U.s. geriatric intervention study to prevent cognitive impairment and disability (U.S.-FINGER)

Background: Lifestyle interventions focused on combining healthy nutrition, physical activity, and social and intellectual challenge may represent a promising therapeutic strategy to protect brain health. The recent results of the population-based 2-year clinical trial, Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), indicated that a multidomain intervention of physical activity, nutritional guidance, cognitive training, social activities and management of heart health risk factors slowed cognitive decline in healthy older adults at increased risk of cognitive decline. As yet, there are no pharmacological treatment options that can rival this effect. Thus, there is an urgent need to expand this work to test the generalizability, adaptability, and sustainability of their findings in diverse and global populations. Methods: The U.S. Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (USFINGER) trial builds on lessons learned from FINGER and will test a 2-year multi-site and community-based multidomain intervention of physical activity, nutritional guidance, cognitive training and social activities, and management of medical co-morbidities in asymptomatic older adults aged 60-79 years. Study candidates will be identified throughmedical history to assess dementia risk using an algorithmthat includes vascular and other established predictors. Family history of dementia and physical activity level will also be queried using followup questionnaires for those identified through the algorithm. A cognitive composite score focused on episodic memory and executive function will serve as the primary outcome. Results: An overview of the study design, target population and recruitment approach, interventions, outcomes, and implementation strategies for US-FINGER will be discussed. Conclusions: In the absence of other effective treatment options and in the wake of promising findings from FINGER, there is a pressing need to replicate FINGER in diverse and larger populations. US-FINGER hopes to expand the scientific footprint of the Finnish study and test the generalizability, adaptability, and sustainability of a multidomain behavioral intervention to effectively prevent cognitive decline and progression to Alzheimer's dementia.