Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability
FINGER
1 other identifier
interventional
1,200
1 country
5
Brief Summary
This multi-center (6 sites: Helsinki, Kuopio, Oulu, Seinäjoki, Turku, Vantaa) intervention study aims to prevent cognitive impairment, dementia and disability in 60-77 year old persons at an increased dementia risk. The 2-year multi-domain life-style intervention includes nutritional guidance, exercise, cognitive training, increased social activity, and intensive monitoring and management of metabolic and vascular risk factors. The primary outcome is cognitive impairment measured by a sensitive Neuropsychological Test Battery (NTB), and Stroop and Trail Making tests to capture early cognitive impairment typical for both Alzheimer's disease and vascular dementia. We hypothesize that the multi-domain intervention will reduce cognitive impairment in the study group compared to the control group during the initial 2-year intervention period and reduce dementia incidence after the extended follow-up (until at least 300 participants have developed dementia).
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Sep 2009
Longer than P75 for not_applicable
5 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
Study Start
First participant enrolled
September 1, 2009
CompletedFirst Submitted
Initial submission to the registry
January 4, 2010
CompletedFirst Posted
Study publicly available on registry
January 5, 2010
CompletedPrimary Completion
Last participant's last visit for primary outcome
December 1, 2013
CompletedStudy Completion
Last participant's last visit for all outcomes
December 1, 2025
CompletedApril 19, 2023
April 1, 2023
4.3 years
January 4, 2010
April 17, 2023
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Cognitive impairment assessed with a Neuropsychological Test Battery, and Stroop and Trail Making tests.
2 years
Secondary Outcomes (7)
Depressive symptoms will be assessed using the Zung depression scale.
2 years
Disability will be assessed using the ADCS-ADL scale
2 years
Quality of Life will be assessed using the RAND-36 and 15D questionnaires.
2 years
Utilization of health resources will be assessed using questionnaire and register data.
2 years
Vascular and metabolic risk factors will be assessed with blood pressure and anthropometric measurements, and laboratory analyses of metabolic biomarkers.
2 years
- +2 more secondary outcomes
Study Arms (2)
Standard health counseling at baseline
NO INTERVENTIONLifestyle counseling
EXPERIMENTALMulti-domain lifestyle counseling including nutritional guidance, increased physical activity, cognitive training, increased social activity and intensive monitoring of vascular and metabolic risk factors.
Interventions
Individual counseling sessions and group meetings will be organized.
Cognitive training will be implemented through 8 group sessions lead by a psychologist and a computer-based cognitive training program available to participants via the internet.
Monitoring and maintenance of metabolic and vascular risk factors
Eligibility Criteria
You may qualify if:
- aged 60-77 years
- dementia Risk Score 6 points or more
- fulfillment of at least one of the following CERAD criteria: i) MMSE: 20-26 points ii) word list memory task (3x10 words): 19 words or less iii) delayed recall: 75% or less
You may not qualify if:
- malignant diseases
- dementia
- substantial cognitive decline
- major depression
- symptomatic cardiovascular disease
- revascularisation within 1 year
- severe loss of vision, hearing or communicative ability
- other conditions inhibiting from safe engagement in the prescribed intervention as judged by the study physician
- other conditions preventing from cooperation as judged by the study physician
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Finnish Institute for Health and Welfarelead
- Academy of Finlandcollaborator
- University of Helsinkicollaborator
- University of Eastern Finlandcollaborator
- University of Oulucollaborator
- Kuopio Research Institute of Exercise Medicinecollaborator
- Western University, Canadacollaborator
- Karolinska Institutetcollaborator
- Umeå Universitycollaborator
Study Sites (5)
Finnish Institute for Health and Welfare
Helsinki, 00300, Finland
University of Eastern Finland
Kuopio, 70211, Finland
University of Oulu
Oulu, 90014, Finland
Research Center Mediwest
Seinäjoki, 60220, Finland
Finnish Institute for Health and Welfare
Turku, 20720, Finland
Related Publications (34)
Kivipelto M, Ngandu T, Laatikainen T, Winblad B, Soininen H, Tuomilehto J. Risk score for the prediction of dementia risk in 20 years among middle aged people: a longitudinal, population-based study. Lancet Neurol. 2006 Sep;5(9):735-41. doi: 10.1016/S1474-4422(06)70537-3.
