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SpecialistBrain health

Miia Kivipelto

MD, PhD · Professor of clinical geriatrics, Karolinska Institutet · Rodman Family Professor of Gerontology, Yale School of Nursing · leader of the FINGER trial

Go-to expert for: lifestyle prevention of dementia

Who and why

Miia Kivipelto is a Finnish geriatrician and researcher who led FINGER, the first large randomised trial to show that a combined lifestyle programme can protect thinking skills in older people at raised dementia risk. She went on to found World-Wide FINGERS, a global network that adapts and tests the FINGER model in other countries.

Why it matters after 50: Many dementia risk factors, such as high blood pressure, inactivity and poor diet, can be changed. FINGER showed that working on several of them at once in your 60s and 70s can help keep the mind sharp.

What Kivipelto recommends

  • Tackle several habits together rather than one. In FINGER, a two-year programme of diet, exercise, brain training and heart-health checks improved overall thinking scores in at-risk 60–77-year-olds compared with general health advice.Strong evidence
  • Exercise: physiotherapist-guided strength and balance training 1–3 times a week plus aerobic exercise 2–5 times a week.Strong evidence
  • Diet: a varied diet rich in vegetables, fruit, wholegrains and fish, supported by sessions with a nutritionist.Strong evidence
  • Brain training: regular computer-based exercises, plus group sessions that also kept people socially active.Some evidence
  • Heart and metabolic health: regular checks of blood pressure, cholesterol, blood sugar and weight, with your own doctor treating anything that needs it.Doctor only
  • The programme also helped people carrying the APOE4 gene variant, the main genetic risk for Alzheimer's, so genes do not cancel out the value of lifestyle.Some evidence

Signature: The FINGER model

A two-year programme combining four parts: nutritional guidance, exercise (strength and aerobic), cognitive training with social activity, and monitoring and management of vascular and metabolic risk factors. It is now being adapted and tested in many countries through World-Wide FINGERS.

In your plan

Choose her for brain health: the FINGER model of training, eating, brain training (3 × 15 min a week) and a reminder to check your blood pressure.

Build my mix

Research and honest caveats

FINGER main result

Among 1,260 at-risk Finns aged 60–77, the intervention group's overall thinking scores improved about 25% more than the control group's over two years, with clear gains in executive function and processing speed but not memory.

Ngandu et al. (Kivipelto senior author), The Lancet, 2015

Benefit despite genetic risk

The FINGER programme's benefit on thinking was not reduced in carriers of the APOE4 Alzheimer's risk gene; the effect did not differ significantly between carriers and non-carriers.

Solomon et al., JAMA Neurology, 2018

  • The improvement in FINGER was modest on average, memory did not improve in the main pre-planned analysis, and it is not yet shown that the programme prevents dementia itself. Because the programme combined everything, it cannot say which part mattered most.

Career highlights

  1. 2006Published the CAIDE dementia risk score, later used to select FINGER participants
  2. 2009FINGER trial began recruiting in Finland
  3. 2015FINGER results published in The Lancet
  4. 2017Launched the World-Wide FINGERS network

Sources