Multidomain lifestyle interventions may reduce CV endpoints and dementia
Finland: A recent study found that among older adults who had a history of cardiovascular disease (CVD), a 2-year multi-domain lifestyle intervention among older adults is effective in preventing total CVD events and cerebrovascular events. The study appears in the European Heart Journal.
The burden of CVD and dementia can be reduced by the joint prevention of both conditions. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) had shown a beneficial effect on the primary outcome i.e. cognition. Jenni Lehtisalo, Finnish Institute for Health and Welfare, Helsinki, Finland, and colleagues aimed to assess the effect of this lifestyle intervention on incident CVD (pre-specified secondary outcome).
The FINGER trial enrolled 1259 people aged 60–77 years. They were randomized in the ratio of 1:1 to receive a 2-year multi-domain intervention with diet, physical and cognitive activity, and vascular monitoring (n = 631), or general health advice (n = 628). Data on CVD including stroke, transient ischaemic attack (TIA), or coronary heart event was taken from national registries.
The findings of the study were as follows:
- 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: the hazard ratio (HR) for combined stroke/TIA was 0.71 after adjusting for background characteristics. Hazard ratio for coronary events was 0.84 and total CVD events 0.80.
- Among those with history of CVD (n = 145), the incidence of both total CVD events (HR: 0.50) and stroke/TIA (HR: 0.40) was lower in the intervention than the control group.
To conclude, "among the 1259 participants, aged 60-77 years, the intervention resulted in 13-20% lower CVD event rates but with large degrees of uncertainty. Cerebrovascular event rates were lower but for total CVD only among those with earlier CVD events."
Reference:
Jenni Lehtisalo, Minna Rusanen, Alina Solomon, Riitta Antikainen, Tiina Laatikainen, Markku Peltonen, Timo Strandberg, Jaakko Tuomilehto, Hilkka Soininen, Miia Kivipelto, Tiia Ngandu, Effect of a multi-domain lifestyle intervention on cardiovascular risk in older people: the FINGER trial, European Heart Journal, 2022;, ehab922, https://doi.org/10.1093/eurheartj/ehab922
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