementia Prevention Initiative EDPI European Dementia Prevention Initiative • FINGER Finnish Geriatric Intervention Study to Prevent • Cognitive Impairment and Disability • preDIVA Prevention of Dementia by Intensive Vascular Care • MAPTMultidomain Alzheimer Preventive Trial

  16. ACKNOWLEDGEMENTS Grant support: Academy of Finland, Novo Nordisk Foundation, FAS, Alzheimer Association, La Carita säätiö Tiina Laatikainen Antti Jula Jaana Lindström Markku PeltonenTiia Ngandu Satu AhtiluotoJenni Lehtisalo Jaakko Tuomilehto Hilkka Soininen Rainer Rauramaa Raimo SulkavaMerja Hallikainen Tuomo Hänninen Teemu PaajanenAlina SolomonMinna RusanenMarjo Eskelinen Miika Vuorinen Timo Strandberg Riitta Antikainen Bengt WinbladLaura Fratiglioni Lars Bäckman Ingemar Kåreholt Krister Håkanson Babak Hooshmand Francesca Mangialasche

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