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Stigsdotter Neely, Anna
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Publications (10 of 31) Show all publications
Turunen, M., Hokkanen, L., Backman, L., Stigsdotter Neely, A., Hanninen, T., Paajanen, T., . . . Ngandu, T. (2019). Computer-based cognitive training for older adults: Determinants of adherence. PLoS ONE, 14(7), Article ID e0219541.
Open this publication in new window or tab >>Computer-based cognitive training for older adults: Determinants of adherence
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2019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 7, article id e0219541Article in journal (Refereed) Published
Abstract [en]

The possibilities of computer-based cognitive training (CCT) in postponing the onset of dementia are currently unclear, but promising. Our aim is to investigate older adults ' adherence to a long-term CCT program, and which participant characteristics are associated with adherence to the CCT. This study was part of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). Participants were 60-77-year-old individuals with increased dementia risk, recruited from previous population-based studies. The participants included in this study (n = 631) had been randomized to receive a multi-domain lifestyle intervention, including CCT. The measure of adherence was the number of completed CCT sessions (max = 144) as continuous measure. Due to a substantial proportion of participants with 0 sessions, the zero inflated negative binomial regression analyses were used to enable assessment of both predictors of starting the training and predictors of completing a higher number of training sessions. Several cognitive, demographic, lifestyle, and health-related variables were examined as potential predictors of adherence to CCT. Altogether, 63% of the participants participated in the CCT at least once, 20% completed at least half of the training, and 12% completed all sessions. Previous experience with computers, being married or cohabiting, better memory performance, and positive expectations toward the study predicted greater odds for starting CCT. Previous computer use was the only factor associated with a greater number of training sessions completed. Our study shows that there is a large variation in adherence to a long-lasting CCT among older adults with an increased risk of dementia. The results indicate that encouraging computer use, and taking into account the level of cognitive functioning, may help boost adherence to CCT.

Place, publisher, year, edition, pages
San Francisco: Public Library of Science, 2019
National Category
Public Health, Global Health, Social Medicine and Epidemiology Geriatrics
Identifiers
urn:nbn:se:umu:diva-164431 (URN)10.1371/journal.pone.0219541 (DOI)000484947800109 ()31291337 (PubMedID)
Available from: 2019-10-22 Created: 2019-10-22 Last updated: 2019-10-22Bibliographically approved
Vaskivuo, L., Hokkanen, L., Hanninen, T., Antikainen, R., Backman, L., Laatikainen, T., . . . Ngandu, T. (2019). Self and Informant Memory Reports in FINGER: Associations with Two-Year Cognitive Change. Journal of Alzheimer's Disease, 71(3), 785-795
Open this publication in new window or tab >>Self and Informant Memory Reports in FINGER: Associations with Two-Year Cognitive Change
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2019 (English)In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 71, no 3, p. 785-795Article in journal (Refereed) Published
Abstract [en]

Background: Subjective memory complaints (SMCs) may be the first sign of cognitive decline in aging. Objective: To examine whether SMCs reported by oneself and informant predict cognitive change over 2 years among at-risk elderly people, and to determine the relationship of different types of SMCs (prospective and retrospective memory complaints) and change in cognitive function. Methods: This investigation is part of the FINGER project, which is a multicenter randomized controlled trial aiming at preventing cognitive decline in cognitively healthy older adults with increased risk of dementia. A subsample of 303 controlgroup participants (aged 60-80 years) and their informants (n = 261) rated the frequency of SMCs, using the Prospective and Retrospective Memory Questionnaire (PRMQ). Cognitive performance was measured at baseline and at 1- and 2-year follow-up visits using a neuropsychological test battery. Results: Participants who reported more SMCs improved less in global cognition, executive function, and memory during the subsequent 2 years in the fully-adjusted analyses. Self-reported retrospective memory problems predicted less improvement in all cognitive domains, whereas prospective memory problems did not. Informant-reported memory problems were not linked to subsequent change in cognition. Conclusion: Our results indicate that self-reported SMCs, measured with PRMQ, predict future cognitive change in several cognitive domains. By contrast, reports by informants were not linked to changes in cognition. Among cognitively healthy at-risk elderly individuals, the persons themselves observe more easily problems relevant for their future cognitive trajectories than their informants.

