FINGER — Multidomain Intervention to Prevent Cognitive Decline

Design

FINGER (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) randomised 1,260 adults aged 60–77 at elevated dementia risk (CAIDE score ≥6) to a 2-year multidomain intervention or general health advice control. The intervention had four components:

1. Nutritional counselling (Nordic Diet pattern).
2. Physical-exercise programme (aerobic + resistance + balance).
3. Cognitive training (group + individual computerised).
4. Vascular risk monitoring (regular BP, lipids, glucose, BMI checks with healthcare contact).

Findings

• Significantly better composite cognitive performance in the intervention arm at 2 years.
• Larger effects on executive function and processing speed; smaller on memory.
• Modest reductions in vascular risk-factor burden.
• High adherence and good safety profile.

Why it matters

FINGER showed that combining the well-evidenced cardiovascular, exercise, nutrition, and cognitive-engagement levers produces additive cognitive benefit — supporting the idea that “there is no magic bullet, but there is a magic combination”.

The World-Wide FINGERS network is replicating and adapting the protocol across >40 countries.

Limitations

• 2-year cognitive change in older adults is modest; the gap between arms was statistically robust but clinically small.
• Cannot isolate which components contributed most.
• Population was Finnish, white, educated, motivated — generalisability to other settings is the focus of ongoing trials.

Related entries

Cognitive decline, Alzheimer's disease, Mediterranean diet, Exercise.