Brain training and healthy lifestyle may slow down cognitive decline
A comprehensive programme providing elderly people at risk of dementia with healthy eating guidance, exercise, brain training, and management of metabolic and vascular risk factors appears to slow down cognitive decline, according to a new randomised controlled trial lead from Karolinska Institutet. The study, which is published in The Lancet, is based on data from 1260 people from Finland and is the largest of its kind ever.
In the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) study, Swedish and Finnish scientist assessed the effects on brain function of a comprehensive intervention aimed at addressing some of the most important risk factors for age-related dementia, such as high body-mass index and heart health. 1260 people from across Finland, aged 60–77 years, were included in the study, with half randomly allocated to the intervention group, and half allocated to a control group, who received regular health advice only. All of the study participants were deemed to be at risk of dementia, based on standardised test scores.
The intensive intervention consisted of regular meetings over two years with physicians, nurses, and other health professionals. Participants were given comprehensive advice on maintaining a healthy diet, exercise programmes including muscle and cardiovascular training, brain training exercises, and management of metabolic and vascular risk factors through regular blood tests, and other means. After two years, study participants’ mental function was scored using a standard test, the Neuropsychological Test Battery (NTB), where a higher score corresponds to better mental functioning.
Even more striking
Overall test scores in the intervention group were 25 percent higher than in the control group. For some parts of the test, the difference between groups was even more striking; for executive functioning (the brain’s ability to organise and regulate thought processes) scores were 83 percent higher in the intervention group, and processing speed was 150 percent higher. Based on a pre-specified analysis, the intervention appeared to have no effect on patients’ memory. However, based on post-hoc analyses, there was a difference in memory scores between the intervention and control groups.
The study was led by Professor Miia Kivipelto, MD, PhD, at Karolinska Institutet’s Department of Neurobiology, Care Sciences and Society, also affiliated to the Aging Research Centre in Stockholm as well as the National Institute for Health and Welfare in Helsinki, Finland and University of Eastern Finland. Funding bodies were, amongst others, the Academy of Finland, La Carita Foundation, Alzheimer Association, Alzheimer’s Research and Prevention Foundation, Juho Vainio Foundation, Novo Nordisk Foundation, Finnish Social Insurance Institution, Ministry of Education and Culture, Salama bint Hamdan Al Nahyan Foundation, and Axa Research Fund, EVO grants, Swedish Research Council, Swedish Research Council for Health, Working Life, and Welfare, and af Jochnick Foundation (full list in the article).
A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial
Tiia Ngandu, Jenni Lehtisalo, Alina Solomon, Esko Levälahti, Satu Ahtiluoto, Riitta Antikainen, Lars Bäckman, Tuomo Hänninen, Antti Jula, Tiina Laatikainen, Jaana Lindström, Francesca Mangialasche, Teemu Paajanen, Satu Pajala, Markku Peltonen, Rainer Rauramaa, Anna Stigsdotter-Neely, Timo Strandberg, Jaakko Tuomilehto, Hilkka Soininen, and Miia Kivipelto
The Lancet, Published Online March 12, 2015 http://dx.doi.org/10.1016/ S0140-6736(15)60461-5