The effect of adherence on cognition in a multidomain lifestyle intervention (FINGER)

Funder: Finnish Social Insurance Institution, Finland
Funder: Finnish Ministry of Education and Culture, Finland
Funder: Juho Vainio Foundation, Finland
Funder: EU Joint Programme ‐ Neurodegenerative Disease Research (MIND‐AD, EURO‐FINGERS)
Funder: Alzheimer's Research and Prevention Foundation, US
Funder: Alzheimerfonden, Sweden
Funder: Hjärnfonden, Sweden
Funder: Swedish Research Council, Sweden
Funder: Center for Innovative Medicine (CIMED) at Karolinska Institutet, Sweden
Funder: Region Stockholm (ALF, NSV), Sweden
Funder: Knut and Alice Wallenberg Foundation, Sweden
Funder: Stiftelsen Stockholms sjukhem, Sweden
Funder: Konung Gustaf V:s och Drottning Victorias Frimurarstiftelse, Sweden
Funder: Finnish Cultural Foundation, Finland
Funder: Jalmari and Rauha Ahokas Foundation, Finland
Funder: Yrjö Jahnsson Foundation, Finland
Funder: State research funding (EVO/VTR grants) of Oulu University Hospital and Oulu City Hospital, and Kuopio University Hospital, Finland
Funder: UEF Strategic funding for UEFBRAIN, Finland
Funder: Swedish Research Council for Health, Working Life and Welfare, Sweden
Funder: The Heart Disease Foundation, Finland
Funder: Umeå University, Sweden
INTRODUCTION: Lifestyle interventions may prevent cognitive decline, but the sufficient dose of intervention activities and lifestyle changes is unknown. We investigated how intervention adherence affects cognition in the FINGER trial (pre-specified subgroup analyses). METHODS: FINGER is a multicenter randomized controlled trial examining the efficacy of multidomain lifestyle intervention (ClinicalTrials.gov NCT01041989). A total of 1260 participants aged 60 to 77 with increased dementia risk were randomized to a lifestyle intervention and control groups. Percentage of completed intervention sessions, and change in multidomain lifestyle score (self-reported diet; physical, cognitive, and social activity; vascular risk) were examined in relation to change in Neuropsychological Test Battery (NTB) scores. RESULTS: Active participation was associated with better trajectories in NTB total and all cognitive subdomains. Improvement in lifestyle was associated with improvement in NTB total and executive function. DISCUSSION: Multidomain lifestyle changes are beneficial for cognitive functioning, but future interventions should be intensive enough, and supporting adherence is essential.