Kivipelto-2013-FINGER trial 芬兰大型痴呆风险人士治疗的随机对照研究型

Alzheimer’s&Dementia9(2013)657–665

TheFinnishGeriatricInterventionStudytoPreventCognitiveImpairmentandDisability(FINGER):Studydesignandprogress

MiiaKivipeltoa,b,c,d,*,AlinaSolomona,c,d,SatuAhtiluotob,TiiaNgandub,d,JenniLehtisalob,RiittaAntikainene,f,LarsB€ackmanc,TuomoH€annineng,AnttiJulab,TiinaLaatikainenb,JaanaLindstr€omb,FrancescaMangialaschec,AulikkiNissinenb,TeemuPaajanena,SatuPajalah,

MarkkuPeltonenb,RainerRauramaai,AnnaStigsdotter-Neelyj,TimoStrandberge,k,

JaakkoTuomilehtol,m,HilkkaSoininena,g

DepartmentofNeurology,InstituteofClinicalMedicine,UniversityofEasternFinland,Kuopio,FinlandDepartmentofChronicDiseasePrevention,NationalInstituteforHealthandWelfare,Helsinki,Finland

c

AgingResearchCenter,KarolinskaInstitutet,Stockholm,Sweden

d

Alzheimer’sDiseaseResearchCenter,KarolinskaInstitutet,Stockholm,Sweden

e

InstituteofHealthSciences/Geriatrics,UniversityofOulu,andUniversityHospital,Oulu,Finland

f

OuluCityHospital,Oulu,Finland

g

DepartmentofNeurology,KuopioUniversityHospital,Kuopio,Finland

h

DepartmentofLifestyleandParticipation,NationalInstituteforHealthandWelfare,Helsinki,Finland

i

KuopioResearchInstituteofExerciseMedicine,Kuopio,Finlandj

DepartmentofPsychology,Ume aUniversity,Ume a,Sweden

k

DepartmentofMedicine,GeriatricClinic,UniversityofHelsinkiandUniversityHospital,Helsinki,Finland

l

DepartmentofPublicHealth,UniversityofHelsinki,Helsinki,Finland

m

SouthOstrobothniaCentralHospital,Sein€ajoki,Finland

ba

Abstract

Background:FinnishGeriatricInterventionStudytoPreventCognitiveImpairmentandDisability

(FINGER)isamulti-center,randomized,controlledtrialongoinginFinland.

Materials:Participants(1200individualsatriskofcognitivedecline)arerecruitedfrompreviouspopulation-basednon-interventionstudies.InclusioncriteriaareCAIDEDementiaRiskScore 6andcognitiveperformanceatthemeanlevelorslightlylowerthanexpectedforage(butnotsubstantialimpairment)assessedwiththeConsortiumtoEstablishaRegistryforAlzheimer’sDisease(CERAD)neuropsychologicalbattery.The2-yearmultidomaininterventionconsistsof:nutritionalguidance;ex-ercise;cognitivetrainingandsocialactivity;andmanagementofmetabolicandvascularriskfactors.Per-sonsinthecontrolgroupreceiveregularhealthadvice.Theprimaryoutcomeiscognitiveperformanceasmeasuredbythemodi edNeuropsychologicalTestBattery,Strooptest,andTrailMakingTest.Mainsecondaryoutcomesare:dementia(afterextendedfollow-up);disability;depressivesymptoms;vascularriskfactorsandoutcomes;qualityoflife;utilizationofhealthresources;andneuroimagingmeasures.Results:ScreeningbeganinSeptember2009andwascompletedinDecember2011.All1200per-sonsareenrolledandtheinterventionisongoingasplanned.Baselineclinicalcharacteristicsindicatethatseveralvascularriskfactorsandunhealthylifestyle–relatedfactorsarepresent,creatingawindowofopportunityforprevention.Theinterventionwillbecompletedduring2014.

Conclusions:TheFINGERisattheforefrontofinternationalcollaborativeeffortstosolvetheclin-icalandpublichealthproblemsofearlyidenti cationofindividualsatincreasedriskoflate-lifecog-nitiveimpairment,andofdevelopinginterventionstrategiestopreventordelaytheonsetofcognitiveimpairmentanddementia.

Ó2013TheAlzheimer’sAssociation.Allrightsreserved.

Cognitiveimpairment;Dementia;Alzheimer’sdisease;Lifestyle;Intervention;Randomizedtrial

Keywords:

*Correspondingauthor.Tel.:146-73-99-409-22;Fax:146-86-90-59-54.E-mailaddress:miia.kivipelto@ki.se

1552-5260/$-seefrontmatterÓ2013TheAlzheimer’sAssociation.Allrightsreserved.

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