A multidomain, systematic lifestyle intervention (SLI) may lead to a significantly greater improvement in global cognitive function over 2 years compared with a flexible lifestyle intervention (FLI) among older adults at high risk of dementia, according to the LatAm-FINGERS* trial presented at AAIC 2026.
The LatAm-FINGERS trial is the first randomized clinical trial to evaluate the feasibility of a culturally adapted, multidomain lifestyle intervention aimed at preventing cognitive decline, and to compare the effects of SLI with FLI on global cognitive function in at-risk older adults across Latin America.
This multicentre, single-blind study involved 1,065 adults (mean age 67.5 years, 74.6 percent female) who were at high risk of dementia and had suboptimal cognition, recruited from 12 Latin‑American countries. Participants were randomly assigned to the SLI (n=539) or FLI (n=526) groups. [Crivelli L, et al, AAIC 2026]
The SLI group received structured multidomain lifestyle interventions, including physical and cognitive training, implementation of the MIND** diet, social engagement, and regular health check-ups, all under supervision and monitoring. In contrast, the FLI group received routine health advice.
After the 2-year intervention, participants in the SLI group showed a significant improvement in global cognitive composite scores compared with those in the FLI group (mean change from baseline, 0.31 vs 0.20 standard deviation [SD]/year; between-group difference, 0.11 SD; p<0.0001). This represented a 55-percent cognitive benefit for SLI over FLI, according to lead author Dr Lucía Crivelli from the Department of Cognitive Neurology at Fleni in Buenos Aires, Argentina.
The benefits of SLI over FLI were also evident across the three cognitive domains: episodic memory (mean between-group difference, 0.14 SD/year; p<0.0001), executive function (mean between-group difference, 0.04 SD/year; p=0.006), and processing speed (mean between-group difference, 0.04 SD/year; p=0.020).
In terms of the feasibility of SLI, recruitment effectiveness (reach) was approximately 62 percent, mean adherence to group meetings (implementation) was 71.6 percent, and maintenance rates were 87.9 percent, 85.3 percent, and 81.4 percent at 6, 12, and 18 months, respectively.
“These results prove that a structured lifestyle intervention can be applicable in Latin America, but not only this, these results are consistent with the findings of the FINGER*** trial and of the U.S. POINTER trial, which means that lifestyle interventions can be implemented and can be effective in different parts of the world with different populations,” said Crivelli.
“We did not simply translate the U.S. POINTER model into Spanish and Portuguese. We adapted it to local cultures and habits while preserving its core elements — making the programme practical, affordable, and feasible as a public health strategy,” she added.
Overall, “a culturally adapted multidomain lifestyle intervention is rigorous, feasible, and effective” in improving cognitive trajectories among at-risk older adults across Latin America, Crivelli concluded.