FINGER-NL

Findings from observational studies have linked several vascular and lifestyle-related risk factors such as diet and exercise with increased risk of late-life cognitive impairment. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) was the first randomised controlled trial to evaluate a multi-modal lifestyle intervention to prevent cognitive decline. FINGER simultaneously targeted four lifestyle domains (physical activity, cognitive training, dietary counselling (MIND diet) and cardiovascular risk management) and showed a positive effect on the cognitive composite primary outcome measure.

Inspired by the positive results in FINGER, World-Wide FINGERS (WW-FINGERS) is a global effort to extend the original findings around the globe, while simultaneously optimising the intervention under local circumstances. Additional lifestyle domains that may benefit cognition are sleep and stress management. Souvenaid is a nutritional product that, with daily consumption, has shown a positive effect on cognition in individuals with mild cognitive impairment, and is included in other WW-FINGERS initiatives to optimise the intervention. Finally, the social aspect may be of particular relevance to maintaining brain health.

The primary objective of FINGER-NL is therefore to investigate the efficacy of an optimised personalised 2-year multi-domain lifestyle intervention on cognitive performance in older adults at risk of cognitive decline.

FINGER-NL is a multi-centre, randomised, controlled, multi-domain lifestyle intervention trial among 1,206 older adults at risk for cognitive decline with a duration of 24 months. Participants are randomised in a 1:1 ratio to a personalised multi-domain lifestyle intervention of high versus low intensity. The intervention targets physical activity, cognitive engagement, cardiovascular risk factors, MIND diet, sleep, stress, and social activities, but with different intensities in both arms. The study is conducted in five study centres (Amsterdam, Maastricht, Wageningen, Groningen, Nijmegen). Outcome assessments for both groups are scheduled at study start, 12 months and 24 months. For recruitment, we leverage the online platform hersenonderzoek.nl.

Currently, we have started with the FINGER-NL extension study, leveraging the 2-yr follow-up via FINGER-NL to a total follow-up of 4 years.