PMID: 16914401BACKGROUNDKivipelto M, Helkala EL, Laakso MP, Hanninen T, Hallikainen M, Alhainen K, Soininen H, Tuomilehto J, Nissinen A. Midlife vascular risk factors and Alzheimer's disease in later life: longitudinal, population based study. BMJ. 2001 Jun 16;322(7300):1447-51. doi: 10.1136/bmj.322.7300.1447.
PMID: 11408299BACKGROUNDKivipelto M, Helkala EL, Hanninen T, Laakso MP, Hallikainen M, Alhainen K, Soininen H, Tuomilehto J, Nissinen A. Midlife vascular risk factors and late-life mild cognitive impairment: A population-based study. Neurology. 2001 Jun 26;56(12):1683-9. doi: 10.1212/wnl.56.12.1683.
PMID: 11425934BACKGROUNDKivipelto M, Helkala EL, Laakso MP, Hanninen T, Hallikainen M, Alhainen K, Iivonen S, Mannermaa A, Tuomilehto J, Nissinen A, Soininen H. Apolipoprotein E epsilon4 allele, elevated midlife total cholesterol level, and high midlife systolic blood pressure are independent risk factors for late-life Alzheimer disease. Ann Intern Med. 2002 Aug 6;137(3):149-55. doi: 10.7326/0003-4819-137-3-200208060-00006.
PMID: 12160362BACKGROUNDRovio S, Kareholt I, Helkala EL, Viitanen M, Winblad B, Tuomilehto J, Soininen H, Nissinen A, Kivipelto M. Leisure-time physical activity at midlife and the risk of dementia and Alzheimer's disease. Lancet Neurol. 2005 Nov;4(11):705-11. doi: 10.1016/S1474-4422(05)70198-8.
PMID: 16239176BACKGROUNDKivipelto M, Ngandu T, Fratiglioni L, Viitanen M, Kareholt I, Winblad B, Helkala EL, Tuomilehto J, Soininen H, Nissinen A. Obesity and vascular risk factors at midlife and the risk of dementia and Alzheimer disease. Arch Neurol. 2005 Oct;62(10):1556-60. doi: 10.1001/archneur.62.10.1556.
PMID: 16216938BACKGROUNDLindstrom J, Ilanne-Parikka P, Peltonen M, Aunola S, Eriksson JG, Hemio K, Hamalainen H, Harkonen P, Keinanen-Kiukaanniemi S, Laakso M, Louheranta A, Mannelin M, Paturi M, Sundvall J, Valle TT, Uusitupa M, Tuomilehto J; Finnish Diabetes Prevention Study Group. Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet. 2006 Nov 11;368(9548):1673-9. doi: 10.1016/S0140-6736(06)69701-8.
PMID: 17098085BACKGROUNDKivipelto M, Rovio S, Ngandu T, Kareholt I, Eskelinen M, Winblad B, Hachinski V, Cedazo-Minguez A, Soininen H, Tuomilehto J, Nissinen A. Apolipoprotein E epsilon4 magnifies lifestyle risks for dementia: a population-based study. J Cell Mol Med. 2008 Dec;12(6B):2762-71. doi: 10.1111/j.1582-4934.2008.00296.x. Epub 2008 Feb 8.
PMID: 18318693BACKGROUNDKivipelto M, Solomon A, Ahtiluoto S, Ngandu T, Lehtisalo J, Antikainen R, Backman L, Hanninen T, Jula A, Laatikainen T, Lindstrom J, Mangialasche F, Nissinen A, Paajanen T, Pajala S, Peltonen M, Rauramaa R, Stigsdotter-Neely A, Strandberg T, Tuomilehto J, Soininen H. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER): study design and progress. Alzheimers Dement. 2013 Nov;9(6):657-65. doi: 10.1016/j.jalz.2012.09.012. Epub 2013 Jan 17.
