What I discussed this morning was the level of evidence we have currently for personalized dementia risk reduction, because we hear a lot in the press or in books for the general population about this reduction of dementia. We have, for example, the ReCODE program from Dale Bredesen that tells you that you can prevent and revert Alzheimer’s disease through a prevention program. So, let me be clear this kind of program may work, I don’t know, but we need scientific evidence to demonstrate it...
What I discussed this morning was the level of evidence we have currently for personalized dementia risk reduction, because we hear a lot in the press or in books for the general population about this reduction of dementia. We have, for example, the ReCODE program from Dale Bredesen that tells you that you can prevent and revert Alzheimer’s disease through a prevention program. So, let me be clear this kind of program may work, I don’t know, but we need scientific evidence to demonstrate it. So, I listed the evidence we have now from randomized controlled clinical trials, for example. The highest level of evidence we have for that is the FINGER trial that was conducted in Finland at the beginning of 2010 and that showed that through a multi-domain intervention -multi-domain, meaning diet, cognitive training, physical activity, monitoring of vascular risk factor – when you do that in high-risk individuals for dementia after two years you had an improvement of the cognitive function that was better than the individual who received a simple advice on their health. So, that’s what we have as a highest level of evidence for the fact that we can prevent cognitive decline in high-risk non-demented population.
We also then have intermediate level of evidence from the prospective epidemiological cohorts that have shown that when you take every of the 12 risk factor of dementia that have been highlighted by the Lancet commission and you make an intervention on it, then we can see an individual effect of this intervention. But, of course, the level of evidence is a bit lower since we are not in a randomized controlled clinical trial, but in prospective longitudinal epidemiological studies.
So, altogether, we have some strong evidence from the FINGER trial and some low to moderate level of evidence regarding the effect of other type of intervention targeting a single risk factor of dementia. That’s what Miia Kivipelto developed on the detail this morning in our presentation. She’s really the leader in the field in Europe regarding this, so, there is much more trial ongoing. There are, for example, the MET-FINGER trial that tries to combine the FINGER approach with a medication approach with metformin. This is an ongoing trial there. She also created the World-Wide FINGER Network to homogenize and connect all the prevention initiatives ongoing worldwide. As long as I can remember, I think there are currently 15 randomized controlled clinical trials running worldwide. So yes, there will be much more data and we will know better regarding prevention in the upcoming years.
