Maintain your brain

Effective, scalable dementia prevention interventions are needed to address modifiable risk factors given global burden of dementia and challenges in developing disease-modifying treatments. A single-blind randomized controlled trial assessed an online multidomain lifestyle intervention to prevent cognitive decline over 3 years. Participants were dementia-free community-dwelling Australians aged 55-77 years with modifiable dementia risk factors. The outcome of this study suggests that these types of interventions could be scalable and may reduce cognitive decline.
Brodaty, H., Chau, T., Heffernan, M., Ginige, J. A., et al. (2025). An online multidomain lifestyle intervention to prevent cognitive decline in at-risk older adults: a randomized controlled trial. Nature medicine, 10.1038/s41591-024-03351-6. Advance online publication. https://doi.org/10.1038/s41591-024-03351-6

The 2024 update of the Lancet Commission on dementia provides new hopeful evidence about dementia prevention, intervention, and care. As people live longer, the number of people who live with dementia continues to rise, even as the age-specific incidence decreases in high-income countries, emphasising the need to identify and implement prevention approaches. We have summarised the new research since the 2020 report of the Lancet Commission on dementia, prioritising systematic reviews and meta-analyses and triangulating findings from different studies showing how cognitive and physical reserve develop across the life course and how reducing vascular damage (eg, by reducing smoking and treating high blood pressure) is likely to have contributed to a reduction in age-related dementia incidence. Evidence is increasing and is now stronger than before that tackling the many risk factors for dementia that we modelled previously (ie, less education, hearing loss, hypertension, smoking, obesity, depression, physical inactivity, diabetes, excessive alcohol consumption [ie, >21 UK units, equivalent to >12 US units], traumatic brain injury [TBI], air pollution, and social isolation) reduces the risk of developing dementia. In this report, we add the new compelling evidence that untreated vision loss and high LDL cholesterol are risk factors for dementia.
Livingston, G., Huntley, J., Liu, K. Y., Costafreda, S. G., Geir Selbæk, Suvarna Alladi, Ames, D., Banerjee, S., Burns, A., Brayne, C., Fox, N. C., Ferri, C. P., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Noeline Nakasujja, Rockwood, K., & Samus, Q. (2024). Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet. https://doi.org/10.1016/s0140-6736(24)01296-0‌

The WHO Guidelines on risk reduction of cognitive decline and dementia provide evidence-based recommendations on lifestyle behaviours and interventions to delay or prevent cognitive decline and dementia.
World Health Organization (WHO). (2019). Risk reduction of cognitive decline and dementia: WHO guidelines. Geneva.

The National Institute on Aging (NIA) initiated this study with the National Academies of Sciences, Engineering, and Medicine to take stock of the current state of knowledge on interventions for preventing cognitive decline and dementia, to help shape the messages NIA conveys to the broader public about these conditions, and to inform future actions and research in this area.
National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Health Sciences Policy, Committee on Preventing Dementia and Cognitive Impairment, Downey, A., Stroud, C., Landis, S., & Leshner, A. I. (Eds.). (2017). Preventing Cognitive Decline and Dementia: A Way Forward. National Academies Press (US).

Midlife has been suggested to be a crucial time to introduce interventions for improving cognitive functions. To investigate the effects of CT on cognition in healthy middle-aged adults and specifically in females during the menopause transition, literature was searched inception to July 2023 and studies were included that examined the effects of CT on a defined cognitive outcome.

Cognition-oriented treatments (COTs) are a group of non-pharmacological treatments aimed at maintaining or improving cognitive functioning. Individual cognitive training and group cognitive training were reported as effective in improving global cognitive functions in people with mild dementia.
Paggetti, A., Druda, Y., Sciancalepore, F., et al. (2024). The efficacy of cognitive stimulation, cognitive training, and cognitive rehabilitation for people living with dementia: a systematic review and meta-analysis. GeroScience, 10.1007/s11357-024-01400-z. Advance online publication. https://doi.org/10.1007/s11357-024-01400-z

The rising prevalence rates of age-related cognitive impairment are a worldwide public concern, bringing about a surge in the number of "brain training" programs commercially available to the general public. Numerous companies advertise that their products improve memory and protect against cognitive decline, though researchers have voiced concerns regarding the validity of such claims. To address this issue, the current meta-analytic investigation examined evidence from 43 studies (encompassing 2,636 participants) to evaluate the efficacy of commercial training programs within two separate populations: healthy older adults and older adults with mild cognitive-impairment (MCI).
Nguyen, L., Murphy, K., & Andrews, G. (2022). A Game a Day Keeps Cognitive Decline Away? A Systematic Review and Meta-Analysis of Commercially-Available Brain Training Programs in Healthy and Cognitively Impaired Older Adults. Neuropsychology review, 32(3), 601–630. https://doi.org/10.1007/s11065-021-09515-2

Bahar-Fuchs, A., Martyr, A., Goh, A. M., Sabates, J., & Clare, L. (2019). Cognitive training for people with mild to moderate dementia. The Cochrane database of systematic reviews, 3(3), CD013069. https://doi.org/10.1002/14651858.CD013069.pub2

Cognitive training may stimulate neuroplasticity thereby increasing cognitive and brain reserve. Commercial brain training programs are computerized, readily-available, easy-to-administer and adaptive but often lack supportive data and their clinical validation literature has not been previously reviewed. Therefore, in this review, we report the characteristics of commercially available brain training programs, critically assess the number and quality of studies evaluating the empirical evidence of these programs for promoting brain health in healthy older adults, and discuss underlying causal mechanisms.
​Shah, T. M., Weinborn, M., Verdile, G., Sohrabi, H. R., & Martins, R. N. (2017). Enhancing Cognitive Functioning in Healthly Older Adults: a Systematic Review of the Clinical Significance of Commercially Available Computerized Cognitive Training in Preventing Cognitive Decline. Neuropsychology review, 27(1), 62–80. doi.10.1007/s11065-016-9338-9.

CogTale is a comprehensive database of design (methodological) features and summary results from all relevant trials of cognitive interventions in the field of cognitive ageing. The scientists behind CogTale are passionate about research on cognitive interventions in older age, and about assisting consumers in making informed treatment decisions, by providing up-to-date, evidence-based information on cognitive intervention treatments.

CogDrisk uses the latest evidence to help you understand your dementia risk profile. The assessment gives you a personalised report that you can discuss with your doctor and takes approximately 20 minutes to complete.
Information about the validity of the test can be found at: https://link.springer.com/article/10.14283/jpad.2023.38

To raise awareness of what factors can reduce the risk of developing dementia NARI has co-designed with culturally and linguistically diverse communities nine short animations about dementia prevention based on the most current evidence available. The animations are available in Arabic, Cantonese, Mandarin, Hindi, Tamil, Greek, Vietnamese, Spanish, & Italian.