PMID: 23332672RESULTNgandu T, Lehtisalo J, Levalahti E, Laatikainen T, Lindstrom J, Peltonen M, Solomon A, Ahtiluoto S, Antikainen R, Hanninen T, Jula A, Mangialasche F, Paajanen T, Pajala S, Rauramaa R, Strandberg T, Tuomilehto J, Soininen H, Kivipelto M. Recruitment and baseline characteristics of participants in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER)-a randomized controlled lifestyle trial. Int J Environ Res Public Health. 2014 Sep 10;11(9):9345-60. doi: 10.3390/ijerph110909345.
PMID: 25211775RESULTNgandu T, Lehtisalo J, Solomon A, Levalahti E, Ahtiluoto S, Antikainen R, Backman L, Hanninen T, Jula A, Laatikainen T, Lindstrom J, Mangialasche F, Paajanen T, Pajala S, Peltonen M, Rauramaa R, Stigsdotter-Neely A, Strandberg T, Tuomilehto J, Soininen H, Kivipelto M. 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. Lancet. 2015 Jun 6;385(9984):2255-63. doi: 10.1016/S0140-6736(15)60461-5. Epub 2015 Mar 12.
PMID: 25771249RESULTKulmala J, Ngandu T, Pajala S, Lehtisalo J, Levalahti E, Antikainen R, Laatikainen T, Oksa H, Peltonen M, Rauramaa R, Soininen H, Strandberg T, Tuomilehto J, Kivipelto M. Leisure-Time and Occupational Physical Activity in Early and Late Adulthood in Relation to Later Life Physical Functioning. J Phys Act Health. 2016 Oct;13(10):1079-1087. doi: 10.1123/jpah.2015-0664. Epub 2016 Aug 16.
PMID: 27254853RESULTStrandberg TE, Levälahti E, Ngandu T, Solomon A, M Kivipelto for FINGER Study Group. Health-Related Quality of Life in a Multidomain Intervention Trial to Prevent Cognitive Decline (FINGER). Eur Ger Med. 2017; 8: 164-167.
RESULTLehtisalo J, Ngandu T, Valve P, Antikainen R, Laatikainen T, Strandberg T, Soininen H, Tuomilehto J, Kivipelto M, Lindstrom J. Nutrient intake and dietary changes during a 2-year multi-domain lifestyle intervention among older adults: secondary analysis of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) randomised controlled trial. Br J Nutr. 2017 Aug;118(4):291-302. doi: 10.1017/S0007114517001982.
PMID: 28875868RESULTMarengoni A, Rizzuto D, Fratiglioni L, Antikainen R, Laatikainen T, Lehtisalo J, Peltonen M, Soininen H, Strandberg T, Tuomilehto J, Kivipelto M, Ngandu T. The Effect of a 2-Year Intervention Consisting of Diet, Physical Exercise, Cognitive Training, and Monitoring of Vascular Risk on Chronic Morbidity-the FINGER Randomized Controlled Trial. J Am Med Dir Assoc. 2018 Apr;19(4):355-360.e1. doi: 10.1016/j.jamda.2017.09.020. Epub 2017 Nov 3.
PMID: 29108888RESULTSolomon A, Handels R, Wimo A, Antikainen R, Laatikainen T, Levalahti E, Peltonen M, Soininen H, Strandberg T, Tuomilehto J, Kivipelto M, Ngandu T. Effect of a Multidomain Lifestyle Intervention on Estimated Dementia Risk. J Alzheimers Dis. 2021;82(4):1461-1466. doi: 10.3233/JAD-210331.
