(38)“FINGER”试验-The FINGER Trial-公开课-关爱惟士
(38)“FINGER”试验-The FINGER Trial


Associate Professor Michael Valenzuela

The FINGER trial came out last year, and was one of the first large-scale studies to look at so-called multi-modal dementia prevention. So this was a trial where they preselected people who had a number of risk factors for dementia, and then they underwent a multi-modal intervention. So what that means is that it was several streams of lifestyle changes that the investigators were trying to target. They targeted physical activity, so more exercise; they targeted cognitive activity, through brain training; they tried to optimise the management of risk factors, like hypertension and smoking; and also optimised their diet. That’s why we call it multi-modal, because it was targeting many different lifestyle factors. And what the study showed was that, after two years of this type of intervention, it was successful. So those in the intervention group improved in their cognitive abilities more than the placebo group. But what is often missed in discussions of the FINGER trial, is a little bit more complicated, and a little bit more technical, but I think worth talking about, which is that the effect size was very small. And, when we’re talking about effect size, we’re talking about what was the magnitude of the difference in the intervention group versus the placebo group. When we talk about effect sizes, we’re often talking about, “Was it small, was it moderate, or was it large?”

去年出现的FINGER试验,是首次进行所谓的多模式认知症预防的大规模研究之一。这是一个预先选择的人群,他们有认知症的一些危险因素,然后他们进行多种模式干预的试验。所以这意味着研究者试图瞄准 几种生活方式的变化。瞄准体育活动,所以他们建议更多的运动;针对认知活动,他们通过大脑训练;他们试图优化高血压和吸烟等危险因素的管理;并优化了他们的饮食。这就是为什么我们称之为多模式,因为它瞄准了许多不同的生活方式因素。研究表明,它是成功的。因此,经过两年的这种干预,干预组的认知能力比安慰剂组提高。但是在FINGER试验的经常错过的讨论是,有点复杂,有点技术性,但我认为值得谈论的是效应量非常小。而且,当我们谈论效应量时,我们讨论的是干预组与安慰剂组之间差异的大小。当我们谈论效果大小时,我们经常谈论,“它是小,是中等,还是大?

Whether a single or multiple lifestyle intervention is the best approach for preventing dementia, we just don’t know. I think there is a question mark now whether we can just assume that combining lifestyle interventions is better than any one or the other. So we’ve really got to do the research, to compare stand-alone interventions versus multi-modal interventions. It may be the case that doing different lifestyle interventions back to back, or one after the other, may be more effective than putting them all at the same time. So I think there’s just a lot more research that has to be done.

我们只是不知道到底是单一还是多重生活方式干预是预防认知症的最佳方法。 我认为现在有一个问号,我们是否可以假设组合生活方式干预比任何一个或其他更好。 因此,我们真的要做研究来比较独立的干预措施与多模式干预措施。可能的情况是,不同的生活方式干预背靠背,或者一个接一个地进行,可能比将它们全部同时进行更加有效。 所以我认为还有很多研究需要做。