Multidomain lifestyle intervention benefits a large elderly population at risk for cognitive decline: Subgroup analyses of the finnish geriatric intervention study to prevent cognitive impairment and disability (FINGER)

Background: FINGER is a randomized controlled trial (NCT01041989) that demonstrated beneficial effects on cognition for a 2-year multidomain lifestyle intervention (diet, exercise, cognitive training and vascular risk monitoring) compared to control (regular health advice). This study investigated whether sociodemographic factors, socioeconomic status, baseline cognition or cardiovascular factors influenced intervention effects on cognition. Methods: FINGER targeted 1260 people aged 60-77 years from the general Finnish population who were at risk for cognitive impairment but without dementia or cognitive impairment. Selection was based on CAIDE Dementia Risk Score and Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological test battery. These criteria selected individuals with risk factors for dementia and cognitive performance at the mean level or slightly lower than expected for age. Primary outcome was change in cognition (Neuropsychological Test Battery z-score). Mixedeffects regression models were used to investigate whether participants' characteristics influenced intervention effects on cognition (intervention x time x characteristic interactions). Results: As reported previously, FINGER intervention had a significant beneficial effect on the primary outcome (p = 0.03). Sociodemographic factors (sex, age), socioeconomic status (education, household income), baseline cognition (MMSE score) and cardiovascular risk factors (BMI, blood pressure, cholesterol levels, fasting glucose, overall cardiovascular risk) as well as cardiovascular comorbidity did not modify response to intervention (p-values for interaction > 0.05). Conclusions: The FINGER multidomain lifestyle intervention was beneficial regardless of sociodemographic factors, socioeconomic status, baseline cognition and level of cardiovascular risk. This indicates that the selection of the target population was successful. Thus, our results suggest that the FINGER intervention can be targeted at a large elderly population with increased risk for cognitive decline and dementia.