Place, publisher, year, edition, pages
IOS PRESS, 2019
Keywords
Aging, cognition, dementia, memory
National Category
Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-164492 (URN)10.3233/JAD-190133 (DOI)000488819100007 ()31424391 (PubMedID)
Available from: 2019-10-22 Created: 2019-10-22 Last updated: 2019-10-22Bibliographically approved
Vaskivuo, L., Hokkanen, L., Hänninen, T., Antikainen, R., Backman, L., Laatikainen, T., . . . Ngandu, T. (2018). Associations between prospective and retrospective subjective memory complaints and neuropsychological performance in older adults: the finger study. Journal of the International Neuropsychological Society, 24(10), 1099-1109
Open this publication in new window or tab >>Associations between prospective and retrospective subjective memory complaints and neuropsychological performance in older adults: the finger study
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2018 (English)In: Journal of the International Neuropsychological Society, ISSN 1355-6177, E-ISSN 1469-7661, Vol. 24, no 10, p. 1099-1109Article in journal (Refereed) Published
Abstract [en]

Objectives: Subjective memory complaints (SMCs) are among the key concerns in the elderly, but their role in detecting objective cognitive problems is unclear. The aim of this study was to clarify the association between SMCs (both prospective and retrospective memory complaints) and neuropsychological test performance in older adults at risk of cognitive decline. Methods: This investigation is part of the FINGER project, a multicenter randomized controlled trial aiming at preventing cognitive decline in high-risk individuals. The cognitive assessment of participants was conducted at baseline using a modified neuropsychological test battery (NTB). SMCs were evaluated with the Prospective and Retrospective Memory Questionnaire (PRMQ) in a sub-sample of 560 participants (mean age, 69.9 years). Results: Having more prospective SMCs was associated with slower processing speed, but not with other NTB domains. Retrospective SMCs were linked to poorer function on NTB total score, processing speed, and memory. Executive function domain was not associated with any PRMQ ratings. Depressive symptoms and poor quality of life diluted the observed associations for NTB total score and memory. However, the association between PRMQ and processing speed remained even after full adjustments. Conclusions: Our results indicate that self-reported memory problems, measured with PRMQ, are associated with objectively measured cognitive performance. Such complaints in healthy elderly people also seem to reflect reduced mental tempo, rather than memory deficits. Slowing of processing speed may thus be negatively related to memory self-efficacy. It is also important to consider affective factors among those who report memory problems.

Place, publisher, year, edition, pages
Cambridge University Press, 2018
Keywords
Subjective memory complaints, Prospective memory, Retrospective memory, Cognitive performance, Memory, Processing speed
National Category
Neurosciences
Identifiers
urn:nbn:se:umu:diva-154072 (URN)10.1017/S135561771800053X (DOI)000450425500009 ()30178733 (PubMedID)
Available from: 2018-12-12 Created: 2018-12-12 Last updated: 2018-12-12Bibliographically approved
Solomon, A., Turunen, H., Ngandu, T., Peltonen, M., Levälahti, E., Helisalmi, S., . . . Kivipelto, M. (2018). Effect of the Apolipoprotein E Genotype on Cognitive Change During a Multidomain Lifestyle Intervention A Subgroup Analysis of a Randomized Clinical Trial. JAMA Neurology, 75(4), 462-470
Open this publication in new window or tab >>Effect of the Apolipoprotein E Genotype on Cognitive Change During a Multidomain Lifestyle Intervention A Subgroup Analysis of a Randomized Clinical Trial
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2018 (English)In: JAMA Neurology, ISSN 2168-6149, E-ISSN 2168-6157, Vol. 75, no 4, p. 462-470Article in journal (Refereed) Published
Abstract [en]

