| 1. |
- Kivipelto, Miia, et al.
(författare)
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The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) : Study design and progress
- 2013
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Ingår i: Alzheimer's & Dementia. - : Wiley. - 1552-5260 .- 1552-5279. ; 9:6, s. 657-665
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Tidskriftsartikel (refereegranskat)abstract
- Background: Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) is a multi-center, randomized, controlled trial ongoing in Finland. Materials: Participants (1200 individuals at risk of cognitive decline) are recruited from previous population-based non-intervention studies. Inclusion criteria are CAIDE Dementia Risk Score >= 6 and cognitive performance at the mean level or slightly lower than expected for age (but not substantial impairment) assessed with the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological battery. The 2-year multidomain intervention consists of: nutritional guidance; exercise; cognitive training and social activity; and management of metabolic and vascular risk factors. Persons in the control group receive regular health advice. The primary outcome is cognitive performance as measured by the modified Neuropsychological Test Battery, Stroop test, and Trail Making Test. Main secondary outcomes are: dementia (after extended follow-up); disability; depressive symptoms; vascular risk factors and outcomes; quality of life; utilization of health resources; and neuroimaging measures. Results: Screening began in September 2009 and was completed in December 2011. All 1200 persons are enrolled and the intervention is ongoing as planned. Baseline clinical characteristics indicate that several vascular risk factors and unhealthy lifestyle related factors are present, creating a window of opportunity for prevention. The intervention will be completed during 2014. Conclusions: The FINGER is at the forefront of international collaborative efforts to solve the clinical and public health problems of early identification of individuals at increased risk of late-life cognitive impairment, and of developing intervention strategies to prevent or delay the onset of cognitive impairment and dementia.
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| 2. |
- Ngandu, Tiia, et al.
(författare)
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A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER) : a randomised controlled trial
- 2015
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Ingår i: The Lancet. - 0140-6736 .- 1474-547X. ; 385:9984, s. 2255-2263
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Tidskriftsartikel (refereegranskat)abstract
- Background Modifiable vascular and lifestyle-related risk factors have been associated with dementia risk in observational studies. In the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), a proof-of-concept randomised controlled trial, we aimed to assess a multidomain approach to prevent cognitive decline in at-risk elderly people from the general population.Methods In a double-blind randomised controlled trial we enrolled individuals aged 60-77 years recruited from previous national surveys. Inclusion criteria were CAIDE (Cardiovascular Risk Factors, Aging and Dementia) Dementia Risk Score of at least 6 points and cognition at mean level or slightly lower than expected for age. We randomly assigned participants in a 1: 1 ratio to a 2 year multidomain intervention (diet, exercise, cognitive training, vascular risk monitoring), or a control group (general health advice). Computer-generated allocation was done in blocks of four (two individuals randomly allocated to each group) at each site. Group allocation was not actively disclosed to participants and outcome assessors were masked to group allocation. The primary outcome was change in cognition as measured through comprehensive neuropsychological test battery (NTB) Z score. Analysis was by modified intention to treat (all participants with at least one post-baseline observation). This trial is registered at ClinicalTrials.gov, number NCT01041989.Findings Between Sept 7, 2009, and Nov 24, 2011, we screened 2654 individuals and randomly assigned 1260 to the intervention group (n=631) or control group (n=629). 591 (94%) participants in the intervention group and 599 (95%) in the control group had at least one post-baseline assessment and were included in the modified intention-to-treat analysis. Estimated mean change in NTB total Z score at 2 years was 0.20 (SE 0.02, SD 0.51) in the intervention group and 0.16 (0.01, 0.51) in the control group. Between-group difference in the change of NTB total score per year was 0.022 (95% CI 0.002-0.042, p=0.030). 153 (12%) individuals dropped out overall. Adverse events occurred in 46 (7%) participants in the intervention group compared with six (1%) participants in the control group; the most common adverse event was musculoskeletal pain (32 [5%] individuals for intervention vs no individuals for control).Interpretation Findings from this large, long-term, randomised controlled trial suggest that a multidomain intervention could improve or maintain cognitive functioning in at-risk elderly people from the general population.
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| 3. |
- Ngandu, Tiia, et al.
