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Psychosocial determinants for adherence to a healthy lifestyle and intervention participation in the FINGER trial: an exploratory analysis of a randomised clinical trial.

School of Medicine, Institute of Clinical Medicine/Neurology, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland. elisa.neuvonen@uef.fi. School of Medicine, Institute of Clinical Medicine/Neurology, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland. Population Health Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland. Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Solnavägen 1, 171 77, Solna, Sweden. Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, St Dunstan's Road, London, W6 8RP, UK. Center for Life Course Health Research/Geriatrics, University of Oulu, P.O. Box 5000, 90014, Oulu, Finland. Medical Research Center Oulu, Oulu University Hospital, P.O. Box 10, 90029 OYS, Oulu, Finland. Ageing, Disability and Functioning Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland. Department of Neurology, Neurocenter, Kuopio University Hospital, P.O. Box 100, 70029 KYS, Kuopio, Finland. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland. Joint Municipal Authority for North Karelia Social and Health Services (Siun Sote), Tikkamäentie 16, 80210, Joensuu, Finland. University of Helsinki and Helsinki University Hospital, P.O. Box 340, 00029 HUS, Helsinki, Finland. Department of Public Health, University of Helsinki, P.O. Box 20, 00014, Helsinki, Finland. South Ostrobothnia Central Hospital, Hanneksenrinne 7, 60220, Seinäjoki, Finland. National School of Public Health, Carlos III Health Institute, Monforte de Lemos 5, 28029, Madrid, Spain. Diabetes Research Group, King Abdulaziz University, P.O. Box 80215, Jiddah, 21589, Saudi Arabia. Theme Aging, Karolinska University Hospital, Karolinska Vägen 22, 171 64, Solna, Sweden.

Aging clinical and experimental research. 2022;(8):1793-1805
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Abstract

BACKGROUND AND AIMS Psychosocial factors may affect adherence to lifestyle interventions and lifestyle changes. The role of psychosocial factors in dementia prevention needs more research. We aimed at clarify the issue in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). METHODS The population included 1260 participants aged 60-77 years at risk for cognitive decline, randomised to a multidomain lifestyle intervention or regular health advice for 2 years. Adherence was evaluated as participation in the provided activities and actual lifestyle changes, separately for each domain (diet, exercise, social/cognitive activity, vascular risk management) and combined into multidomain. Psychosocial factors were measured at trial baseline (depressive symptoms; study perception; health-related quality of life, HRQoL) and earlier life (hopelessness; satisfaction with family life, achievements, and financial situation). RESULTS Depressive symptoms, hopelessness, and nonpositive study perception were negatively and HRQoL positively associated with participation in the multidomain intervention. Depressive symptoms, lower HRQoL, hopelessness and dissatisfaction with financial situation were associated with unhealthier lifestyles at baseline. Baseline depressive symptoms and lower HRQoL predicted less improvement in lifestyle, but did not modify the intervention effect on lifestyle change. DISCUSSION AND CONCLUSIONS Several psychosocial factors were associated with participation in lifestyle intervention, while fewer of them contributed to lifestyle changes. Although the intervention was beneficial for lifestyle changes independent of psychosocial factors, those most in need of lifestyle improvement were less likely to be active. Tailoring lifestyle-modifying strategies based on the need for psychosocial support may add efficacy in future trials. TRIAL REGISTRY ClinicalTrials.gov NCT01041989 2010-01-05.

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Publication Type : Randomized Controlled Trial

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