LatAm-FINGERS Initiative for Cognitive Change

Last updated: July 2, 2024
Sponsor: Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia
Overall Status: Active - Recruiting

Phase

N/A

Condition

N/A

Treatment

Flexible Lifestyle Intervention

Systematic Lifestyle Intervention

Clinical Study ID

NCT06492967
SG-21-715176-LatAm-FINGERS
  • Ages 60-77
  • All Genders

Study Summary

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.

Eligibility Criteria

Inclusion

Inclusion Criteria

  • Age: 60-77 years.

  • Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) Risk Score >

  • Mini-Mental State Examination (MMSE) z score between 0 and -1.5 OR

  • CERAD Word List Learning Task (10 word x 3 repetitions) < 0 z score OR

  • CERAD (delayed word list recall) < z score < 0

Exclusion Criteria

  • MMSE < 20

  • Dementia

  • Any medical condition that affects the participant's safety.

  • Severe osteoarticular problems that preclude the implementation of the physical activity intervention outlined in the protocol, such as, for example: osteoarthrosis of the knee(s), coxofemoral, or other.

  • Significant neurological disease, including dementia, cognitive impairment, Parkinson's disease, Huntington's disease, normal pressure hydrocephalus, brain tumor, progressive supranuclear palsy, seizure disorder, subdural hematoma, multiple sclerosis or history of significant head injury with persistent neurological sequelae or structural brain abnormalities, major depressive disorder within the last 2 months, history of bipolar disorder or schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders V (DSM V) criteria.

  • Severe cardiovascular disease, including heart failure, clinically significant aortic stenosis, history of uncontrolled acute myocardial infarction (AMI) or angina and Cardiac rhythm disorders: g3 conduction block, uncontrolled arrhythmia, alterations in Q wave, S waver and T wave segment or QT segment and auricular fibrillation (AF) of less than one year of evolution, venous thrombosis or pulmonary thromboembolism (PTE) of less than 6 months of evolution and any pathology that in clinical judgment compromises the intervention of physical activity.

  • Body Mass Index >40

  • Cerebral vascular disease in the last 2 years.

  • Insulin-dependent diabetes mellitus.

  • Pulmonary disease requiring oxygen and/or steroids.

  • Renal disease defined as increased renal glomerular filtration rate <60ml/min/1.73mt2 or albumin excretion rate (AER) > 30mg/24 hrs.

  • Clinically significant laboratory abnormalities as judged by the investigator.

  • History within the last 2 years of treatment for primary or recurrent malignant disease.

  • History of hip fracture, knee replacement, or spinal surgery within the last 6 months.

  • Being in cardiopulmonary rehabilitation.

  • History of bariatric surgery.

  • Cardiac surgery in the last year.

  • Severe sensory loss or loss of communication skills.

  • No schooling.

  • Use of psychoactive medications within the past 3 months, including tricyclic antidepressants, antipsychotics, psychotropic mood-stabilizing agents (e.g., lithium salts), psychostimulants, opioid analgesics, antiparkinsonian medications, anticonvulsant medications (except gabapentin and pregabalin for non-convulsant indications), systemic corticosteroids, or medications with significant central anticholinergic activity; in the absence of major depression, stable doses of selective serotonin reuptake inhibitors or serotonin and norepinephrine reuptake inhibitors are permitted.

  • Active participation in another intervention study.

  • History of alcoholism or substance abuse in the last 2 years, according to DSM V criteria.

Study Design

Total Participants: 1200
Treatment Group(s): 2
Primary Treatment: Flexible Lifestyle Intervention
Phase:
Study Start date:
September 01, 2021
Estimated Completion Date:
December 01, 2027

Study Description

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.

Connect with a study center

  • Fleni

    Ciudad Autonoma de Buenos Aire,
    Argentina

    Site Not Available

  • Centro Neurológico Mente Activa

    La Paz,
    Bolivia

    Site Not Available

  • Universidade Federal de Minas Gerais

    Belo Horizonte, Minas Gerais
    Brazil

    Site Not Available

  • University of Sao Paulo School of Medicine

    São Paulo,
    Brazil

    Site Not Available

  • Hospital Clínico Universidad de Chile

    Santiago,
    Chile

    Site Not Available

  • Antioquia University

    Antioquia,
    Colombia

    Site Not Available

  • Hospital Clínica Bíblica

    San José,
    Costa Rica

    Site Not Available

  • Universidad Nacional Pedro Henriquez Urena (UNPHU)

    Santo Domingo,
    Dominican Republic

    Site Not Available

  • Neuromedicenter - Cognitive Disorders Unit

    Quito,
    Ecuador

    Site Not Available

  • Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez

    Ciudad de mexico,
    Mexico

    Site Not Available

  • Instituto Peruano de Neurociencas

    Lima,
    Peru

    Site Not Available

  • Universidad de Puerto Rico

    San Juan,
    Puerto Rico

    Active - Recruiting

  • Clínica de la Memoria - Hospital Británico

    Montevideo,
    Uruguay

    Site Not Available

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