(författare)
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Recruitment and Baseline Characteristics of Participants in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) : A Randomized Controlled Lifestyle Trial
- 2014
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 11:9, s. 9345-9360
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Tidskriftsartikel (refereegranskat)abstract
- Our aim is to describe the study recruitment and baseline characteristics of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) study population. Potential study participants (age 60-77 years, the dementia risk score >= 6) were identified from previous population-based survey cohorts and invited to the screening visit. To be eligible, cognitive performance measured at the screening visit had to be at the mean level or slightly lower than expected for age. Of those invited (n = 5496), 48% (n = 2654) attended the screening visit, and finally 1260 eligible participants were randomized to the intervention and control groups (1: 1). The screening visit non-attendees were slightly older, less educated, and had more vascular risk factors and diseases present. The mean (SD) age of the randomized participants was 69.4 (4.7) years, Mini-Mental State Examination 26.7 (2.0) points, systolic blood pressure 140.1 (16.2) mmHg, total serum cholesterol 5.2 (1.0) mmol/L for, and fasting glucose 6.1 (0.9) mmol/L for, with no difference between intervention and control groups. Several modifiable risk factors were present at baseline indicating an opportunity for the intervention. The FINGER study will provide important information on the effect of lifestyle intervention to prevent cognitive impairment among at risk persons.
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| 4. |
- Hoppe, Julia A., et al.
(författare)
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Assistive robots in care : Expectations and pereceptions of older people
- 2020
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Ingår i: Aging between Participation and Simulation. - : De Gruyter Open. ; , s. 139-156
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Bokkapitel (refereegranskat)abstract
- This chapter analyzes older people’s expectations and perceptions about welfare technology and in particular about robots in elderly care. Assistive robots may serve as a means to prolonged autonomy in old age as well as support for nursing staff. Justified by a rapid change in the health care sector, the need to focus on user driven and not technology driven development of assistive robots must be emphasized to ensure an adequate and sustainable orientation process toward assistive robots. This study presents an inventory of the expectations and perceptions of older people regarding assistive robots, by conducting a qualitative approach with focus group discussions. Our findings reveal that seven themes in particular need to be addressed in order to improve older people’s perceptions of robot technology: (1) independence and safety, (2) physical and mental assistance, (3) communication and socialization, (4) relief to nursing staff, (5) individual’s right to decide, (6) data protection, and (7) liability. Additionally, the focus group interviews stress that dissemination of information on how robots can provide assistance may change older people’s attitudes towards technology
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| 5. |
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| 6. |
- Johansson-Pajala, Rose-Marie, et al.
(författare)
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Care Robot Orientation : What, Who and How? Potential Users' Perceptions
- 2020
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Ingår i: International Journal of Social Robotics. - : Springer. - 1875-4791 .- 1875-4805. ; 12:5, s. 1103-1117
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Tidskriftsartikel (refereegranskat)abstract
- Exploring the specific field of care robot orientation generates many questions regarding the meaning, content and how it should be conducted. The issue is important due to the general digitalisation and implementation of welfare technology and care robots. The aim of the study was to explore perceptions of care robot orientation from the potential users' perspective. Data were collected by focus group interviews in Finland, Germany and Sweden. In all three countries, potential user groups were represented: older adults, relatives, professional caregivers and care service managers. A qualitative descriptive method was used for analysing data. The data revealed three aspects of care robot orientation: (1) What care robot orientation is, (2) Who needs it and by Whom it should be given and (3) How it should be performed. The need for care robot orientation is general in society. In the absence of knowledge about care robots, it is nearly impossible to know what to ask for or actually seek information about. Therefore, care robot orientation must be founded on agile implementation planning for care robots, with a firm basis in trustworthy knowledge and information and respecting individuals' wishes. This also gives rise to an ethical challenge when care robots are offered to people having reduced decision-making ability (dementia, cognitive impairment), along with the issue of who then should make the decision. The mapping of the What, Who/Whom and How aspects of care robot orientation offers a foundation for the creation of orientation models, which might facilitate structured and goal-oriented care robot orientation strategies.
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| 7. |
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| 8. |
- Pekkarinen, Satu, et al.
(författare)
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Embedding care robots into society and practice : Socio-technical considerations
- 2020
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Ingår i: Futures. - : Elsevier. - 0016-3287 .- 1873-6378. ; 122
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Tidskriftsartikel (refereegranskat)abstract
- Robots are not yet typical in daily use in elder care services, but recent studies suggest that they will soon be mainstream. In this study, we focus on the future of elder care, affected by the emergence of care robotics. We tackle the socio-technical transition—a multi-level change with a re-configuration of social and technological elements of the system—of elder care. The transition in the elder care system and the conditions of the embedding the robots in welfare services and society in three European countries, Germany, Sweden and Finland, are examined. Our qualitative study focuses on current situation in the use of robots in elder care as well as advancing and hindering elements in embedding robots into society and elder care practices. According to the results, there is a shift towards using robots in care, but remarkable inertia exists in both technological development and socio-institutional adaptation. Advancing and hindering elements in transition are both technical and social – and increasingly interrelated, which needs to be considered in management and policy measures to promote successful future transition pathways. The change of attitudes and embedding robots into society is promoted, for instance, by raising relevant knowledge on robots at different levels.
