A 2-year multi-domain lifestyle intervention in older adults reduced the incidence of combined stroke/TIA (HR 0.71; 95% CI 0.51-0.99) compared to general health advice.
RCT (n=1,259)
1:1
Does a 2-year multi-domain lifestyle intervention reduce incident cardiovascular disease in older adults aged 60-77 years?
A 2-year multi-domain lifestyle intervention in older adults significantly reduces the risk of cerebrovascular events, with broader cardiovascular benefits observed in patients with a prior history of CVD.
Effect estimate: HR 0.80 (95% CI 0.61-1.04)
Absolute Event Rate: 17% vs 19.4%
AIMS: Joint prevention of cardiovascular disease (CVD) and dementia could reduce the burden of both conditions. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) demonstrated a beneficial effect on cognition (primary outcome) and we assessed the effect of this lifestyle intervention on incident CVD (pre-specified secondary outcome). METHODS AND RESULTS: FINGER enrolled 1259 individuals aged 60-77 years (ClinicalTrials.gov NCT01041989). They were randomized (1:1) to a 2-year multi-domain intervention with diet, physical and cognitive activity, and vascular monitoring (n = 631), or general health advice (n = 628). National registries provided data on CVD including stroke, transient ischaemic attack (TIA), or coronary heart event. During an average of 7.4 years, 229 participants (18%) had at least one CVD diagnosis: 107 in the intervention group and 122 in the control group. The incidence of cerebrovascular events was lower in the intervention than the control group: hazard ratio (HR) for combined stroke/TIA was 0.71 95% confidence interval (CI): 0.51-0.99 after adjusting for background characteristics. Hazard ratio for coronary events was 0.84 (CI: 0.56-1.26) and total CVD events 0.80 (95% CI: 0.61-1.04). Among those with history of CVD (n = 145), the incidence of both total CVD events (HR: 0.50, 95% CI: 0.28-0.90) and stroke/TIA (HR: 0.40, 95% CI: 0.20-0.81) was lower in the intervention than the control group. CONCLUSION: A 2-year multi-domain lifestyle intervention among older adults was effective in preventing cerebrovascular events and also total CVD events among those who had history of CVD.
“We have shown that multidomain interventions are effective and feasible. Now we are moving to precision prevention, optimizing and adapting FINGER for different target populations.”
Lehtisalo et al. (Sun,) conducted a rct in Cardiovascular disease and cognitive impairment (n=1,259). Multi-domain lifestyle intervention (diet, physical and cognitive activity, and vascular monitoring) vs. General health advice was evaluated on Incident CVD (total CVD events) (HR 0.80, 95% CI 0.61-1.04). A 2-year multi-domain lifestyle intervention in older adults reduced the incidence of combined stroke/TIA (HR 0.71; 95% CI 0.51-0.99) compared to general health advice.