From October 21st to October 25th 2015 the WONCA (World Organization of Family Doctors) Europe conference took place in Istanbul. In this large event, over 3,500 general practitioners from Europe and beyond gathered to exchange scientific, clinical and organizational knowledge. Three HATICE PhD students from the Netherlands attended the conference. Susan Jongstra presented the protocol of the HATICE-trial and Cathrien Beishuizen presented the results of a meta-analysis on internet-interventions for older people. Throughout the conference, there was considerable attention for cardiovascular prevention, risk management and eHealth.
A good environment to promote HATICE!
On 11-13 June the 7th Kuopio Alzheimer symposium was held. With 24-hour daylight in the sky, inside the Technopolis centre in Kuopio important discussions took place on Alzheimer's disease research. HATICE was well-represented. Hilkka Soininen was chair of the organization committee.
Miia Kivipelto presented encouraging data on the recently published FINGER trial, which illustrated the proof of principle of the effect of a multidomain intervention on cognitive functioning. Sandrine Andrieu presented some interesting lessons learned from the MAPT trial, which is currently under analysis. Edo Richard presented preliminary data on preDIVA, which is also under analysis at this very moment. HATICE was discussed extensively. All in all the theme dementia prevention was high on the agenda and led to lively discussions.
All are very much looking forward to the final results of MAPT and preDIVA later this year.
In the beginning of March the trial has started. All countries are recruiting participants now, and already 800 participants have been included in the trial.
A comprehensive programme providing older people at risk of dementia with healthy eating guidance, exercise, brain training, and management of metabolic and vascular risk factors appears to slow down cognitive decline, according to the first ever randomised controlled trial of its kind, published in The Lancet in March 2015.
In the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) study, researchers led by Professor Miia Kivipelto from the Karolinska Institutet in Stockholm, Sweden, National Institute for Health and Welfare in Helsinki, and University of Eastern Finland in Kuopio, assessed the effects on brain function of a comprehensive intervention aimed at addressing some of the most important risk factors for age‐related dementia, such as high body‐mass index and heart health.
1260 people from across Finland, aged 60–77 years, were included in the study, with half randomly allocated to the intervention group, and half allocated to a control group, who received regular health advice only. All of the study participants were deemed to be at risk of dementia, based on standardised test scores.
The intensive intervention consisted of regular meetings over two years with physicians, nurses, and other health professionals, with participants given comprehensive advice on maintaining a healthy diet, exercise programmes including both muscle and cardiovascular training, brain training exercises, and management of metabolic and vascular risk factors through regular blood tests, and other means.
After two years, study participants’ mental function was scored using a standard test, the Neuropsychological Test Battery (NTB), where a higher score corresponds to better mental functioning. Overall test scores in the intervention group were 25% higher than in the control group. For some parts of the test, the difference between groups was even more striking—for executive functioning (the brain’s ability to organise and regulate thought processes) scores were 83% higher in the intervention group, and processing speed was 150% higher. Based on a pre‐specified analysis, the intervention appeared to have no effect on patients’ memory. However, based on post‐hoc analyses, there was a difference in memory scores between the intervention and control groups.
According to Professor Kivipelto, “Much previous research has shown that there are links between cognitive decline in older people and factors such as diet, heart health, and fitness. However, our study is the first large randomised controlled trial to show that an intensive programme aimed at addressing these risk factors might be able to prevent cognitive decline in elderly people who are at risk of dementia.”
A seven-year follow-up of the study participants is planned to determine whether the diminished cognitive decline seen in this trial is followed by reduced levels of dementia and Alzheimer’s diagnoses. The researchers will also be investigating possible mechanisms whereby the intervention might affect brain function.
This study received core funding by the Academy of Finland, La Carita Foundation, Alzheimer Association, Alzheimer’s Research and Prevention Foundation, Juho Vainio Foundation, Novo Nordisk Foundation, Finnish Social Insurance Institution, Ministry of Education and Culture, Salama bint Hamdan Al Nahyan Foundation, and Axa Research Fund, EVO grants, Swedish Research Council, Swedish Research Council for Health, Working Life, and Welfare, af Jochnick Foundation (full list in the article).
On December 15th and 16th 2014, the biennial HATICE General Assembly consortium meeting with representatives from each institution took place in Amsterdam. During this meeting the results from the pilot study and the preparations for the randomised controlled trial were discussed. The randomised controlled trial is expected to commence in March 2015.