IMPORTANCE: The role of the apolipoprotein E (APOE) epsilon 4 allele as an effect modifier in lifestyle interventions to prevent cognitive impairment is still unclear. OBJECTIVE: To examine whether the APOE epsilon 4 allele modifies the previously reported significant cognitive benefits of a multidomain lifestyle intervention (prespecified subgroup analysis). DESIGN, SETTING, AND PARTICIPANTS: The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) was a randomized clinical trial in 6 centers across Finland (screening and randomization performed from September 7, 2009, through November 24, 2011; intervention duration, 2 years). Data analysis was performed from August 1, 2015, to March 31, 2016. The study population was at-risk older individuals from the general population. Inclusion criteria were age of 60 to 77 years; Cardiovascular Risk Factors, Aging, and Dementia risk score of at least 6 points; and cognition at a mean level or slightly lower than expected for age. Individuals with dementia or substantial cognitive impairment and conditions that prevented cooperation or safe engagement in the intervention were excluded. APOE genotype data were available for 1175 of the 1260 participants. INTERVENTIONS: Participants were randomly assigned in a 1: 1 ratio to a multidomain intervention group (diet, exercise, cognitive training, and vascular risk management) or a control group (general health advice). Group allocation was not actively disclosed to participants, and outcome assessors were masked to group allocation. MAIN OUTCOMES AND MEASURES: Primary outcome was change in cognition measured through a comprehensive neuropsychological test battery. Analysis was based on modified intention to treat (participants with at least 1 postbaseline assessment). RESULTS: A total of 1109 participants (mean [SD] age, 69.3 [4.7] years; 514 [46.3%] female) were included in the analysis: 362 APOE epsilon 4 allele carriers (173 intervention and 189 control) and 747 noncarriers (380 intervention and 367 control). The APOE epsilon 4 carriers and noncarriers were not significantly different at baseline (except for serum cholesterol level). The difference between the intervention and control groups in annual neuropsychological test battery total score change was 0.037 (95% CI, 0.001 to 0.073) among carriers and 0.014 (95% CI, -0.011 to 0.039) among noncarriers. Intervention effect was not significantly different between carriers and noncarriers (0.023; 95% CI, -0.021 to 0.067). CONCLUSIONS AND RELEVANCE: Healthy lifestyle changesmay be beneficial for cognition in older at-risk individuals even in the presence of APOE-related genetic susceptibility to dementia. Whether such benefits are more pronounced in APOE epsilon 4 carriers compared with noncarriers should be further investigated. The findings also emphasize the importance of early prevention strategies that target multiple modifiable risk factors simultaneously.

Place, publisher, year, edition, pages
American Medical Association, 2018
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-147329 (URN)10.1001/jamaneurol.2017.4365 (DOI)000429439000012 ()29356827 (PubMedID)
Available from: 2018-05-18 Created: 2018-05-18 Last updated: 2018-06-09Bibliographically approved
Rosenberg, A., Ngandu, T., Rusanen, M., Antikainen, R., Bäckman, L., Havulinna, S., . . . Kivipelto, M. (2018). Multidomain lifestyle intervention benefits a large elderly population at risk for cognitive decline and dementia regardless of baseline characteristics: The FINGER trial. Alzheimer's & Dementia, 14(3), 263-270
Open this publication in new window or tab >>Multidomain lifestyle intervention benefits a large elderly population at risk for cognitive decline and dementia regardless of baseline characteristics: The FINGER trial
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2018 (English)In: Alzheimer's & Dementia, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 14, no 3, p. 263-270Article in journal (Refereed) Published
Abstract [en]

Introduction: The 2-year Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) multidomain lifestyle intervention trial (NCT01041989) demonstrated beneficial effects on cognition. We investigated whether sociodemographics, socioeconomic status, baseline cognition, or cardiovascular factors influenced intervention effects on cognition.

Methods: The FINGER recruited 1260 people from the general Finnish population (60-77 years, at risk for dementia). Participants were randomized 1: 1 to multidomain intervention (diet, exercise, cognition, and vascular risk management) and regular health advice. Primary outcome was change in cognition (Neuropsychological Test Battery z-score). Prespecified analyses to investigate whether participants' characteristics modified response to intervention were carried out using mixed-model repeated-measures analyses.