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| 9. |
- Solomon, Alina, et al.
(författare)
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Effect of the Apolipoprotein E Genotype on Cognitive Change During a Multidomain Lifestyle Intervention A Subgroup Analysis of a Randomized Clinical Trial
- 2018
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Ingår i: JAMA Neurology. - : American Medical Association (AMA). - 2168-6149 .- 2168-6157. ; 75:4, s. 462-470
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE The role of the apolipoprotein E (APOE) epsilon 4 allele as an effect modifier in lifestyle interventions to prevent cognitive impairment is still unclear. OBJECTIVE To examine whether the APOE epsilon 4 allele modifies the previously reported significant cognitive benefits of a multidomain lifestyle intervention (prespecified subgroup analysis). DESIGN, SETTING, AND PARTICIPANTS The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) was a randomized clinical trial in 6 centers across Finland (screening and randomization performed from September 7, 2009, through November 24, 2011; intervention duration, 2 years). Data analysis was performed from August 1, 2015, to March 31, 2016. The study population was at-risk older individuals from the general population. Inclusion criteria were age of 60 to 77 years; Cardiovascular Risk Factors, Aging, and Dementia risk score of at least 6 points; and cognition at a mean level or slightly lower than expected for age. Individuals with dementia or substantial cognitive impairment and conditions that prevented cooperation or safe engagement in the intervention were excluded. APOE genotype data were available for 1175 of the 1260 participants. INTERVENTIONS Participants were randomly assigned in a 1: 1 ratio to a multidomain intervention group (diet, exercise, cognitive training, and vascular risk management) or a control group (general health advice). Group allocation was not actively disclosed to participants, and outcome assessors were masked to group allocation. MAIN OUTCOMES AND MEASURES Primary outcome was change in cognition measured through a comprehensive neuropsychological test battery. Analysis was based on modified intention to treat (participants with at least 1 postbaseline assessment). RESULTS A total of 1109 participants (mean [SD] age, 69.3 [4.7] years; 514 [46.3%] female) were included in the analysis: 362 APOE epsilon 4 allele carriers (173 intervention and 189 control) and 747 noncarriers (380 intervention and 367 control). The APOE epsilon 4 carriers and noncarriers were not significantly different at baseline (except for serum cholesterol level). The difference between the intervention and control groups in annual neuropsychological test battery total score change was 0.037 (95% CI, 0.001 to 0.073) among carriers and 0.014 (95% CI, -0.011 to 0.039) among noncarriers. Intervention effect was not significantly different between carriers and noncarriers (0.023; 95% CI, -0.021 to 0.067). CONCLUSIONS AND RELEVANCE Healthy lifestyle changesmay be beneficial for cognition in older at-risk individuals even in the presence of APOE-related genetic susceptibility to dementia. Whether such benefits are more pronounced in APOE epsilon 4 carriers compared with noncarriers should be further investigated. The findings also emphasize the importance of early prevention strategies that target multiple modifiable risk factors simultaneously.
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| 10. |
- Tuisku, Outi, et al.
(författare)
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Assistant nurses and orientation to care robot use in three European countries
- 2022
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Ingår i: Behavior and Information Technology. - : Informa UK Limited. - 0144-929X .- 1362-3001.
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Tidskriftsartikel (refereegranskat)abstract
- This study investigates assistant nurses’ views on and needs for orientation to care robot use in three European countries. The use of care robots is gradually being incorporated into welfare services. Orientation to care robot use (in short, introduction to the use of the care robot technology) has thus become a key issue for care services. A survey was sent to assistant nurses in Finland, Germany, and Sweden, to which 302 participants responded (Finland n = 117; Germany n = 73; Sweden n = 112). Only 11.3% of assistant nurses had experience of giving orientation to care robot use to older adults or colleagues, but over 50% were willing to do so. Those with experience of using care robots should take part in orientation. Orientation to care robot use should be seen as part of care management and an issue that may affect the whole organisation. Management should, firstly, allow assistant nurses to get to know care robots by offering information, and secondly, consider with the assistant nurses the ways care robots can change their work and the implications of this change. Emphasising the social factors and practical orientation to care robot use extends the previous theories and perspectives of technology acceptance, adoption and diffusion.
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