Journal
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
Volume 19, Issue 4, Pages 355-+Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jamda.2017.09.020
Keywords
Diet; physical exercise; cognitive training; vascular risk; chronic morbidity; randomized clinical trial
Categories
Funding
- Academy of Finland's Responding to Public Health Challenges Research Programme (SALVE) [259615, 278457, 305810]
- Joint Program of Neurodegenerative Disorders - prevention (MINDAD)
- La Carita Foundation
- Alzheimer Association [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, Seinajoki Central hospital
- 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
- Academy of Finland (AKA) [259615] Funding Source: Academy of Finland (AKA)
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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. (C) 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
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