Results: Sociodemographics (sex, age, and education), socioeconomic status (income), cognition (Mini-Mental State Examination), cardiovascular factors (body mass index, blood pressure, cholesterol, fasting glucose, and overall cardiovascular risk), and cardiovascular comorbidity did not modify response to intervention (P-values for interaction > .05). Conclusions: The FINGER intervention was beneficial regardless of participants' characteristics and can thus be implemented in a large elderly population at increased risk for dementia. 

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Prevention, Cognitive impairment, Dementia, Alzheimer's disease, Multidomain, Lifestyle, tervention, Randomized controlled trial
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-146577 (URN)10.1016/j.jalz.2017.09.006 (DOI)000427993000001 ()29055814 (PubMedID)
Available from: 2018-05-15 Created: 2018-05-15 Last updated: 2018-06-09Bibliographically approved
Sipilä, S., Tirkkonen, A., Hänninen, T., Laukkanen, P., Alen, M., Fielding, R. A., . . . Törmäkangas, T. (2018). Promoting safe walking among older people: the effects of a physical and cognitive training intervention vs. physical training alone on mobility and falls among older community-dwelling men and women (the PASSWORD study): design and methods of a randomized controlled trial. BMC Geriatrics, 18, Article ID 215.
Open this publication in new window or tab >>Promoting safe walking among older people: the effects of a physical and cognitive training intervention vs. physical training alone on mobility and falls among older community-dwelling men and women (the PASSWORD study): design and methods of a randomized controlled trial
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2018 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 18, article id 215Article in journal (Refereed) Published
Abstract [en]

Background: Safe and stable walking is a complex process involving the interaction of neuromuscular, sensory and cognitive functions. As physical and cognitive functions deteriorate with ageing, training of both functions may have more beneficial effects on walking and falls prevention than either alone. This article describes the study design, recruitment strategies and interventions of the PASSWORD study investigating whether a combination of physical and cognitive training (PTCT) has greater effects on walking speed, dual-task cost in walking speed, fall incidence and executive functions compared to physical training (PT) alone among 70-85-year-old community-dwelling sedentary or at most moderately physically active men and women.

Methods: Community-dwelling sedentary or at most moderately physically active, men and women living in the city of Jyvaskyla will be recruited and randomized into physical training (PT) and physical and cognitive training (PTCT). The 12-month interventions include supervised training sessions and home exercises. Both groups attend physical training intervention, which follows the current physical activity guidelines. The PTCT group performes also a web-based computer program targeting executive functions. Outcomes will be assessed at baseline and at 6 and 12 months thereafter. Falls data are collected during the interventions and the subsequent one-year follow-up. The primary outcome is 10-m walking speed. Secondary outcomes include 6-min walking distance, dual-task cost in walking speed, fall incidence and executive function assessed with color Stroop and Trail Making A and B tests. Explanatory outcomes include e.g. body composition and bone characteristics, physical performance, physical activity, life-space mobility, fall-related self-efficacy, emotional well-being and personality characteristics.

Discussion: The study is designed to capture the additive and possible synergistic effects of physical and cognitive training. When completed, the study will provide new knowledge on the effects of physical and cognitive training on the prevention of walking limitations and rate of falls in older people. The expected results will be of value in informing strategies designed to promote safe walking among older people and may have a significant health and socio-economic impact.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Aging, Executive function, Physical activity, Prevention, Sedentary
National Category
Geriatrics Physiotherapy
Identifiers
urn:nbn:se:umu:diva-152403 (URN)10.1186/s12877-018-0906-0 (DOI)000444654400003 ()30219032 (PubMedID)
Funder
Knut and Alice Wallenberg Foundation
Available from: 2018-10-05 Created: 2018-10-05 Last updated: 2018-10-05Bibliographically approved
Nordvall, O., Stigsdotter Neely, A. & Jonsson, B. (2017). Self-Reported Impulsivity and its Relation to Executive Functions in Interned Youth. Psychiatry, Psychology and Law, 24(6), 910-922
Open this publication in new window or tab >>Self-Reported Impulsivity and its Relation to Executive Functions in Interned Youth
2017 (English)In: Psychiatry, Psychology and Law, ISSN 1321-8719, E-ISSN 1934-1687, Vol. 24, no 6, p. 910-922Article in journal (Refereed) Published
Abstract [en]

