Abstract
Objective
To verify whether a multidomain intervention lowers the risk of developing new chronic
diseases in older adults.
Methods
Multicenter, double-blind randomized controlled trial started in October 2009, with
2-year follow-up. A total of 1260 people aged 60 to 77 years were enrolled in the
Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability
(FINGER). Participants were randomly assigned in a 1:1 ratio to a 2-year multidomain
intervention (n = 631) (nutritional guidance, exercise, cognitive training, and management
of metabolic and vascular risk factors) or a control group (n = 629) (general health
advice). Data on most common chronic diseases were collected by a physician at baseline
and 2 years later.
Results
At 2-year follow-up, the average number of new chronic diseases was 0.47 [standard
deviation (SD) 0.7] in the intervention group and 0.58 (SD 0.8) in the control group
(P < .01). The incidence rate per 100 person-years for developing 1+ new disease(s)
was 17.4 [95% confidence interval (CI) = 15.1-20.1] in the intervention group and
20.5 (95% CI = 18.0-23.4) in the control group; for developing 2+ new diseases, 4.9
(95% CI = 3.7-6.4) and 6.1 (95% CI = 4.8-7.8); and for 3+ new diseases, 0.7 (95% CI = 0.4-1.5)
and 1.8 (95% CI = 1.1-2.8), respectively. After adjustment for age, sex, education,
current smoking, alcohol intake, and the number of chronic diseases at baseline, the
intervention group had a hazard ratio ranging from 0.80 (0.66-0.98) for developing
1+ new chronic disease(s) to 0.38 (0.16-0.88) for developing 3+ new chronic diseases
compared to the control group.
Conclusions
Findings from this randomized controlled trial suggest that a multidomain intervention
could reduce the risk of developing new chronic diseases in older people.
Keywords
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Article info
Publication history
Published online: November 03, 2017
Footnotes
A.M. and D.R. are co–first authors.
The authors declare no conflicts of interest.
This study was funded by the following: Academy of Finland's Responding to Public Health Challenges Research Programme (SALVE) and grants 259615, 278457, 305810; and Joint Program of Neurodegenerative Disorders – prevention (MIND-AD), La Carita Foundation, Alzheimer Association grant (HAT-10-173121), Juho Vainio Foundation, Finnish Medical Foundation, Novo Nordisk Foundation, Finnish Social Insurance Institution, Ministry of Education and Culture Research Grant, EVO/VTR grants of University Hospitals of Kuopio, Oulu and Turku, Seinäjoki Central hospital and Oulu City Hospital for FINGER project, Swedish Research Council; Alzheimer's Research & Prevention Foundation USA; AXA Research Fund; Knut and Alice Wallenberg Foundation Sweden, Center for Innovative Medicine (CIMED) at Karolinska Institutet Sweden, Stiftelsen Stockholms sjukhem Sweden, Konung Gustaf V:s och Drottning Victorias Frimurarstiftelse Sweden, af Jochnick Foundation Sweden. The study funders had no role in study design, data collection, analysis, interpretation, writing of the report, or the decision to submit for publication.
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© 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
