Currently, 40% of global dementia cases can be prevented through lifestyle changes, with Latin America having a 56% potential reduction due to its high-risk factors. At the moment, there are no medications that halt the clinical expression of dementia. LatAm-FINGERS, a multicenter study across 12 Latin American countries, aims to study the feasibility of an intervention modifying lifestyle in individuals aged 60 to 77 at risk of dementia. Success could influence public policy on clinical care for older adults.
Today we know that 40% of dementia cases worldwide can be prevented through lifestyle modification. If we look at Latin America, this number is 56%. Latin America is a region with high-risk factors for dementia due to weakened socioeconomic infrastructure, an impoverished healthcare system, and low average education levels in the region. Additionally, we know that cardiovascular health is an important factor in the development of dementia. Under this scenario, LatAm-FINGERS is a multicenter study designed to prevent memory decline through lifestyle modification in people aged 60 to 77 at risk of dementia. Twelve Latin American countries are participating (Argentina, Bolivia, Brazil, Chile, Colombia, Dominican Republic, Mexico, Puerto Rico, Uruguay, Costa Rica, Ecuador, and Peru), with 100 individuals per center. These individuals are randomly assigned to two groups: (1) a group making systematic lifestyle changes (physical and cognitive training, implementation of the Mediterranean-dietary approach to stop hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet, socialization, and regular health check-ups) and (2) a group receiving regular health advice. The main objective of LatAm-FINGERS is to determine if this intervention is feasible in Latin America. Secondarily, we want to test if this lifestyle change can lead to improvements in participants' cognition over time (2 years). If successful, the results of this study will have large-scale implications for public policy regarding the standard of clinical care and prescriptive practices for a fast-growing and vulnerable population of older adults. LatAm-FINGERS is based on the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), which demonstrated that lifestyle modification promotes positive changes in memory and attention. Additionally, our study is aligned with the U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER), which is conducting a similar intervention in the United States. This project is fully funded by the Alzheimer's Association.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
1,200
Lifestyle intervention that involves providing participants with education, support, and tangible tools to assist them in developing and carrying out healthier lifestyle practices.
Lifestyle intervention that involves a structured program of diet, physical and cognitive exercise, and management of cardiometabolic risks.
Fleni
Ciudad Autonoma de Buenos Aire, Argentina
ACTIVE_NOT_RECRUITINGCentro Neurológico Mente Activa
La Paz, Bolivia
ACTIVE_NOT_RECRUITINGUniversidade Federal de Minas Gerais
Belo Horizonte, Minas Gerais, Brazil
ACTIVE_NOT_RECRUITINGUniversity of Sao Paulo School of Medicine
São Paulo, Brazil
ACTIVE_NOT_RECRUITINGHospital Clínico Universidad de Chile
Santiago, Chile
ACTIVE_NOT_RECRUITINGAntioquia University
Antioquia, Colombia
ACTIVE_NOT_RECRUITINGHospital Clínica Bíblica
San José, Costa Rica
ACTIVE_NOT_RECRUITINGUniversidad Nacional Pedro Henriquez Urena (UNPHU)
Santo Domingo, Dominican Republic
ACTIVE_NOT_RECRUITINGNeuromedicenter - Cognitive Disorders Unit
Quito, Ecuador
ACTIVE_NOT_RECRUITINGInstituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez
Mexico City, Mexico
ACTIVE_NOT_RECRUITING...and 3 more locations
Reach
It refers to the effectiveness of recruiting the target population. It will be measured by the ratio of randomized participants versus the ratio of screen-failures.
Time frame: Up to 2 years
Implementation
Adherence rate of participants to the protocol in both arms. It will be measured through the percentage of attendance to group meetings, attendance to physical and cognitive training sessions, and completion of dietary records.
Time frame: Up to 2 years
Maintenance
It consists of each center's ability to sustain the intervention. It will be measured through the percentage of subjects who complete outcome measures at each trial event (baseline, 6, 12, 18, and 24 months).
Time frame: Up to 2 years
Global cognition
Global cognitive function will be obtained from a composite score derived from subtest scores on the LatAm Neuropsychological Test Battery (LatAm-NTB) that includes: Free and Cued Selective Reminding Test, Logical Memory, Digit Span, Concept Shifting Test, Digit Symbol Substitution Test, Semantic and phonological fluency, Trial Making Test, Stroop Test. Scores from each individual test will be converted to z-scores that typically range from -3 to 3, with higher scores reflecting better performance, and averaged to form a composite.
Time frame: Up to 2 years
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