[F4–09–01]: FROM THE FINNISH GERIATRIC INTERVENTION STUDY TO PREVENT COGNITIVE IMPAIRMENT AND DISABILITY TO THE GLOBAL DEMENTIA PREVENTION INITIATIVE: APPLICABILITY OF MULTI‐DOMAIN INTERVENTIONS

Prevention can be pivotal in halting the expected worldwide increase of Alzheimerś disease (AD) and dementia cases. Given the multifactorial etiology of dementia and late-onset AD, multi-domain interventions targeting several vascular and lifestyle-related risk factors are most likely to be effective. Successful preventative approaches should be cost-effective, accessible, feasible, and sustainable for populations with different geographical, economic and cultural settings. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) is a pioneer multi-domain randomized controlled trial (RCT), where 1260 participants aged 60–77 years were recruited from the general population using the CAIDE Dementia Risk Score. Participants were randomized (1:1) either into a 2-year multi-domain intervention or the control group. The intervention included nutritional guidance, physical exercise, cognitive training and social activities, as well as management of vascular and metabolic risk factors. The control group received regular health advice. Primary outcome after 2 years was change in cognition (neuropsychological test battery, NTB z-score). A significant beneficial intervention effect on overall cognitive performance and various cognitive domains was found, showing for the first time that a multi-domain intervention may benefit cognitive functions in older subjects at increased risk of dementia. Intervention benefited also secondary outcomes (Body Mass Index, diet, physical exercise). New results concerning quality of life, functional level, and other secondary outcomes will be presented, as well as the extended follow-up. FINGER represents a successful pragmatic model, which is now being tested in diverse population-based settings (Europe, Singapore, USA, Australia). Novel approaches include combination of lifestyle intervention with pharmacological intervention (e.g. Multimodal preventive trials for AD) and use of modern technology (e.g. Healthy Aging Through Internet Counselling in the Elderly). To promote synergy across these studies and optimize efforts towards dementia prevention, we launched the Global Dementia Prevention Initiative (GDPI). GDPI is an interdisciplinary network, to share experiences, ideas and data, and plan joint initiatives focusing on cognitive impairment/dementia prevention. GDPI will facilitate synergistic use of data from several countries, creating a unique opportunity for rapid implementation of knowledge and definition of effective prevention programs for diverse populations.