UEF - Nordic-UK Brain Network  (UEF-NBN)

Research

Cardiovascular Risk Factors, Aging and Dementia Study

Principal Investigator: Miia Kivipelto
Scientific Coordinators: Alina Solomon, Tiia Ngandu, Jenni Kulmala
Field Coordinators: Mariagnese Barbera, Inna Lisko

 

CAIDE is a population-based cohort study initiated in 1998 to investigate the potential role of midlife modifiable risk and protective factors in the development of dementia.

It initially included 2000 people who participated in Finnish, mid-life, population-based surveys (The North Karelia project and FINMONICA studies, later FINRISK) between 1972 and 1987, in the Kuopio and Joensuu areas of Eastern Finland.

The study first follow-up was conducted in 1998 and the second in 2005-2008, an average of 21 and 28 years after the mid-life examination, respectively.  Between 2006 and 2009, a secondo cohort was recruited about 20 years after their mid-life examination (1987-1992) for their first follow-up.

The findings from the CAIDE study have, so far, provided essential knowledge on several risk and protective factors for dementia, including interactions between genetics and lifestyle. Based on these findings, the CAIDE Dementia Risk Score, the first tool to predict the risk of late-life dementia based on lifestyle and cardiovascular risk factors at mid-life, was developed (Kivipelto et al., The Lancet Neurology, 2006). Its current main application is as a research tool; for example, it was used to select older adults at increased risk of cognitive decline as participants in the FINGER trial.

The third follow-up (CAIDE 85+) is currently ongoing in Kuopio and Joensuu, almost 50 years after the first examination.

Study Registration Number: NCT03938727.   

Funding: Juho Vainio Foundation, Sigrid Juselius Foundation, Academy of Finland.

Study Webpage

 

Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability

Principal Investigator: Miia Kivipelto
Scientific Coordinators: Tiia Ngandu, Alina Solomon
Field Coordinator: Katri Hemiö

 

FINGER is a large multi-centre randomised controlled trial across Finland (Helsinki, Vantaa, Kuopio, Oulu, Turku, and Seinäjoki and their surrounding areas) that investigates the efficacy of a multidomain lifestyle intervention including dietary guidance, physical activity, cognitive training, and monitoring and management of cardiovascular risk factors in preventing cognitive decline. For this trial, 1260 cognitively unimpaired older adults at risk for future cognitive decline were randomized into the multidomain intervention arm or a control arm receiving regular health advice. It is centrally coordinated from the Finnish Institute for Health and Welfare (THL) and it was the first study of its kind to show that a multidomain lifestyle intervention is beneficial for prevention of cognitive decline (Ngandu et al., Lancet, 2015). FINGER-type interventios are currently tested worldwide in diverse populations and settings.

After the 2-year interventions 5- and 7-year follow ups have been completed and the 10-year follow up is being planned.

Trial registration number: NCT01041989

Funding: 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 Research Grant, Salama bint Hamdan Al Nahyan Foundation, Axa Research Grant, and EVO grants of University Hospitals of Kuopio, Oulu, and Turku, Seinäjoki Central Hospital and Oulu City Hospital

Study Webpage

 

LipiDiDiet

UEF Principal Investigator: Hilkka Soininen
UEF Scientific Coordinator: Alina Solomon

 

LipiDiDiet is an international project addressing the impact of nutritional lipids on neuronal and cognitive performance in ageing, Alzheimer’s disease (AD) and vascular dementia. The project includes 16 partners Europe-wide.

Within LipiDiDiet, a randomised, controlled, double-blind, trial), including 11 sites among Finland (UEF), Germany, the Netherlands, and Sweden, was carried out. The aim was to investigate the effects of a medical nutrition drink containing a specific combination of essential fatty acids, vitamins, and other nutrients (Fortasyn ConnectTM), on cognition and related measures in the prodromal stage of AD.

311 older adults with prodromal AD were recruited for the 24-month core trial and randomised to take either the medical nutrition or an iso-caloric control drink,. The trial showed that people who consumed the medical nutrition drink, whilst not improving in a specific neuropsychological test battery, had a significant stabilisation of everyday cognitive and functional performance, as well as reduced brain shrinkage, compared to the control participants (Soininen et al., Lancet Neurology, 2017).

A trial extension allowed participants to continue the controlled, double-blind, parallel-group intervention up to a maximum of 72 months, making LipiDiDiet the longest completed trial on prodromal AD, to date (data analysis currently ongoing).

Dutch Trial Registration Number, NTR1705

Funding: EU Seventh Framework programme (FP7)

Study Webpage

 

Multimodal Preventive Trial for Alzheimer's Disease (MIND-ADmini)

Principal Investigator: Miia Kivipelto
Scientific Coordinators: Shireen Sindi, Alina Solomon
Field Coordinators: Charlotta Thunborg, Anna Rosenberg (UEF)

 

MIND-AD is an international multicentre study aiming to identify effective prevention strategies for AD/dementia tailored to different “at-risk” groups.
The project is based on experiences and data from five ongoing European intervention trial on AD/dementia prevention, including FINGER (Finland), MAPT (France), PreDIVA (Netherlands), LipiDiDiet (Germany, Finland, Netherlands, Sweden) and HATICE (Finland, France, Netherlands,) studies.   
As part of the study, a pilot trial was also conducted testing for the first time the feasibility of and adherence to a 6-month multimodal preventive intervention in prodromal AD. The participants were randomised into three arms: 1. FINGER-like multidomain lifestyle intervention adapted for prodromal AD; 2.  multidomain lifestyle intervention + medical nutrition drink tested in the LipiDiDiet trial; 3. control receiving regular health advice and care.  The trial was conducted in Sweden, Finland (UEF), Germany and France.
MIND-AD serves as a model and platform for trials combining non-pharmacological and pharmacological interventions.

Trial Registration Number: NCT03249688

Funding: EU JPND Programme

Study Webpage

 

Healthy Aging Through Internet Counselling in the Elderly        

UEF Principal Investigator: Hilkka Soininen
UEF Scientific and Field Coordinator: Mariagnese Barbera

 

HATICE is an international project launched within the European Dementia Prevention Initiative (EDPI) collaboration network and focusing on the role of modifiable cardiovascular risk factors in healthy ageing and the development of dementia. The partners are: University of Eastern Finland (Fi); the Amsterdam Academic Medical Center (Nl); Inserm, University of Toulouse (Fr); Karolinska Institutet (Se); University of Cambridge (UK); Vital Health Software (Nl); and Novapten (Fr).

Within HATICE, an 18-month multi-centre, open-label, blinded end-point, randomised controlled trial (ISRCTN48151589) was carried out in Finland, France and the Netherlands; the Finnish arm of the trial was coordinated and conducted at the University of Eastern Finland. The trial aimed to test the efficacy of an internet-based platform, specifically designed for older adults, together with the remote support of a lifestyle coach, in optimising the self-management of cardiovascular risk factors, improving cardiovascular risk profile, and reducing the risk of cardiovascular disease and cognitive decline.

2724 (883 in Finland) community dwellers aged 65 years or more and at increased risk of cardiovascular disease participated in the trial. The intervention was delivered through the interactive internet platform focused on seven risk factors: hypertension, dyslipidaemia, diabetes, obesity, smoking, sedentary life, and unhealthy diet. The coach provided information, advice, and motivational support.

The main findings of the HATICE trial showed that the use of the platform, with the support of an online coach, has the potential to help older adults in improving their lifestyle and adopt healthier behaviours (Richard et al., The Lancet Digital Health, 2019).

Trial Registration Number ISRCTN48151589

Funding: EU Seventh Framework programme (FP7)

Study Website