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People at risk for dementia who were assigned to an intervention program that included healthy eating guidance, personalized exercise plans, and computer-based brain training scored better on cognitive tests after two years than a control group that only received general medical advice, according to research published online ahead of print March 11 in Lancet. Results from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) show that multidomain interventions may help people at risk for dementia improve or maintain cognitive function, researchers said.
Miia Kivipelto, MD, PhD, Professor of Clinical Geriatric Epidemiology at the Karolinska Institutet Center for Alzheimer’s Research in Stockholm and Professor at the National Institute for Health and Welfare in Helsinki, and colleagues identified 1,260 participants, ages 60 to 77, who had a dementia risk score on the Cardiovascular Risk Factors, Aging, and Dementia tool of at least 6 points and cognition at mean level or slightly lower than expected. Participants randomly were assigned to the intervention or control groups. The intervention program included sessions with nutritionists who tailored the participants’ diets, physiotherapists who created individualized strength training and aerobic exercise programs, and psychologists who led group sessions that reviewed memory and reasoning strategies. Intervention group participants also were assigned computer-based brain training exercises. Physicians and nurses measured metabolic and vascular risk factors and made lifestyle management recommendations.
After two years, participants’ cognitive performance was scored using an extended version of the neuropsychologic test battery (NTB). Estimated mean change in NTB Z score at two years was 0.20 in the intervention group and 0.16 in the control group. Improvement in NTB total score after two years was 25% higher in the intervention group than in the control group. Improvement in executive functioning was 83% higher in the intervention group than in the control group, and improvement in processing speed was 150% higher in the intervention group. The intervention was not associated with significant change in memory. NTB total score fell in 28% of participants, and the risk of cognitive decline increased in the control group.
“Much previous research has shown that there are links between cognitive decline in older people and factors such as diet, heart health, and fitness. However, our study is the first large randomized controlled trial to show that an intensive program aimed at addressing these risk factors might be able to prevent cognitive decline in elderly people who are at risk of dementia,” Dr. Kivipelto said.
Researchers plan to follow study participants for at least seven years to determine whether the diminished cognitive decline seen in the trial is followed by reduced levels of dementia and diagnoses of Alzheimer’s disease.