In adolescence, antisocial behaviors increase in prevalence, an occurrence that has been related to the parallel increase of impulsive behaviors. However, impulsivity is a conglomerate of unidimensional impulsigenic traits, divided into aspects of behavioral dyscontrol and sensation seeking. In the present study, we examine how these traits differ between interned youth and an aged-matched control group, and how they relate to executive functioning. Results indicate that impulsigenic traits related to behavioral dyscontrol, but not sensation seeking, are more pronounced in interned adolescents. Also, executive functioning was predictive of lack of premeditation, a trait specifically related to antisocial behavior. One implication of this is that interventions improving executive functioning could be beneficial in the rehabilitation of interned adolescents with impulsivity-related problems.

Place, publisher, year, edition, pages
Routledge, 2017
Keywords
adolescence, antisocial behavior, executive function, impulsivity, interned youth, self assessment, UPPS.
National Category
Psychology (excluding Applied Psychology)
Research subject
Psychology
Identifiers
urn:nbn:se:umu:diva-142547 (URN)10.1080/13218719.2017.1327312 (DOI)000423286000010 ()
Available from: 2017-12-03 Created: 2017-12-03 Last updated: 2018-06-09Bibliographically approved
diva2:970568
Open this publication in new window or tab >>Long-term effects of executive process training in young and old adults
2016 (English)In: Neuropsychological rehabilitation (Print), ISSN 0960-2011, E-ISSN 1464-0694, Vol. 26, no 5-6, p. 761-782Article in journal (Refereed) Published
Abstract [en]

Prior studies have examined the magnitude of training and transfer effects after process-based training in early and late adulthood. However, little is known about how long-lasting these effects are. Here we investigate the degree of stability of training gains and transfer effects in younger and older adults 18 months after completion of executive process training, tapping updating, inhibition, and shifting. From the original sample, 24 out of 30 older participants, and 19 out of 29 young adults, returned for follow-up assessment at which the criterion and transfer tests from pre- and post-test were re-administered. The results demonstrated stability of training gains in the updating criterion task (Letter Memory Running Span), and in a near transfer updating task (Number Memory Running Span) for both age groups. The young adults improved performance in two complex working memory tasks immediately after training. These transfer effects did not survive across time. Our results provide evidence that executive process training has its greatest effect on transfer tasks with a substantial process overlap with the trained tasks: only those effects are maintained over an 18 month period in both early and late adulthood.

Keywords
Cognitive training, Executive functions, Long-term effects, Working memory, Updating, Shifting, hibition
National Category
Psychology
Identifiers
urn:nbn:se:umu:diva-125575 (URN)10.1080/09602011.2015.1108205 (DOI)000380246100005 ()26599201 (PubMedID)
External cooperation:
Available from: 2016-09-14 Created: 2016-09-13 Last updated: 2018-06-07Bibliographically approved
Sandberg, P., Rönnlund, M., Derwinger-Hallberg, A. & Stigsdotter Neely, A. (2016). Memory plasticity in older adults: Cognitive predictors of training response and maintenance following learning of number-consonant mnemonic. Neuropsychological rehabilitation (Print), 26(5-6), 742-760
Open this publication in new window or tab >>Memory plasticity in older adults: Cognitive predictors of training response and maintenance following learning of number-consonant mnemonic
2016 (English)In: Neuropsychological rehabilitation (Print), ISSN 0960-2011, E-ISSN 1464-0694, Vol. 26, no 5-6, p. 742-760Article in journal (Refereed) Published
Abstract [en]

