World-Wide FINGERS Network: A global approach to risk reduction and prevention of dementia

Miia Kivipelto, Francesca Mangialasche, Heather M. Snyder, Ricardo Allegri, Sandrine Andrieu, Hidenori Arai, Laura Baker, Sylvie Belleville, Henry Brodaty, Sonia M. Brucki, Ismael Calandri, Paulo Caramelli, Christopher Chen, Howard Chertkow, Effie Chew, Seong H. Choi, Neerja Chowdhary, Lucía Crivelli, Rafael De La Torre, Yifeng DuTarun Dua, Mark Espeland, Howard H. Feldman, Maris Hartmanis, Tobias Hartmann, Megan Heffernan, Christiani J. Henry, Chang H. Hong, Krister Håkansson, Takeshi Iwatsubo, Jee H. Jeong, Gustavo Jimenez-Maggiora, Edward H. Koo, Lenore J. Launer, Jenni Lehtisalo, Francisco Lopera, Pablo Martínez-Lage, Ralph Martins, Lefkos Middleton, José L. Molinuevo, Manuel Montero-Odasso, So Y. Moon, Kristal Morales-Pérez, Ricardo Nitrini, Haakon B. Nygaard, Yoo K. Park, Markku Peltonen, Chengxuan Qiu, Yakeel T. Quiroz, Rema Raman, Naren Rao, Vijayalakshmi Ravindranath, Anna Rosenberg, Takashi Sakurai, Rosa M. Salinas, Philip Scheltens, Gustavo Sevlever, Hilkka Soininen, Ana L. Sosa, Claudia K. Suemoto, Mikel Tainta-Cuezva, Lina Velilla, Yongxiang Wang, Rachel Whitmer, Xin Xu, Lisa J. Bain, Alina Solomon, Tiia Ngandu, Maria C. Carrillo

Research output: Contribution to journalArticlepeer-review

214 Scopus citations


Reducing the risk of dementia can halt the worldwide increase of affected people. The multifactorial and heterogeneous nature of late-onset dementia, including Alzheimer's disease (AD), indicates a potential impact of multidomain lifestyle interventions on risk reduction. The positive results of the landmark multidomain Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) support such an approach. The World-Wide FINGERS (WW-FINGERS), launched in 2017 and including over 25 countries, is the first global network of multidomain lifestyle intervention trials for dementia risk reduction and prevention. WW-FINGERS aims to adapt, test, and optimize the FINGER model to reduce risk across the spectrum of cognitive decline—from at-risk asymptomatic states to early symptomatic stages—in different geographical, cultural, and economic settings. WW-FINGERS aims to harmonize and adapt multidomain interventions across various countries and settings, to facilitate data sharing and analysis across studies, and to promote international joint initiatives to identify globally implementable and effective preventive strategies.

Original languageEnglish
Pages (from-to)1078-1094
Number of pages17
JournalAlzheimer's and Dementia
Issue number7
StatePublished - 1 Jul 2020

Bibliographical note

Funding Information:
Another study in Spain, the “Prevention of cognitive decline after a multimodal intervention combined with epigallocatechin gallate in carriers with subjective cognitive decline” (PENSA study: in Catalan PENSA means “think about”; NCT03978052) is an ongoing project in Barcelona, performed in collaboration with the Hospital del Mar Medical Research Institute (IMIM) and the BarcelonaBeta Brain Research Center (BBRC). PENSA will randomize 200 individuals meeting criteria of subjective cognitive decline (SCD), fulfilling four SCD plus features, including subjects older than 60 years and carriers. The project combines a multidomain lifestyle intervention including diet, physical activity, and cognitive stimulation and training and the administration as dietary supplement of the flavanol from green tea, epigallocatechin gallate (EGCG, 5 to 6 mg/kg up to 532 mg/day). The intervention will last 12 months. Participants will be randomized into one of four study arms (Table 1 ), and the primary outcome is global cognition measured with the ADCS Preclinical Alzheimer Cognitive Composite‐Plus‐exe. Secondary and exploratory outcomes include neuroimaging (structural and functional MRI); microbiota; neuroinflammation biomarkers; metabolomics; blood, brain‐derived exosomes, and CSF neuropathological biomarkers; physical activity, dietary assessments, cognitive training performance, and quality‐of‐life records. The project is primarily funded by the Alzheimer's Association, with additional support from the Spanish Ministry of Science, Innovation and Universities (Instituto Carlos III). APOE4 APOE 4