PMID: 34151805RESULTLehtisalo J, Rusanen M, Solomon A, Antikainen R, Laatikainen T, Peltonen M, Strandberg T, Tuomilehto J, Soininen H, Kivipelto M, Ngandu T. Effect of a multi-domain lifestyle intervention on cardiovascular risk in older people: the FINGER trial. Eur Heart J. 2022 Jun 1;43(21):2054-2061. doi: 10.1093/eurheartj/ehab922.
PMID: 35051281RESULTWimo A, Handels R, Antikainen R, Eriksdotter M, Jonsson L, Knapp M, Kulmala J, Laatikainen T, Lehtisalo J, Peltonen M, Skoldunger A, Soininen H, Solomon A, Strandberg T, Tuomilehto J, Ngandu T, Kivipelto M. Dementia prevention: The potential long-term cost-effectiveness of the FINGER prevention program. Alzheimers Dement. 2023 Mar;19(3):999-1008. doi: 10.1002/alz.12698. Epub 2022 Jul 16.
PMID: 35841619RESULTSaaskilahti M, Aarnio E, Levalahti E, Lehtisalo J, Kivipelto M, Strandberg T, Antikainen R, Soininen H, Laatikainen T, Tuomilehto J, Solomon A, Mangialasche F, Ngandu T. Cardiovascular and glucose-lowering medication use among older adults: results from 9-year follow-up of the FINGER trial. Eur Geriatr Med. 2025 Dec 3. doi: 10.1007/s41999-025-01354-1. Online ahead of print.
PMID: 41339545DERIVEDLorenzon G, Marseglia A, Mohanty R, Lehtisalo J, Poulakis K, Ngandu T, Solomon A, Kivipelto M, Westman E. Brain patterns and risk factors in the FINGER RCT multimodal lifestyle intervention. J Prev Alzheimers Dis. 2025 Dec;12(10):100390. doi: 10.1016/j.tjpad.2025.100390. Epub 2025 Sep 24.
PMID: 40998691DERIVEDLorenzo T, Ngandu T, Lehtisalo J, Antikainen R, Gispert JD, Kemppainen N, Laatikainen T, Lindstrom J, Rinne J, Soininen H, Strandberg T, Torre R, Tuomilehto J, Solomon A, Kivipelto M. Associations of Prediabetes, Diabetes and Glucose-Related Markers With Cognition and Neuroimaging in a 2-Year Multidomain Lifestyle Randomised Controlled Trial. Diabetes Metab Res Rev. 2025 Jul;41(5):e70053. doi: 10.1002/dmrr.70053.
PMID: 40478656DERIVEDLehtisalo J, Saaskilahti M, Harkanen T, Kulmala J, Hemio K, Siltanen S, Zhi Z, Mangialasche F, Laatikainen T, Strandberg T, Antikainen R, Tuomilehto J, Soininen H, Kivipelto M, Ngandu T. Changes in older persons' lifestyle and perceived health over time and during the COVID-19 pandemic: findings from the extended follow-up of the FINGER randomized controlled trial from 2009 to 2020. BMC Geriatr. 2025 May 3;25(1):308. doi: 10.1186/s12877-025-05979-6.
PMID: 40319270DERIVEDKekkonen E, Hall A, Antikainen R, Havulinna S, Kivipelto M, Kulmala J, Laatikainen T, Paajanen TI, Sindi S, Soininen H, Strandberg T, Tuomilehto J, Ngandu T, Solomon A. Impaired sleep, depressive symptoms, and pain as determinants of physical activity and exercise intervention adherence: an exploratory analysis of a randomized clinical trial. BMC Geriatr. 2025 Mar 29;25(1):211. doi: 10.1186/s12877-025-05830-y.
PMID: 40158087DERIVEDVaskivuo L, Hokkanen L, Levalahti E, Hanninen T, Antikainen R, Backman L, Laatikainen T, Paajanen T, Stigsdotter Neely A, Strandberg T, Tuomilehto J, Soininen H, Kivipelto M, Ngandu T. Subjective Memory Complaints and the Effect of a Multidomain Lifestyle Intervention on Cognition: The FINGER Trial. J Gerontol B Psychol Sci Soc Sci. 2024 Dec 11;80(1):gbae179. doi: 10.1093/geronb/gbae179.
