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Brain volumes and cortical thickness on MRI in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER).

Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland. Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland. yawu.liu@kuh.fi. Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland. yawu.liu@kuh.fi. Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland. Division of Clinical Geriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden. Center for Life Course Health Research/Geriatrics, University of Oulu, Oulu, Finland. Medical Research Center Oulu, Oulu University Hospital and Oulu City Hospital, Oulu, Finland. Combinostics, Tampere, Finland. Turku University Hospital, Turku, Finland. Turku PET Centre, University of Turku, Turku, Finland. Seinäjoki City Hospital, Seinäjoki, Finland. University of Helsinki, Clinicum, and Helsinki University Hospital, Helsinki, Finland. Department of Public Health, University of Helsinki, Helsinki, Finland. South Ostrobothnia Central Hospital, Seinäjoki, Finland. Department of Neurosciences and Preventive Medicine, Danube-University Krems, Krems an der Donau, Austria. Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia. Dasman Diabetes Institute, Dasman, Kuwait. Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland. Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.

Alzheimer's research & therapy. 2019;(1):53
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Abstract

BACKGROUND The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) was a multicenter randomized controlled trial that reported beneficial effects on cognition for a 2-year multimodal intervention (diet, exercise, cognitive training, vascular risk monitoring) versus control (general health advice). This study reports exploratory analyses of brain MRI measures. METHODS FINGER targeted 1260 older individuals from the general Finnish population. Participants were 60-77 years old, at increased risk for dementia but without dementia/substantial cognitive impairment. Brain MRI scans were available for 132 participants (68 intervention, 64 control) at baseline and 112 participants (59 intervention, 53 control) at 2 years. MRI measures included regional brain volumes, cortical thickness, and white matter lesion (WML) volume. Cognition was assessed at baseline and 1- and 2-year visits using a comprehensive neuropsychological test battery. We investigated the (1) differences between the intervention and control groups in change in MRI outcomes (FreeSurfer 5.3) and (2) post hoc sub-group analyses of intervention effects on cognition in participants with more versus less pronounced structural brain changes at baseline (mixed-effects regression models, Stata 12). RESULTS No significant differences between the intervention and control groups were found on the changes in MRI measures. Beneficial intervention effects on processing speed were more pronounced in individuals with higher baseline cortical thickness in Alzheimer's disease signature areas (composite measure of entorhinal, inferior and middle temporal, and fusiform regions). The randomization group × time × cortical thickness interaction coefficient was 0.198 (p = 0.021). A similar trend was observed for higher hippocampal volume (group × time × hippocampus volume interaction coefficient 0.1149, p = 0.085). CONCLUSIONS The FINGER MRI exploratory sub-study did not show significant differences between the intervention and control groups on changes in regional brain volumes, regional cortical thicknesses, or WML volume after 2 years in at-risk elderly without substantial impairment. The cognitive benefits on processing speed of the FINGER intervention may be more pronounced in individuals with fewer structural brain changes on MRI at baseline. This suggests that preventive strategies may be more effective if started early, before the occurrence of more pronounced structural brain changes. TRIAL REGISTRATION ClinicalTrials.gov, NCT01041989 . Registered January 5, 2010.

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