Funding Information:
This work was supported by the Academy of Finland; Joint Program of Neurodegenerative Disorders—prevention (MIND‐AD) grant through the following funding organizations under the aegis of JPND— Finland, Suomen Akatemia (Academy of Finland, 291803); Sweden, Vetenskapsrådet (VR) (Swedish Research Council, 529‐2014‐7503) France, French National Agency for Research (ANR), ANR‐14‐JPPS‐0001‐02]; Swedish Research Council grant 2017‐06105; Juho Vainio Foundation, Finnish Medical Foundation; Finnish Social Insurance Institution; Ministry of Education and Culture Research Grant; Finnish Cultural Foundation; 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; Alzheimer's Research and Prevention Foundation; the European Research Council Starting Grant (ERC‐804371), Alzheimerfonden Sweden; Region Stockholm (ALF and NSV grants), Sweden. U.S. POINTER trial is supported by the Alzheimer's Association POINTER‐19‐611541 and POINTER‐19‐612024 (PIs: Laura Baker, Mark Espeland, Miia Kivipelto, Rachel Whitmer, and ALZ PIs: Maria C. Carrillo and Heather M. Snyder), and ancillary Neuroimaging study to U.S. POINTER with National Institutes of Health (NIH) grant number R01AG062689 (PI: S Landau). Additional support was provided by the Wake Forest Alzheimer's Disease Core Center (P30AG049638‐01A1). The MYB trial is funded by a National Health and Medical Research Council (NHMRC) Boosting Dementia Research Team Grant (APP1095097). The SINGER study was supported by Centre For Healthy Ageing, National University Health System, Singapore. The J‐MINT study is supported by Japan Agency for Medical Research and Development. The Canadian Thumbs Up Platform Trial is part of the Canadian Consortium on Neurodegeneration in Aging (CCNA) Phase 2, which is funded by the Canadian Institutes of Health Research (CIHR #201901CNA‐417847‐CAN‐ABPI‐ 32054) and a consortium of partners including the Alzheimer Society of Canada. The work in India is made possible by funding from Centre for Brain Research, Bengaluru, India. The PENSA study is funded by the Alzheimer's Association (18PTC‐R‐592192) and the Instituto Carlos III (PI17/00223). MIND‐CHINA was supported by the National Key R&D Program of China from the Ministry of Science and Technology of China (grant no.: 2017YFC1310100), and additional grants were received from the Shandong Taishan Scholar Program, Shandong, China; the Sino‐Sweden joint research project grants from the National Natural Science Foundation of China (NSFC grant no.: 81861138008) and the Swedish Research Council (grants no.: 2017‐00740 and 2017‐05819); and the Joint China‐Sweden Mobility Programme grants from the National Natural Science Foundation of China NSFC (grant no.: 8191101618) and the Swedish Foundation for International Cooperation in Research and Higher Education (STINT, grant no.: CH2019‐8320). GOIZ ZAINDU project has been partially financed by the Health Department of the Basque Government (File No. 2017111120). Paulo Caramelli holds a senior research fellowship () from CNPq, Brazil. SUPERBRAIN was supported by the grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (HI18C0479). bolsa de produtividade em pesquisa

Publisher Copyright:
© 2020 The Authors. Alzheimer's & Dementia published by Wiley Periodicals, Inc. on behalf of Alzheimer's Association


  • Alzheimer's disease
  • World-Wide FINGERS
  • cognitive impairment
  • dementia
  • lifestyle
  • multidomain intervention
  • prevention
  • randomized controlled trial


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