World-Wide FINGERS

A global network of clinical trials for prevention and risk reduction of dementia

World-Wide FINGERS is a global interdisciplinary network with a mission to share knowledge and experiences on trials for dementia prevention and risk reduction, harmonize data, and plan joint international initiatives for the prevention of cognitive impairment and dementia.

ABOUT THE WORLD-WIDE FINGERS NETWORK

Multidomain interventions for prevention and risk reduction of cognitive decline and dementia

  • Dementia is one of the leading causes of disability and death among older adults world-wide.
  • Today there are around 50 million persons with dementia globally but by 2050 this number is estimated to increase to 150 million.
  • Alzheimer´s disease is one the main causes of dementia, and disease modifying treatments are not yet widely available. Therefore, effective and sustainable approaches for dementia prevention and risk reduction are urgently needed.
  • Given the complex and multifactorial etiology or dementia and late-life Alzheimer´s disease, targeting several risk factors and mechanisms simultaneously is likely to be needed for optimal preventive effects.
  • Dementia is a global problem but low- and middle-income countries are disproportionately affected.
  • To make progress on dementia risk reduction and prevention, the solutions must be viable across multiple countries, cultures, and resource levels.

The ground-breaking FINGER (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) randomized clinical trial, launched by Professor Miia Kivipelto, demonstrated that an intervention ameliorating modifiable lifestyle factors (diet, exercise, cognitive training, vascular risk monitoring, and social stimulation) can slow cognitive decline and even improve performace in general cognition and various specific cognitive domains in people at risk of dementia. Using the FINGER trial’s methodology as a basis, Professor Kivipelto has expanded the multidomain lifestyle intervention model for risk reduction and prevention of dementia and Alzheimer´s disease into a global network of clinical trials: World-Wide FINGERS.

The FINGER trial

Results from the FINGER trial

World-Wide FINGERS: a global approach to preventing cognitive decline and dementia disorders

World-Wide FINGERS is a unique network that brings together research teams from over 40 countries around the world. The network promotes international joint initiatives and a novel approach to clinical trials in an effort to identify strategies for prevention and risk reduction of cognitive impairment, dementia, and Alzheimer’s disease. Alongside being implementable and effective in a global setting, these strategies are also tailored to different geographical, cultural, and economic settings. Through synergistic use of data from multiple countries, World-Wide FINGERS creates a unique opportunity for rapid knowledge dissemination and implementation world-wide.

Countries currently in the WW-FINGERS network

The clinical trials that are currently being conducted as part of World-Wide FINGERS include common methodological features, following the core principles of the original FINGER study: 

  • a focus on multidomain interventions (such as diet, exercise, cognitive training, control of vascular or metabolic risk factors, and/or social stimulation)
  • delivery of the intervention through group and individual sessions
  • tailoring of the intervention to individual needs
  • randomisation of participants so that the results of the intervention can be compared with a control group
  • prospective harmonisation of outcomes to allow for data pooling and large-scale multi-trial analysis  

Each trial is tailored to the needs of the participants in the specific country, according to local habits, resources, and other cultural factors. Our aim is to harmonize both outcomes and interventions, and to eventually have a biorepository to also harmonize the collection of, for example, fluid biomarkers.

The clinical trials within the World-Wide FINGER network are currently at different stages of implementation and alignment to the original FINGER study. Each trial falls within a specific level based on its current status.

Activities

Data harmonization, pooling, and joint analysis

All clinical trials conducted within World-Wide FINGERS share common methodology, which allows for harmonization and data pooling. To help ensure this common methodology, the World-Wide FINGERS Scientific Helpdesk has created Harmonization Guidelines, detailing how trials can be conducted to ensure maximum harmonization of data, while still allowing for the interventions to be tailored to cultural and regional factors. In collaboration with the FINGERS Brain Health Institute (FBHI), World-Wide FINGERS is in the process of creating a federated database system as part of the data pooling and joint analysis. This would allow multiple, decentralized databases to be connected and enable joint analysis without the transfer of underlying data.

Comprehensive Randomized Control Trial (RCT) support

Dementia is a global problem but low- and middle-income countries are disproportionately affected. If progress on dementia risk reduction and prevention is to be made then the solutions must be viable across multiple countries, cultures, and resource levels. Therefore, one of the main priorities of the World-Wide FINGERS network is to enable researchers in all settings to establish and run their own clinical trials. To accomplish this, World-Wide FINGERS offers guidance, funding application support, and infrastructure advice for every stage of clinical trial development; from writing grant proposals, to detailed instructions on study design (Harmonization Guidelines), to providing the digital infrastructure needed to collect, store, combine, and analyze clinical trial data.