PMID: 39450437DERIVEDGoikolea J, Gerenu G, Daniilidou M, Mangialasche F, Mecocci P, Ngandu T, Rinne J, Solomon A, Kivipelto M, Cedazo-Minguez A, Sandebring-Matton A, Maioli S. Serum Thioredoxin-80 is associated with age, ApoE4, and neuropathological biomarkers in Alzheimer's disease: a potential early sign of AD. Alzheimers Res Ther. 2022 Feb 24;14(1):37. doi: 10.1186/s13195-022-00979-9.
PMID: 35209952DERIVEDAlenius M, Ngandu T, Koskinen S, Hallikainen I, Hanninen T, Karrasch M, Kivipelto M, Raivio MM, Laakkonen ML, Kruger J, Suhonen NM, Hokkanen L. Education-Based Cutoffs for Cognitive Screening of Alzheimer's Disease. Dement Geriatr Cogn Disord. 2022;51(1):42-55. doi: 10.1159/000521982. Epub 2022 Feb 23.
PMID: 35196653DERIVEDNeuvonen E, Lehtisalo J, Solomon A, Antikainen R, Havulinna S, Hanninen T, Laatikainen T, Lindstrom J, Rautio N, Soininen H, Strandberg T, Tuomilehto J, Kivipelto M, Ngandu T. Psychosocial determinants for adherence to a healthy lifestyle and intervention participation in the FINGER trial: an exploratory analysis of a randomised clinical trial. Aging Clin Exp Res. 2022 Aug;34(8):1793-1805. doi: 10.1007/s40520-022-02088-x. Epub 2022 Feb 19.
PMID: 35182352DERIVEDNgandu T, Lehtisalo J, Korkki S, Solomon A, Coley N, Antikainen R, Backman L, Hanninen T, Lindstrom J, Laatikainen T, Paajanen T, Havulinna S, Peltonen M, Neely AS, Strandberg T, Tuomilehto J, Soininen H, Kivipelto M. The effect of adherence on cognition in a multidomain lifestyle intervention (FINGER). Alzheimers Dement. 2022 Jul;18(7):1325-1334. doi: 10.1002/alz.12492. Epub 2021 Oct 20.
PMID: 34668644DERIVEDSandebring-Matton A, Goikolea J, Bjorkhem I, Paternain L, Kemppainen N, Laatikainen T, Ngandu T, Rinne J, Soininen H, Cedazo-Minguez A, Solomon A, Kivipelto M. 27-Hydroxycholesterol, cognition, and brain imaging markers in the FINGER randomized controlled trial. Alzheimers Res Ther. 2021 Mar 6;13(1):56. doi: 10.1186/s13195-021-00790-y.
PMID: 33676572DERIVEDSindi S, Solomon A, Kareholt I, Hovatta I, Antikainen R, Hanninen T, Levalahti E, Laatikainen T, Lehtisalo J, Lindstrom J, Paajanen T, Peltonen M, Singh Khalsa D, Wolozin B, Strandberg T, Tuomilehto J, Soininen H, Ngandu T, Kivipelto M; FINGER Study Group. Telomere Length Change in a Multidomain Lifestyle Intervention to Prevent Cognitive Decline: A Randomized Clinical Trial. J Gerontol A Biol Sci Med Sci. 2021 Feb 25;76(3):491-498. doi: 10.1093/gerona/glaa279.
PMID: 33175128DERIVEDStephen R, Liu Y, Ngandu T, Antikainen R, Hulkkonen J, Koikkalainen J, Kemppainen N, Lotjonen J, Levalahti E, Parkkola R, Pippola P, Rinne J, Strandberg T, Tuomilehto J, Vanninen R, Kivipelto M, Soininen H, Solomon A; FINGER study group. Brain volumes and cortical thickness on MRI in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). Alzheimers Res Ther. 2019 Jun 4;11(1):53. doi: 10.1186/s13195-019-0506-z.
