Alzheimer’s Drug Discovery Foundation Funds Second Phase of Global Alzheimer’s Prevention FINGER TRIAL
The groundbreaking FINGER trial has already shown that lifestyle interventions—such as diet and exercise—can prevent cognitive decline. With the Alzheimer’s Drug Discovery Foundation’s (ADDF) support, the next phase of the trial will add the diabetes drug metformin to the lifestyle interventions to see if this combination is even better at preventing cognitive decline.
The ADDF is investing $3 million in the second phase, called MET-FINGER, of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) trial. According to Dr. Howard Fillit, Co-Founder and Chief Science Officer of the ADDF, Alzheimer’s is caused by a combination of age-related changes in the brain. Studies like FINGER explore the many underlying factors in the aging brain that lead to cognitive problems and the onset and progression of Alzheimer’s disease. Metformin works by improving brain metabolism, insulin sensitivity and other mechanisms and could regulate age-related metabolic problems in the brain that lead to cognitive decline.
“It is vital that we find ways to prevent Alzheimer’s disease even if only by a few years, because any delay of onset makes a great difference in people’s lives,” said Dr. Fillit. “This is why the ADDF supports clinical trials like the FINGER study, which has transformed how we view lifestyle interventions for Alzheimer’s prevention, and which is now taking it a step further to examine a combination approach.”
In the first phase of the multi-site World-Wide FINGERS network of trials, which was the first global network of trials to indicate that multidomian lifestyle-based interventions can prevent cognitive decline, lead investigator Dr. Miia Kivipelto and her colleagues found lifestyle interventions were most effective in older people (aged 60+) who carry a gene called APOE4, the strongest risk factor gene for Alzheimer’s disease. At least half of the 500 people included in the next phase of the trial will carry this gene.
Dr. Kivipelto and her team are now exploring how the safe and widely prescribed diabetes drug metformin can help the brain use insulin more effectively, helping people maintain their brain health and delay, or even completely prevent, cognitive decline.
The trial will test both the effect of lifestyle interventions alone and in combination with metformin over 24 months, primarily looking at impact on an overall composite measure of cognition. It will also study changes in individual cognitive components like memory and executive functioning, as well as changes in physical functioning and symptoms of depression.
“The support of the Alzheimer’s Drug Discovery Foundation is a great recognition of our Alzheimer’s prevention work that integrates lifestyle with drug interventions,” said Dr. Kivipelto. “We are at an exciting time in Alzheimer’s research and thrilled to be continuing our work to develop the next generation of clinical trials that will give physicians and patients practical, individualized treatment options to achieve the best possible preventive effect.”
Dr. Kivipelto serves as the Founder of the FINGERS Brain Health Institute, Professor of Clinical Geriatrics at the Karolinska Institute Center for Alzheimer Research, and Senior Geriatrician and Director for Research and Development of Theme Inflammation and Aging at Karolinska University Hospital. She is also Chair in Neuroepidemiology at AGE Unit, Imperial College London.
The ADDF has been a long-time supporter of Dr. Kivipelto, who also serves on the ADDF Board of Governors and was awarded the 2021 Melvin R. Goodes Prize for Excellence in Alzheimer’s Drug Discovery. Recently, the ADDF announced nearly $18 million in funding for projects representing cutting-edge Alzheimer’s prevention, treatment and biomarker research, including Dr. Kivipelto’s trial.