Advancing the development of novel trial designs

World-Wide FINGERS aims to develop the next generation of clinical trials, where novel trial designs are created that build on the strengths of the original FINGER multidomain intervention model. These include FINGER 2.0, which combines an updated FINGER model with pharmacological interventions, and E-FINGERS, which utilizes new technologies to help implement interventions and monitor outcomes.

The World-Wide FINGERS COVID-19 survey

 




To assess the impact of the COVID-19 pandemic on older adults at risk of dementia, the World-Wide FINGERS Scientific Helpdesk has launched the ‘SARS-CoV-2 Survey’. This aims to explore how the pandemic, including pandemic-related public health measures, has affected the lifestyles, behaviors, and mental wellbeing of older adults world-wide.


This survey, developed by the WW-FINGERS Scientific Helpdesk, contains a core set of questions and methodology to facilitate data harmonization, multi-site analyses, and cross-national comparisons, while also allowing for cultural adaptation. It is being administered across the World-Wide FINGERS network to allow for a unique and essential insight into how the COVID-19 pandemic has affected the lives of older adults across the globe. While the survey is at varying stages of implementation in different countries, the first results from Finland can already be viewed.

World-Wide FINGERS Scientific Helpdesk

To support scientific aspects of the development and implementation of national studies within the World-Wide FINGERS network, Professor Kivipelto leads a team of skilled scientists in the Scientific Helpdesk of World-Wide FINGERS. The Helpdesk drives forward the scientific scope, coordination and harmonization activities of the network and assists researchers all over the world. Members within the World-Wide FINGERS network can use the Helpdesk to receive methodological, scientific, and statistical support for their own multidomain dementia prevention trials.

World-Wide FINGERS Scientific Helpdesk Team

The World-Wide FINGERS Scientific Helpdesk provides support to research groups at all stages of mutidomain dementia prevention trials:

  • Miia Kivipelto, MD, PhD, Professor
    Chief/Coordinating Investigator
  • Maris Hartmanis, PhD, Professor
    Data Infrastructure Development
  • Tiia Ngandu, MD, PhD, Associate Professor
    Scientific Coordinator
  • Alina Solomon, MD, PhD, Adjunct Professor
    Scientific Coordinator
  • Francesca Mangialasche, MD, PhD
    Scientific and Clinical Coordinator
  • Markku Peltonen, PhD, Professor
    Senior Statistician
  • Jenni Lehtisalo, PhD
    Scientific Coordinator
  • Katie Palmer, PhD
    Senior Epidemiologist
  • Celeste Loots, PhD
    Senior Neuropsychologist
  • Nicola Payton, PhD
    Scientific Communication Officer

The World-Wide FINGERS Scientific Helpdesk provides support to research groups at all stages of mutidomain dementia prevention trials:

  • Developing and adapting local protocols
  • Preparing feasibility and efficacy trials
  • Advancing novel trial designs
  • Designing observational surveys to prepare for intervention studies
  • Writing grant applications
  • Coordinating network activities
  • Coordinating COVID-19 surveys
  • Harmonizing data, data pooling, and joint analysis
  • Creating a federated database
  • Scientific dissemination

Latest news

29 Mar 2022

Recent article highlights lower cognition in patients who have recovered from COVID-19

Professor Miia Kivipelto and Drs Mangialasche and Palmer have published a paper on how COVID-19 affects memory and cognition. The article highlights that patients who have recovered from COVID-19 have lower general cognition compared to healthy individuals.

Impairment in executive functions, attention, and memory were found in post-COVID- 19 patients. This can last up to seven months after COVID-19 illness.

The co-authors included researchers from within the WW-FINGERS network, such as FLENI institute in Argentina.

The full article is available here.

24 Mar 2022

A study from the WorldWide FINGERS network investigates the prevalence of MCI in China

A recent paper published by MIND-AD, one of the members of the WorldWide FINGERS (WW-FINGERS) network, details the prevalence of mild cognitive impairment among rural Chinese participants aged 60 years and over.

The study finds that over a quarter (26.48%) of participants suffered from some form of cognitive impairment. Risk factors included being female, low educational attainment, and having previously suffered from a stroke.