PMID: 31164160DERIVEDKulmala J, Ngandu T, Havulinna S, Levalahti E, Lehtisalo J, Solomon A, Antikainen R, Laatikainen T, Pippola P, Peltonen M, Rauramaa R, Soininen H, Strandberg T, Tuomilehto J, Kivipelto M. The Effect of Multidomain Lifestyle Intervention on Daily Functioning in Older People. J Am Geriatr Soc. 2019 Jun;67(6):1138-1144. doi: 10.1111/jgs.15837. Epub 2019 Feb 26.
PMID: 30809801DERIVEDLehtisalo J, Levalahti E, Lindstrom J, Hanninen T, Paajanen T, Peltonen M, Antikainen R, Laatikainen T, Strandberg T, Soininen H, Tuomilehto J, Kivipelto M, Ngandu T. Dietary changes and cognition over 2 years within a multidomain intervention trial-The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). Alzheimers Dement. 2019 Mar;15(3):410-417. doi: 10.1016/j.jalz.2018.10.001. Epub 2018 Dec 4.
PMID: 30527596DERIVEDSolomon A, Turunen H, Ngandu T, Peltonen M, Levalahti E, Helisalmi S, Antikainen R, Backman L, Hanninen T, Jula A, Laatikainen T, Lehtisalo J, Lindstrom J, Paajanen T, Pajala S, Stigsdotter-Neely A, Strandberg T, Tuomilehto J, Soininen H, Kivipelto M. Effect of the Apolipoprotein E Genotype on Cognitive Change During a Multidomain Lifestyle Intervention: A Subgroup Analysis of a Randomized Clinical Trial. JAMA Neurol. 2018 Apr 1;75(4):462-470. doi: 10.1001/jamaneurol.2017.4365.
PMID: 29356827DERIVED
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Miia Kivipelto, professor
Finnish Institute for Health and Welfare
- STUDY DIRECTOR
Tiina K Laatikainen, professor
Finnish Institute for Health and Welfare
- STUDY DIRECTOR
Hilkka S Soininen, professor
University of Eastern Finland
- STUDY DIRECTOR
Jaakko Tuomilehto, professor
University of Helsinki
- STUDY DIRECTOR
Timo E Strandberg, professor
University of Oulu
- STUDY DIRECTOR
Raimo Sulkava, professor
University of Eastern Finland
- STUDY DIRECTOR
Rainer Rauramaa, professor
Kuopio Research Institute of Exercise Medicine
- STUDY DIRECTOR
Antti Jula, research prof
Finnish Institute for Health and Welfare
- STUDY DIRECTOR
Markku Peltonen, research professor
Finnish Institute for Health and Welfare
- STUDY DIRECTOR
Satu Havulinna, PhD
Finnish Institute for Health and Welfare
- STUDY DIRECTOR
Jaana Lindström, Adjunct prof.
Finnish Institute for Health and Welfare
- STUDY DIRECTOR
Riitta Antikainen, professor
Oulu City Health Services
- STUDY DIRECTOR
Tiia Ngandu, MD, PhD, Adjunct professor
Finnish Institute for Health and Welfare
- STUDY DIRECTOR
Tuomo Hänninen, Adjunct prof
University of Eastern Finland
- STUDY DIRECTOR
Jenni Lehtisalo, PhD
Finnish Institute for Health and Welfare
- STUDY DIRECTOR
Alina Solomon, MD, PhD, Adjunct professor
University of Eastern Finland
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- OUTCOMES ASSESSOR
- Purpose
- PREVENTION
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER GOV
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Professor
Study Record Dates
First Submitted
January 4, 2010
First Posted
January 5, 2010
Study Start
September 1, 2009
Primary Completion
December 1, 2013
Study Completion
December 1, 2025
Last Updated
April 19, 2023
Record last verified: 2023-04