The LatAm-FINGERS trial shows promising lifestyle interventions could significantly reduce dementia risk, especially by targeting modifiable factors.
LONDON — The recent Alzheimer's Association International Conference buzzed with fresh discussions about dementia prevention among over 10,000 global experts. However, a standout moment occurred when Isabel Beltre, a participant in a pioneering trial called LatAm-FINGERS, shared her inspiring journey in a compelling video.
Beltre was one of 1,200 individuals aged 60 to 77 who enrolled in this groundbreaking study, which focused on culturally tailored lifestyle modifications to tackle the rising rates of cognitive decline in Latin America. Unlike conventional methods attempting to address dementia post-diagnosis, LatAm-FINGERS targeted pivotal risk factors—such as smoking and lack of physical activity—ultimately aiming to mitigate the onset of the condition.
Amidst the excitement at the conference, Beltre expressed her gratitude in Spanish, emphasizing how the trial transformed her life. The results released that day revealed statistically significant improvements in cognitive abilities among participants who engaged in lifestyle interventions—such as exercise regimes and cognitive training—compared to a control group that received minimal assistance, primarily basic health guidelines.
Parallel studies, including the U.S.-conducted POINTER trial, share similar goals as the LatAm-FINGERS initiative, intending to reduce the global prevalence of dementia. For LatAm-FINGERS, its achievements have sparked optimism, as it stands out as the most successful trial in this series, thus far.
Identifying Risk Factors
In the realm of dementia prevention, few sources carry as much weight as the Lancet Commission’s guidelines. Across its three editions, the commission has cataloged key risk factors, with the latest report, published in 2024, identifying 14 major contributors, including smoking, social isolation, and insufficient physical activity. Collectively, these factors are estimated to influence 45% of dementia cases globally.
Dr. Miia Kivipelto from the Karolinska Institute has long sought to address these factors, both individually and collectively. Driven by the desire to implement actionable changes, Kivipelto developed the FINGER study in Finland. This two-year trial involved 1,260 participants who were divided into two groups, one receiving basic health advice while the other underwent a comprehensive intervention combining personalized nutrition, brain training, physical activities, and more.
At the conclusion of the FINGER study, improvements in cognitive functions—such as processing speed and memory—were recorded for both groups. Yet the comprehensive intervention group showcased a noteworthy 25% enhancement compared to their counterparts, which, while statistically substantial, highlighted only a modest effect when analyzed through a statistical measure known as a z-score.
Tailoring Interventions to Demographics
Despite criticism regarding the modest outcomes of Kivipelto's approach, its influence has been broadened through replication worldwide, including the recent LatAm-FINGERS trial. Dr. Gill Livingston from University College London, who contributed to the 2024 Lancet Commission report, emphasizes that effective dementia interventions must align with the specific risks faced by participants.
In terms of demographic differences, the POINTER study revealed a highly educated sample—70% held college degrees—compared to around 43% across the general U.S. population. This discrepancy indicates that trial participants may have had lower susceptibility to dementia, making it more challenging to observe significant changes through lifestyle interventions.
LatAm-FINGERS aimed to adapt its approach based on geographical and contextual realities, with opportunities for adjustments in dietary plans and environmental considerations influencing exercise programs. This trial recruited diverse participants from countries including Argentina, Brazil, Ecuador, and Mexico, showcasing a demographic more aligned with typical populations at risk for cognitive decline. In LatAm-FINGERS, 37% of participants had no education beyond high school, a stark contrast to only 5% in POINTER.
The announcement of the LatAm-FINGERS results evoked cheers among conference attendees as it reported a z-score difference of 0.11 points between test and control groups, more than doubling the improvement noted in the FINGER trial. This translated to a 55% relative enhancement in cognitive function for the intervention group.
Examining the Factors of Success
Crivelli, Kivipelto, and Livingston attribute the success of LatAm-FINGERS to the prevalence of modifiable risk factors among participants. Given the higher prevalence of cardiovascular issues and lower educational levels, there was a greater opportunity for impactful intervention compared to previous studies.
Nevertheless, the findings revealed that the intervention's benefits were gender-specific, as only female participants demonstrated improved cognitive skills, while male participants did not show the same level of engagement. Potential cultural factors influencing participation rates in lifestyle activities were noted by researchers.
Prospects for Future Dementia Prevention
The compelling outcomes from LatAm-FINGERS strongly suggest that targeted lifestyle interventions can play a significant role in curbing dementia risk. Livingston is enthusiastic about applying these insights in a forthcoming UK trial, which will focus on personalized strategies for participants to address their specific risk factors.
While the impact of LatAm-FINGERS remains promising, it's essential to recognize that determining actual reductions in dementia incidents requires extended study durations and extensive participant recruitment. Progress towards such large-scale implementations remains complex, as expressed by Crivelli, who notes that interventions need to be condensed for broad application.
Kivipelto expresses optimism about new advances in Alzheimer's screening that could enable quicker indicators of the effectiveness of FINGER-style programs against dementia, allowing for indirect evaluations without requiring lengthy observational periods.
Despite the unresolved questions about the scope of impact from trials like these, participants like Beltre affirm their efficacy. She now confidently manages her daily responsibilities independently, a testament to the transformative potential of the interventions involved.
This article is intended for informational purposes and should not be taken as medical advice.
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