Lifestyle Intervention Maintains Cognitive Functioning in Elderly
the Neurology Advisor take:
Vascular and lifestyle interventions can help maintain or improve cognitive function in older adults who are at risk for cognitive decline, according to a study published in The Lancet.
Previous observational studies have indicated that dementia risk is linked to modifiable vascular and lifestyle-related risk factors.
The study, called the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), included 1,260 participants aged 60 to 77 years. Participants had Dementia Risk Scores of at least six points and average or slightly lower than average cognitive abilities.
The researchers randomly assigned 631 participants to an intervention group that included dietary changes, exercise, cognitive training, and vascular risk monitoring. The control group received general health advice.
The primary study outcome was change in cognition, which was measured through comprehensive neuropsychological test battery (NTB) Z score. After 2 years of follow-up, the intervention group had a mean Z score change of 0.20 and the control group has a mean change of 0.16.
Adverse effects were seen in 46 participants in the intervention group compared with just six in the control group. The most common adverse effect was musculoskeletal pain.
The results of this study indicate that intervention may help maintain or improve cognitive functioning in elderly people who are at-risk for cognitive decline.
Lifestyle and vascular interventions can help reduce cognitive decline in older adults.
Modifiable vascular and lifestyle-related risk factors have been associated with dementia risk in observational studies. In the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), a proof-of-concept randomised controlled trial, we aimed to assess a multidomain approach to prevent cognitive decline in at-risk elderly people from the general population.
In a double-blind randomised controlled trial we enrolled individuals aged 60–77 years recruited from previous national surveys. Inclusion criteria were CAIDE (Cardiovascular Risk Factors, Aging and Dementia) Dementia Risk Score of at least 6 points and cognition at mean level or slightly lower than expected for age. We randomly assigned participants in a 1:1 ratio to a 2 year multidomain intervention (diet, exercise, cognitive training, vascular risk monitoring), or a control group (general health advice). Computer-generated allocation was done in blocks of four (two individuals randomly allocated to each group) at each site. Group allocation was not actively disclosed to participants and outcome assessors were masked to group allocation. The primary outcome was change in cognition as measured through comprehensive neuropsychological test battery (NTB) Z score. Analysis was by modified intention to treat (all participants with at least one post-baseline observation).
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