Combining Lifestyle With Metformin to Reduce Dementia Risk - Updates From MET-FINGER Trial

Sep 28, 2026

Uploaded by Bintang

Updates from the MET-FINGER trial evaluate a randomized controlled approach that combines healthy lifestyle changes with metformin to prevent cognitive impairment in an APOEε4-enriched at-risk older-adult population. The trial enrolls 600 participants and compares the FINGER 2.0 lifestyle plus metformin active arm with regular health advice, then further randomizes eligible high T2D-risk participants to 2000 mg/day, 1000 mg/day, or placebo in a double-blind design. The study tracks global cognition via a neuropsychological test battery and examines secondary cognitive domains, functional ability, and AD/dementia risk factors, with feasibility and interaction effects as exploratory endpoints.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Abstract

Trial design and population

Interventions and outcomes

Feasibility and exploratory endpoints

Challenges and lessons learned

92 Innovation in Aging, 2025, Vol. 9, No. S2 Abstract citation ID: igaf122.306 COMBINING LIFESTYLE WITH METFORMIN TO REDUCE DEMENTIA RISK: UPDATES FROM MET-FINGER TRIAL Dinithi Perera1, Mariagnese Barbera2, Alina Solomon3, Jenni Lehtisalo4, Francesca Mangialasche5, Lefkos Middleton6, Tiia Ngandu7, and Miia Kivipelto3, 1. FINGERS Brain Health Institute, Stockholm, Stockholms Lan, Sweden, 2. University of Eastern Finland, Kuopio, Pohjois-Savo, Finland, 3. Karolinska Institutet, Solna, Stockholms Lan, Sweden, 4. Finnish Institute for Health and Welfare, Helsinki, Uusimaa, Finland, 5. Division of Clinical Geriatrics, Stockholm, Stockholms Lan, Sweden, 6. Imperial College London, London, England, United Kingdom, 7. Finnish Institute for Health and Wefare, Helsinki, Uusimaa, Finland MET-FINGER is the first randomized controlled trial combining healthy lifestyle changes with a putative disease-modifying drug (metformin) for the prevention of cognitive impairment, in Innovation in Aging, 2025, Vol. 9, No. S2 93 an APOEε4-enriched at-risk population of older adults. The potential benefits of metformin repurposing are based on the link between Type-II Diabetes (T2D) and Alzheimer’s Disease (AD), and emerging evidence of independent neuro-protective effects. Findings will provide crucial information for innovative precision-prevention strategies aimed at cognitive impairment and dementia risk-reduction. 600 participants are randomly allocated to the FINGER 2.0 intervention (lifestyle for all + metformin, where appropriate; active arm), or regular health advice (control arm) . Participants in the FINGER 2.0 group and at increased risk of T2D, are further randomised to 2000mg/day metformin, 1000mg/day metformin, or placebo (double-blind) . The multimodal lifestyle intervention is an optimised version of the FINGER model. Metformin is administered as Glucophage®XR/SR 500,(Merck Healthcare KGaA, Darmstadt, Germany; 500mg oral tablets) . Primary outcome is change in global cognition (combined z-score of a neuropsychological test battery). Secondary outcomes are changes in individual cognitive domains; functional ability; and risk factors for AD/dementia. The feasibility, potential lifestyle-metformin interaction, and disease-modifying effects of the lifestyle-metformin combination are exploratory outcomes. 489 eligible participants have been identified; 365 have been randomised. The main challenges experienced are linked to balancing APOEε4-carriers enrichment and the eligibility rate for metformin treatment (e.g., APOEε4-carriers were less likely to fulfil some eligibility criteria for metformin) . Lessons learned, pertaining to trial design, set-up, recruitment, and delivery, for future combination-therapy studies, will be presented.

FAQs

What is the main purpose of the MET-FINGER trial?

To test whether combining healthy lifestyle changes with metformin can reduce the risk of cognitive impairment and dementia in an APOEε4-enriched at-risk older-adult population.

How are participants allocated in the MET-FINGER trial?

A total of 600 participants are randomized to the FINGER 2.0 intervention (lifestyle for all plus metformin where appropriate) or regular health advice, and higher-risk participants are further double-blind randomized to 2000 mg/day, 1000 mg/day, or placebo.

What outcomes does the trial measure?

Primary outcome is change in global cognition using a combined z-score from a neuropsychological test battery. Secondary outcomes include changes in specific cognitive domains, functional ability, and AD/dementia risk factors; feasibility and lifestyle-metformin interaction are exploratory.

Sep 28, 2026

Uploaded by Bintang