GOIZ ZAINDU study: a FINGER-like multidomain lifestyle intervention feasibility randomized trial to prevent dementia in Southern Europe
Authors: Tainta Mikel , Ecay-Torres Mirian , de Arriba Maria , Barandiaran Myriam , Otaegui-Arrazola Ane , Iriondo Ane , Garcia-Sebastian Maite , Estanga Ainara , Saldias Jon , Clerigue Montserrat , Gabilondo Alazne , Ros Naia , Mugica Justo , Barandiaran Aitziber , Mangialasche Francesca , Kivipelto Miia , Arrospide Arantzazu , Mar Javier , Martinez-Lage Pablo ,   on behalf of the GOIZ ZAINDU study group, Aquizu I. , Arrondo M. A. , Baztarrika E. , Etxeberria L. , García-Arrea E. , García-Domínguez M. , Imaz E. , Iparragirre M. , Iridoy M. , Larrea A. , López M. D. , Martin F. , Olaskoaga A. , Pacheco P. , Pérez-Rodiguez A. M. , Porres Y. , Ruibal M. , San Juan B. , Tilves M. J. , Zapirain E. 
Published: February 2024

Abstract
Background
GOIZ ZAINDU (“caring early” in Basque) is a pilot study to adapt the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) methodology to the Basque population and evaluate the feasibility and adherence to a FINGER-like multidomain intervention program. Additional aims included the assessment of efficacy on cognition and data collection to design a large efficacy trial.

Method
GOIZ ZAINDU is a 1-year, randomized, controlled trial of a multidomain intervention in persons aged 60+ years, with Cardiovascular Risk Factors, Aging and Dementia (CAIDE) risk score ≥ 6, no diagnosis of dementia, and below-than-expected performance in at least one of three cognitive screening tests. Randomization to a multidomain intervention (MD-Int) or regular health advice (RHA) was stratified by sex, age (>/≤ 75), and cognitive status (mild cognitive impairment (MCI)/normal cognition). MD-Int included cardiovascular risk factor control, nutritional counseling, physical activity, and cognitive training. The primary outcomes were retention rate and adherence to the intervention program. Exploratory cognitive outcomes included changes in the Neuropsychological Test Battery z-scores. Analyses were performed according to the intention to treat.

Results
One hundred twenty-five participants were recruited (mean age: 75.64 (± 6.46); 58% women). The MD-Int (n = 61) and RHA (n = 64) groups were balanced in terms of their demographics and cognition. Fifty-two (85%) participants from the RHA group and 56 (88%) from the MD-Int group completed the study. More than 70% of the participants had high overall adherence to the intervention activities. The risk of cognitive decline was higher in the RHA group than in the MD-Int group in terms of executive function (p =.019) and processing speed scores (p =.026).

Conclusions
The GOIZ-ZAINDU study proved that the FINGER methodology is adaptable and feasible in a different socio-cultural environment. The exploratory efficacy results showed a lower risk of decline in executive function and processing speed in the intervention group. These results support the design of a large-scale efficacy trial.

Trial registration
GOIZ ZAINDU feasibility trial was approved and registered by the Euskadi Drug Research Ethics Committee (ID: PI2017134) on 23 January 2018. Retrospectively registered in ClinicalTrials.gov (NCT06163716) on 8 December 2023.