# Impact of multidomain lifestyle intervention on dynamics of cognitive frailty: post hoc analysis of the FINGER trial

## TL;DR

A lifestyle intervention helped prevent and reverse cognitive frailty in older adults at risk of dementia.

## Contribution

The study shows that a multidomain lifestyle intervention can reverse cognitive frailty in older adults.

## Key findings

- The intervention reduced the risk of developing cognitive frailty compared to standard advice.
- Participants with MCI or pre-frailty were at higher risk for cognitive frailty than healthy individuals.
- Reversal from cognitive frailty was more likely in the intervention group.

## Abstract

Cognitive frailty (CF), a condition with physical frailty and mild cognitive impairment (MCI) without dementia, is potentially reversible and linked to adverse outcomes. We aimed to investigate the impact of a multidomain lifestyle intervention on temporal dynamics of CF in older adults at risk of dementia.

In the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), 1259 participants, aged 60-77, were randomized to a 2-year multidomain lifestyle intervention or standard health advice. Frailty was defined by the modified Fried phenotype, and MCI by the lowest quintile in the neuropsychological test battery z score. Having pre-frailty/frailty and MCI was classified as CF. Transition probabilities and predictiveness of CF by 4 different baseline groups (healthy, MCI, pre-frail/frail, CF) were examined using multinomial logistic regression.

At baseline, 219 participants (18%) had CF. The risk for developing CF at 2 years was higher in the control group (risk ratio [RR], 1.88, p = .003). The intervention effect was not modified by baseline CF (p = .493). Reversal from CF to no-CF group was more likely in the intervention group, and progression to or persisting with CF was more likely in the control group. Compared with healthy participants (n = 401) at baseline, the MCI group (n = 244) had an RR of 5.10, pre-frail/frail (n = 336) of 3.06, and CF of 30.61 for having CF at 2 years, with no difference between MCI and pre-frail/frail groups (p = .116).

The 2-year multidomain lifestyle intervention was effective in preventing and reversing CF. Participants with MCI or pre-frailty/frailty were both at increased risk for CF compared with healthy participants.