Linus Jönsson

Research problem, specific questionsMaintaining cognitive and functional ability into late life is a lifelong process and health promotion/early intervention are the vital components of public health efforts to achieve healthy aging. The FINGER multidomain intervention trial, which integrates five healthy behaviour domains—nutrition, exercise, cognitive training, social activity, and vascular risk monitoring and management, was the first large-scale randomized controlled trial in the world showing evidence for cognitive benefit in older adults at-risk for dementia. The benefit was also extended to physical function, cardiovascular health, quality of life, and health economic aspects. Despite the compelling evidence, more questions remain to be answered: Are the findings from the FINGER trial generalizable to different settings in the Swedish context (e.g., memory clinic, primary care, and municipality)? Can the FINGER model contribute to additional parameters central for healthy aging? Is there an evidence-based need to further refine the FINGER model? How can the FINGER model be adapted and implemented across socioeconomically diverse populations? In this 6-year program, we address these questions by adapting and implementing the FINGER model in different settings and sociocultural contexts.Data and methodWe plan six interrelated work packages: a) Adapting and implementing the FINGER model across different settings in Swedish society

b) Testing the FINGER model for healthy aging

c) Refining the FINGER model with novel risk factors and sex differences in the response to lifestyle interventions

d) Adapting and implementing the FINGER model in sociocultural contexts

e) Health economic assessment, payment models and sustainment

and f) Knowledge dissemination, implementation of findings and public involvement. We use data from a) existing FINGER and FINGER-based trials in many countries (e.g., MIND-AD, MIND-China)

b) ongoing FINGER-based implementation studies in different contexts: specialist (Brain Health Clinic), primary care (STRONGER), and municipality (Train your Brain)

and c) pilot studies to capture younger people and family caregivers (Family FINGERS).Relevance and utilisationThe program will generate new knowledge on tailored intervention approaches at individual and population levels to support longer and healthier lives in different settings and sociocultural contexts. This knowledge is critical knowledge for the development of health policies to promote of healthy aging and equal health care.Plan for programme realisationThe program is carried out by an interdisciplinary team of experts with expertise in relevant disciplines, e.g., epidemiology, gerontology, clinical geriatrics, clinical trials, implementation research, psychology, health economics, biostatistics, and care science. The budget is used for supporting researchers to implement the study plan and collect new data. The applicant will coordinate all research activities.

Purpose and goal: Alzheimer´s disease and other dementias are among the biggest societal challenges of the coming decades. The innovation milieu PREDEM aims to prevent dementia disorders by developing and introducing new methods for early detection and investigation, accurate diagnostics and individualized prevention and treatment. The vision for PREDEM is that all people who are at risk of developing dementia are offered the best available preventive measures and treatments based on their individual circumstances. Expected results and effects: New tools and work procedures can lead to earlier detection of incipient dementia, faster and safer diagnostics, as well as better accessibility and adaptation of investigation methods to different patient groups. More accurate forecasting models can facilitate that the right efforts for prevention and treatment are implemented at the right time, and that the resources of healthcare and society are thus used in the best possible way. In the longer term, these measures are expected to lead to fewer people developing dementia. Approach and implementation: In the innovation milieu, we introduce digital tools and working methods for early detection and investigation of cognitive impairment. Moreover, we develop, validate and introduce new classes of biomarkers for precision diagnostics. We develop prediction models and decision support for individualized prevention and treatment and develop methods for evaluating cost-effectiveness of new diagnostic and treatment strategies as well as new payment models to ensure fast and equal access to cost-effective treatment.