Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2025 Feb 2;54(2):afaf041.
doi: 10.1093/ageing/afaf041.

Impact of frailty status on the effect of a multidomain lifestyle intervention on cognition

Johanna Pöyhönen  1   2 , Jenni Lehtisalo  2   3 , Hanna-Maria Roitto  1   2   4 , Esko Levälahti  2 , Timo Strandberg  1   4   5 , Miia Kivipelto  2   6   7   8 , Jenni Kulmala  2   6   9 , Riitta Antikainen  5   10 , Hilkka Soininen  3   11 , Jaakko Tuomilehto  2   12   13   14 , Tiina Laatikainen  2   15 , Tiia Ngandu  2   6
Affiliations
Randomized Controlled Trial

Impact of frailty status on the effect of a multidomain lifestyle intervention on cognition

Johanna Pöyhönen et al. Age Ageing. .

Abstract

Background: Frailty often precedes and co-occurs with dementia. A multidomain lifestyle intervention has shown favourable effects on cognition. We aimed to investigate if frailty status modifies this intervention effect.

Methods: The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) recruited 1259 participants aged 60-77 years who were at risk of dementia. They were randomised to receive a multidomain intervention (diet, exercise, cognitive training and vascular risk monitoring) or regular health advice for two years. The outcome was a change in cognition (neuropsychological test battery composite score). Frailty and prefrailty were defined according to the Fried phenotype. Mixed models were used to investigate if frailty status at baseline modified the intervention effect on cognition.

Results: Frailty status (prefrail/frail n = 520, robust n = 625) at baseline did not modify the effect of intervention on global cognition during the 2-year follow-up (P-value for frailty × intervention × time interaction > .05). Concerning cognitive subdomains, similar results were found. Among prefrail/frail persons, within-group analyses suggested a beneficial intervention effect on executive function and processing speed and also on global cognition when frail participants (n = 15) were excluded from the analyses. Being prefrail/frail was related to less improvement in global cognition, memory and executive function domains compared with being robust when intervention was not taken into consideration.

Conclusions: A multidomain intervention is likely to be beneficial to cognition regardless of frailty status. Prefrail participants seemed particularly responsive to preventive intervention. Thus, an optimal time for a multidomain lifestyle intervention may be at the prefrailty stage.

Keywords: cognition; frailty; lifestyle intervention; older people; prefrailty.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Flow chart. A total of 1145 of 1259 participants in the FINGER trial with reliable baseline data on frailty and cognition with at least one assessment of cognition at 12 or 24 months (mITT) were selected for the present study.
Figure 2
Figure 2
Intervention effect on cognitive performance (NTB total z score and domain z scores) modified by baseline frailty status (2 years). Estimated change in cognitive performance (total z score) in intervention and control groups within robust (A, left panel) and prefrail/frail (A, right panel) participants. P-values are for the difference between intervention and control groups within frailty subgroups (intervention × time) and the difference in intervention effect between frailty subgroups (frailty status × intervention × time). Error bars depict 95% confidence intervals. Same for the domain z scores (B–D). Abbreviations: NTB, Neuropsychological Test Battery; I, intervention; C, control.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Nichols E, Steinmetz JD, Vollset SE et al. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in 2050: an analysis for the global burden of disease study 2019. Lancet Public Health. 2022;7:e105–25. 10.1016/S2468-2667(21)00249-8. - DOI - PMC - PubMed
    1. Ngandu T, Lehtisalo J, Solomon A et al. 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. Lancet. 2015;385:2255–63. 10.1016/S0140-6736(15)60461-5. - DOI - PubMed
    1. Robertson DA, Savva GM, Kenny RA. Frailty and cognitive impairment—a review of the evidence and causal mechanisms. Ageing Res Rev. 2013;12:840–51. 10.1016/j.arr.2013.06.004. - DOI - PubMed
    1. Fried LP, Tangen CM, Walston J et al. Frailty in older adults: evidence for a phenotype. J Gerontol A. 2001;56:M146–57. 10.1093/gerona/56.3.M146. - DOI - PubMed
    1. Rockwood K, Mitnitski AB, MacKnight C. Some mathematical models of frailty and their clinical implications. Rev Clin Gerontol. 2002;12:109–17. 10.1017/S0959259802012236. - DOI

Publication types

MeSH terms