The full article is available here.

15 Mar 2022

A lifestyle intervention reduces the risk of cardiovascular diseases

The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) has released new research showing that lifestyle interventions can have a long-lasting, positive impact on heart and brain health.

By adhering to the two-year lifestyle intervention participants saw fewer incidence of cardiovascular diseases, including stroke, transient ischaemic attack (“mini stroke”) or coronary heart events during the following seven years. Results from the study can be found here.

17 Feb 2022

Alzheimer’s Disease International and WW-FINGERS renew their commitment to work together to reduce the global risk of dementia

We are pleased to announce the formalisation of a long-standing collaboration with Alzheimer’s Disease International (ADI) by joining in partnership to reduce the risk of dementia worldwide.

With over 55 million people living with dementia worldwide and numbers expected to increase to 139 million by 2050, there has never been a more vital time for ADI and WW-FINGERS to work together in raising awareness, sharing knowledge and building capacity to better promote dementia risk reduction. Both ADI and WW-FINGERS will work together to increase impact and help improve the lives of people affected by dementia.

Full details on the WW-FINGER/FBHI-ADI collaboration can be found here

10 Feb 2022

A new addition to the FINGERS Brain Health Institute and WW-FINGERS team

FINGERS Brain Health Institute is pleased to announce the appointment of Dinithi Perera as its new Project Manager/Operations Manager.

Dinithi will be responsible for the management & coordination of FBHI projects, including the activities of the “World-Wide FINGERS – first global network of multidomain dementia trials: Data harmonisation and data sharing” project and the WW-FINGERS Scientific Helpdesk.

04 Oct 2021

Alzheimer’s Disease Data Initiative continues its support of WW-FINGERS with a two-year grant, including the adoption of the AD Workbench as a data sharing resource

Alzheimer’s Disease Data Initiative (ADDI) is continuing to work on a project involving WW-FINGERS, a global network of dementia-prevention trials. As part of this ongoing effort, ADDI and FBHI are implementing the AD Workbench, which will support data sharing among WW-FINGERS investigators and provides permissioned access to a global community of researchers.

ADDI is also working with FBHI to support the WW-FINGERS Scientific Helpdesk at FBHI, and harmonization efforts in the clinical trials within the WW-FINGERS network, which are key to expanding the data’s usability among researchers. 

05 Aug 2021

Over 40 countries join the World-Wide FINGERS Global Meeting on multidomain dementia prevention trials

The World-Wide FINGERS Network held their Global meeting on the 5th August. Members of the network from across the globe met via a video conference.

The meeting was a great opportunity for members of the World-Wide FINGERS to present updates from their ongoing and new multidomain dementia prevention trials and discuss challenges with their colleagues. We also welcomed new members to the network including research groups from Mauritius, Philippines, Burundi, taking the total number of participating countries to over 40.

27 Jul 2021

World-Wide FINGERS researchers to present at the AAIC congress

The Alzheimer’s Associated International Conference (AAIC) is being held on July 26-30, 2021.

Professor Miia Kivipelto, Co-Founder of FBHI gave a speech on Tuesday 27th July titled “Epidemiology and Risk Factors for Dementia Around the World: European focus”. Her talk highlighted the importance of ongoing multidomain dementia prevention trials such as the FINGER study and other studies in the World-Wide FINGERS network. Importantly, she emphased the need for tailored interventions for people with specific “at-risk” profiles and the need for trials that combine lifestyle and nutrition-based interventions with pharmacological treatments.

01 Jul 2021

World-Wide FINGERS Global Meeting

The World-Wide FINGERS network will hold their Global Meeting on August 5th 2021. The event will be held virtually and will include presentations from researchers across multiple continents, providing new results from FINGER-inspired multidomain dementia prevention trials. The meeting is a fantastic opportunity for the different research teams to interact, exchange ideas, and get feedback on the results of their trials.

05 Jun 2021

The WW-FINGERS-SARS-CoV-2 Initiative

The World-Wide FINGERS network has launched a survey to monitor the effects of the COVID-19 pandemic in older adults, in terms of changes in lifestyle, behaviour, and mental wellbeing. Many studies in the World-Wide FINGERS network have been collecting data from their participants at different waves of the COVID-19 pandemic and the first results are available from Finland.


Several universities, institutes and organizations globally are involved in the WW-FINGERS network through local trials, research, and implementation programs.