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[Correspondence] Pointing the FINGER at multimodal dementia prevention – Authors’ reply

The contradictory interpretations of findings from the FINGER trial1 discussed by Amit Lampit and Michael Valenzuela (too weak an effect) and Mika Kivimäki and colleagues (too large an effect) highlight challenges in assessment of intervention effects on cognition in at-risk populations who have not yet developed dementia and who are mostly independent in daily activities. No gold standard exists for which scales should be used and how often, and which intervention results should be expected. At-risk states and pre-dementia stages, by definition, do not have the well known cognitive decline seen in dementia, and cognitive and functional assessment scales cannot simply be copied from previous dementia trials.