“It’s never too late for brain health promotion,” Professor Alina Solomon says.
Looking at the big picture of brain aging
This year, Solomon started as Professor of Neuroepidemiology at the University of Eastern Finland, where she has been doing research for nearly twenty years. Her research covers a wide range of aspects related to brain aging, brain health promotion, risk assessment and risk reduction, with a special focus on dementias. Many of her projects also aim at better diagnostic and prognostic tools, and at clinical decision support systems to help clinicians choose the best care for each patient.
Throughout her research career, Solomon has been closely involved in the launch and further development of the FINGER model for dementia risk reduction. FINGER, short for the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability, showed for the first time that a multidomain lifestyle intervention can improve brain health and prevent cognitive decline. The model combines dietary guidance, physical and cognitive activities, and management of cardiovascular risk factors.
The FINGER model is being further adapted and tested in a global network led by Professor Miia Kivipelto, with Solomon as Scientific Coordinator. “The work is nowhere near done until the model can be implemented from research settings to the healthcare system.”
“We are now testing if it can be enhanced with digital tools, and we also want to combine it with disease modifying drugs, whether repurposed or new.”
An ongoing trial is expected to show the added benefit of a diabetes drug, metformin, in preventing cognitive decline. Type 2 diabetes increases the risk of dementia, but there is already evidence that metformin can have a protective effect.
“We hope to try other drugs and drug combinations later. In fact, the approach to dementia should be more like the approach to cardiovascular diseases or HIV, where cocktails of drugs with different mechanisms of action are prescribed depending on the patient’s disease profile. That is the direction to go, instead of focusing on a single approach, such as anti-amyloid drugs, which won’t work for all patients.”
Hearing impairment is a less investigated risk factor for dementia. Together with Professor Aarno Dietz at Kuopio University Hospital, Solomon is launching a new trial to study how an individualised hearing rehabilitation affects cognitive function, compared to the standard protocol.
Small but sustainable steps
The trials have involved people at different stages of cognitive decline, from at-risk to prodromal Alzheimer’s disease. “People often ask if it’s too late for them to make lifestyle changes, especially if they already have memory impairment. The earlier the better, of course, but it’s never too late to reduce the risk of severe outcomes or comorbidities. If you have diabetes or heart disease, complying with the treatment plan promotes your brain health too, as the risk factors overlap.”
“Even small changes in multiple lifestyle habits can make a difference if sustained. In the FINGER study, following at least half of the recommendations resulted in cognitive benefits.”
What if you think you have memory problems, but tests show nothing wrong? Subjective cognitive complaints are common at old age, and there’s debate whether they can predict later problems. “Usually that’s not the case, looking at the big picture on the population level.”
Nowadays, Solomon prefers talking about dementia risk reduction rather than dementia prevention. “People on our advisory boards have pointed out that prevention sounds like a promise of never getting dementia. Risk reduction is a more realistic concept.”
“All projects now have advisory boards involving people with dementia or with an increased risk of it. They give valuable feedback on things like how to make our research more understandable to participants or how it is going to benefit the target group. When I started in the field, public involvement activities were unheard of, but they have been a game-changer.” Much of Solomon’s research takes place at the UEF Brain Research Unit that offers clinical trial services to both academic projects and the pharmaceutical industry. “The activities don’t focus just on dementia, but span a broader range of neurological diseases, which sometimes also gives us ideas from one disease to another.”
Alina Solomon
Professor of Neuroepidemiology, University of Eastern Finland, 1.1.2024–
- Medical Doctor, Carol Davila University of Medicine and Pharmacy, Romania, 2004
- PhD (Neurology), University of Eastern Finland, 2011
- Docent (Neuroepidemiology), University of Eastern Finland, 2014
Key roles
- Associate Professor (Tenure track), University of Eastern Finland, 2020-2023
- Academy of Finland Research Fellow, University of Eastern Finland, 2015-2020
- Postdoctoral Researcher, University of Eastern Finland, 2011-2014
- Visiting Professor, Imperial College London, 2019-
- Senior Researcher, Karolinska Institute, Sweden, 2014-
- Senior Researcher / Scientific Coordinator for clinical trials, Karolinska University Hospital Theme Aging, Clinical Trials Unit, Sweden, 2012-