The study investigated the relationship between cognitive factors and gains in number recall following training in a number–consonant mnemonic in a sample of 112 older adults (M = 70.9 years). The cognitive factors examined included baseline episodic memory, working memory, processing speed, and verbal knowledge. In addition, predictors of maintenance of gains to a follow-up assessment, eight months later, were examined. Whereas working memory was a prominent predictor of baseline recall, the magnitude of gains in recall from pre- to post-test assessments were predicted by baseline episodic memory, processing speed, and verbal knowledge. Verbal knowledge was the only significant predictor of maintenance. Collectively, the results indicate the need to consider multiple factors to account for individual differences in memory plasticity. The potential contribution of additional factors to individual differences in memory plasticity is discussed.

Keywords
Plasticity, predictors, individual differences, older adults, training, gain, maintenance
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:umu:diva-96718 (URN)10.1080/09602011.2015.1046459 (DOI)000380246100004 ()26043066 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Note

Special Issue: SI

Originally included in thesis in manuscript form.

Available from: 2014-11-27 Created: 2014-11-27 Last updated: 2018-06-07Bibliographically approved
Ngandu, T., Lehtisalo, J., Solomon, A., Levälahti, E., Ahtiluoto, S., Antikainen, R., . . . Kivipelto, M. (2015). A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. The Lancet, 385(9984), 2255-2263
Open this publication in new window or tab >>A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial
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2015 (English)In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 385, no 9984, p. 2255-2263Article in journal (Refereed) Published
Abstract [en]

Background Modifiable vascular and lifestyle-related risk factors have been associated with dementia risk in observational studies. In the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), a proof-of-concept randomised controlled trial, we aimed to assess a multidomain approach to prevent cognitive decline in at-risk elderly people from the general population.

Methods In a double-blind randomised controlled trial we enrolled individuals aged 60-77 years recruited from previous national surveys. Inclusion criteria were CAIDE (Cardiovascular Risk Factors, Aging and Dementia) Dementia Risk Score of at least 6 points and cognition at mean level or slightly lower than expected for age. We randomly assigned participants in a 1: 1 ratio to a 2 year multidomain intervention (diet, exercise, cognitive training, vascular risk monitoring), or a control group (general health advice). Computer-generated allocation was done in blocks of four (two individuals randomly allocated to each group) at each site. Group allocation was not actively disclosed to participants and outcome assessors were masked to group allocation. The primary outcome was change in cognition as measured through comprehensive neuropsychological test battery (NTB) Z score. Analysis was by modified intention to treat (all participants with at least one post-baseline observation). This trial is registered at ClinicalTrials.gov, number NCT01041989.

Findings Between Sept 7, 2009, and Nov 24, 2011, we screened 2654 individuals and randomly assigned 1260 to the intervention group (n=631) or control group (n=629). 591 (94%) participants in the intervention group and 599 (95%) in the control group had at least one post-baseline assessment and were included in the modified intention-to-treat analysis. Estimated mean change in NTB total Z score at 2 years was 0.20 (SE 0.02, SD 0.51) in the intervention group and 0.16 (0.01, 0.51) in the control group. Between-group difference in the change of NTB total score per year was 0.022 (95% CI 0.002-0.042, p=0.030). 153 (12%) individuals dropped out overall. Adverse events occurred in 46 (7%) participants in the intervention group compared with six (1%) participants in the control group; the most common adverse event was musculoskeletal pain (32 [5%] individuals for intervention vs no individuals for control).

Interpretation Findings from this large, long-term, randomised controlled trial suggest that a multidomain intervention could improve or maintain cognitive functioning in at-risk elderly people from the general population.

National Category
General Practice
Identifiers
urn:nbn:se:umu:diva-106007 (URN)10.1016/S0140-6736(15)60461-5 (DOI)000355943500027 ()25771249 (PubMedID)
Available from: 2015-07-09 Created: 2015-07-03 Last updated: 2018-06-07Bibliographically approved
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