نبذة مختصرة : Background and aims Psychosocial factors may affect adherence to lifestyle interventions and lifestyle changes. The role of psychosocial factors in dementia prevention needs more research. We aimed at clarify the issue in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). Methods The population included 1260 participants aged 60-77 years at risk for cognitive decline, randomised to a multidomain lifestyle intervention or regular health advice for 2 years. Adherence was evaluated as participation in the provided activities and actual lifestyle changes, separately for each domain (diet, exercise, social/cognitive activity, vascular risk management) and combined into multidomain. Psychosocial factors were measured at trial baseline (depressive symptoms; study perception; health-related quality of life, HRQoL) and earlier life (hopelessness; satisfaction with family life, achievements, and financial situation). Results Depressive symptoms, hopelessness, and nonpositive study perception were negatively and HRQoL positively associated with participation in the multidomain intervention. Depressive symptoms, lower HRQoL, hopelessness and dissatisfaction with financial situation were associated with unhealthier lifestyles at baseline. Baseline depressive symptoms and lower HRQoL predicted less improvement in lifestyle, but did not modify the intervention effect on lifestyle change. Discussion and conclusions Several psychosocial factors were associated with participation in lifestyle intervention, while fewer of them contributed to lifestyle changes. Although the intervention was beneficial for lifestyle changes independent of psychosocial factors, those most in need of lifestyle improvement were less likely to be active. Tailoring lifestyle-modifying strategies based on the need for psychosocial support may add efficacy in future trials. Trial Registry ClinicalTrials.gov NCT01041989 2010-01-05 ; Peer reviewed
Relation: Open access funding provided by University of Eastern Finland (UEF) including Kuopio University Hospital. This study was supported by the Academy of Finland (Grant Nos. 287490, 294061, 319318, and 317465), Alzheimer's Research and Prevention Foundation, Juho Vainio Foundation, Finnish Social Insurance Institution, Ministry of Education and Culture Research Grant, Salama bint Hamdan Al Nahyan Foundation, Axa Research Grant, EVO/VTR grants of University Hospitals of Kuopio, Oulu, and Turku, Seinajoki Central Hospital, and Oulu City Hospital, European Research Council (Grant No. 804371), Finnish Cultural Foundation, Yrjo Jahnsson Foundation, Alzheimerfonden, Region Stockholm ALF, Saastamoinen Foundation, Loo och Hans Osterman Foundation, Stiftelsen Dementia, EU Joint Programme-Neurodegenerative Disease Research for MIND-AD and EURO-FINGERS, EU 7th framework collaborative project grant for HATICE, UEF Strategic funding for UEFBRAIN, Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse, Swedish Research Council, Center for Innovative Medicine (CIMED) at Karolinska Institutet, Knut and Alice Wallenberg Foundation, Stiftelsen Stockholms sjukhem, Jalmari and Rauha Ahokas Foundation, Swedish Society for Medical Research, Orion Research Foundation, and Finnish Medical Foundation. The blood pressure monitoring devices were provided by Microlife (Vilnius, Lithuania). The views expressed are those of the authors and do not necessarily represent those of the funding sources.; Neuvonen , E , Lehtisalo , J , Solomon , A , Antikainen , R , Havulinna , S , Hanninen , T , Laatikainen , T , Lindstrom , J , Rautio , N , Soininen , H , Strandberg , T , Tuomilehto , J , Kivipelto , M & Ngandu , T 2022 , ' Psychosocial determinants for adherence to a healthy lifestyle and intervention participation in the FINGER trial : an exploratory analysis of a randomised clinical trial ' , Aging Clinical and Experimental Research , vol. 34 , no. 8 , pp. 1793-1805 . https://doi.org/10.1007/s40520-022-02088-x; ORCID: /0000-0001-6299-925X/work/116874745; http://hdl.handle.net/10138/346652; 141674ff-7e54-4d68-ba2a-14f618594103; 000758308500002
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