In the last issue we mentioned a major trial called the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment (FINGER).
The study was designed to see if it was possible to lower the risk of cognitive decline with changes in lifestyle that almost any motivated person could make.
Commenting on the outcome of the research, Joe Verghese, head of cognitive and motor aging at Albert Einstein College of Medicine in New York, enthused, “The result of the FINGER study is exciting and has major implications for clinical practice.”
Let’s see why he was so upbeat.
Training and Advice on Diet, Exercise and Mental Tasks
The study enrolled 1,260 Finnish people aged between 60 and 77. Based on cognitive testing, the participants were assessed as being at risk of dementia. They were reasonably healthy, hadn’t developed major memory problems and were considered representative of people in their age group.
Half were allocated to the intervention group while the other half acted as controls, just receiving regular health advice.
Over a period of two years the intervention group program focused on three areas:
- Healthy eating: advice given in both individual and group sessions included high levels of fruits and vegetables, whole grains, two or more portions of fish a week, limited sugar
- Physical activity: group and individual muscle training to increase strength one to three times a week and aerobic exercise two to five times a week; exercises for postural balance.
- Cognitive training: group sessions with a psychologist, plus regular short training sessions three times a week to improve several aspects of memory, conducted over two periods of six months.
Social interaction was also considered important; hence there were group get-togethers which included cookery sessions and how to prepare healthy meals.
The researchers regularly checked metabolic and vascular risk factors. These included weight, body mass index, hip/waist circumference, blood pressure and other physical examinations.
At the end of two years, when the cognitive tests were repeated, the overall test score improvement was 25% higher in the intervention group than in the controls.
Even more impressive were the improvements in executive function (the ability to organize thoughts) and processing ability (the speed at which different tasks are conducted). Compared to the control group they were 83% and 150% higher respectively.
For each of these tests, the risk of cognitive decline was greater in the control group.
The dropout rates for participants was low, adherence to the program was high, and there were few side effects, suggesting that this is a highly practical plan to stay healthy.
“A Real Breakthrough”
Professor Mila Kivipelto from the Karolinska Institute in Stockholm, Sweden, who led the study, described it as “a real breakthrough and [it] feels very exciting.”
She continued, “Our results suggest prevention is the key. We can do things before memory problems develop to lower the risk. And our interventions are not difficult to do — they are very simple and pragmatic. We can all start following them today to lower our risk of future cognitive problems.
“I think we can start to give advice based on our results. I think it would be unethical not to.”
As well as changing to a healthier diet and exercising, she recommends regularly challenging the brain with memory games, puzzles, problem-solving and learning new skills.
She also suggests that benefits come from social interaction, so why not join a group to learn a new language, discuss books, go walking, join a dance class etc.? Professor Kivipelto believes combining physical, cognitive and social factors is the ideal.