Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability - FINGER

Jan 31, 2022
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Author/Summarized by Author:
Anthony A. Bavry, MD,MPH,FACC
Summary Reviewer:
Deepak L. Bhatt, MD, MPH, MBA, FACC
Trial Sponsor:
Academy of Finland; Finnish Social Insurance Institution
Date Published:
01/20/2022
Date Updated:
01/31/2022
Original Posted Date:
01/31/2022
References

Contribution To Literature:

The FINGER trial showed that a multi-domain intervention may prevent cardiovascular events.

Description:

The goal of the trial was to evaluate a multi-domain intervention compared with control among individuals at risk for dementia.

Study Design

  • Randomization
  • Parallel

Participants were randomized to intensive multi-domain lifestyle intervention (n = 631) versus regular health advice (n = 628). In the intervention group, participants received dietary counseling, exercise training, cognitive training, and management of cardiovascular/metabolic risk factors.

  • Total number of enrollees: 1,259
  • Duration of follow-up: mean 7.4 years
  • Mean patient age: 69 years
  • Percentage female: 47%

Inclusion criteria:

  • Individuals 60-77 years of age with elevated risk for dementia based on the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) risk score

Exclusion criteria:

  • Malignant disease
  • Major depression
  • Symptomatic cardiovascular disease
  • Coronary revascularization within the last year
  • Severe loss of vision, hearing, or communicative ability
  • Disorders preventing cooperation
  • Participation in another trial

Principal Findings:

The primary outcome, incident cardiovascular disease (coronary event, stroke, or transient ischemic attack [TIA]) occurred in 17.0% of the intervention group compared with 19.4% of the control group (p = 0.098).

Among those with baseline cardiovascular disease, the hazard ratio for incident cardiovascular disease (intervention vs. control) was 0.50 (p = 0.022) and among those without baseline cardiovascular disease, the hazard ratio for incident cardiovascular disease (intervention vs. control) was 0.87 (p = 0.39).

Secondary outcomes:

  • Stroke or TIA: 10.5% with intervention vs. 13.9% with control (p = 0.043)
  • Coronary event: 7.6% with intervention vs. 8.1% with control (p = 0.40)

Interpretation:

Among individuals at risk for dementia, a multi-domain intervention appeared to be beneficial compared to control. Among all participants, there was a numerical reduction in cardiovascular disease events for multi-modal intervention vs. control. When the results were analyzed according to baseline history of cardiovascular disease, multi-modal intervention was associated with greater benefit among those with baseline history of cardiovascular disease.

References:

Lehtisalo J, Rusanen M, Solomon A, et al. Effect of a multi-domain lifestyle intervention on cardiovascular risk in older people: the FINGER trial. Eur Heart J 2022;43:2054-61.

Clinical Topics: Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Geriatric Cardiology, Prevention, Diet, Exercise, Sleep Apnea

Keywords: Aging, Cognition, Counseling, Dementia, Diet, Exercise, Geriatrics, Ischemic Attack, Transient, Life Style, Metabolic Syndrome, Primary Prevention, Risk Factors, Stroke, Vascular Diseases


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