Lifestyle interventions to prevent cognitive impairment, dementia and Alzheimer disease
Abstract
Research into dementia prevention is of paramount importance if the dementia epidemic is to be halted. Observational studies have identified several potentially modifiable risk factors for dementia, including hypertension, dyslipidaemia and obesity at midlife, diabetes mellitus, smoking, physical inactivity, depression and low levels of education. Randomized clinical trials are needed that investigate whether interventions targeting these risk factors can reduce the risk of cognitive decline and dementia in elderly adults, but such trials are methodologically challenging. To date, most preventive interventions have been tested in small groups, have focused on a single lifestyle factor and have yielded negative or modest results. Given the multifactorial aetiology of dementia and late-onset Alzheimer disease, multidomain interventions that target several risk factors and mechanisms simultaneously might be necessary for an optimal preventive effect. In the past few years, three large multidomain trials (FINGER, MAPT and PreDIVA) have been completed. The FINGER trial showed that a multidomain lifestyle intervention can benefit cognition in elderly people with an elevated risk of dementia. The primary results from the other trials did not show a statistically significant benefit of preventive interventions, but additional analyses among participants at risk of dementia showed beneficial effects of intervention. Overall, results from these three trials suggest that targeting of preventive interventions to at-risk individuals is an effective strategy. This Review discusses the current knowledge of lifestyle-related risk factors and results from novel trials aiming to prevent cognitive decline and dementia. Global initiatives are presented, including the World Wide FINGERS network, which aims to harmonize studies on dementia prevention, generate high-quality scientific evidence and promote its implementation.
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Research shows a positive correlation between increased physical activity, cognitive training, improved nutrition, and slowing cognitive and functional decline and intensity of BPSD.
“Indeed, research shows a positive correlation between increased physical activity, cognitive training, improved nutrition, and slowing cognitive and functional decline and intensity of BPSD.”
From Alzheimer's Disease: Treatment Strategies and Their Limitations. (2022) · cites this paper as [167]
Cites
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
McKhann, G. M., Knopman, D. S., Chertkow, H., Hyman, B. T., Jack, C. R., Kawas, C. H., Klunk, W. E., Koroshetz, W. J., Manly, J. J., Mayeux, R., et al. (2011) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2011.03.005 · Cited by 18,657 · see citing works
Ngandu, T., Lehtisalo, J., Solomon, A., Levälahti, E., Ahtiluoto, S., Antikainen, R., Bäckman, L., Hänninen, T., Jula, A., Laatikainen, T., et al. (2015) · The Lancet · doi:10.1016/s0140-6736(15)60461-5 · Cited by 3,689 · see citing works
Self-citationLong-term Effects of Cognitive Training on Everyday Functional Outcomes in Older Adults
Willis, S. L., Tennstedt, S. L., Marsiske, M., Ball, K., Elias, J., Koepke, K. M., Morris, J. N., Rebok, G. W., Unverzagt, F. W., Stoddard, A. M., et al. (2006) · JAMA · doi:10.1001/jama.296.23.2805 · Cited by 1,496 · see citing works
Kuiper, J. S., Zuidersma, M., Oude Voshaar, R. C., Zuidema, S. U., van den Heuvel, E. R., Stolk, R. P., & Smidt, N. (2015) · Ageing Research Reviews · doi:10.1016/j.arr.2015.04.006 · Cited by 1,090 · see citing works
Cerebral infarctions and the likelihood of dementia from Alzheimer disease pathology
Schneider, J. A., Wilson, R. S., Bienias, J. L., Evans, D. A., & Bennett, D. A. (2004) · Neurology · doi:10.1212/01.wnl.0000118211.78503.f5 · Cited by 436 · see citing works
Barha, C. K., Davis, J. C., Falck, R. S., Nagamatsu, L. S., & Liu-Ambrose, T. (2017) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2017.04.002 · Cited by 432 · see citing works
Skrobot, O. A., Black, S. E., Chen, C., DeCarli, C., Erkinjuntti, T., Ford, G. A., Kalaria, R. N., O'Brien, J., Pantoni, L., Pasquier, F., et al. (2018) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2017.09.007 · Cited by 431 · see citing works
Sink, K. M., Espeland, M. A., Castro, C. M., Church, T., Cohen, R., Dodson, J. A., Guralnik, J., Hendrie, H. C., Jennings, J., Katula, J., et al. (2015) · JAMA · doi:10.1001/jama.2015.9617 · Cited by 402 · see citing works
Zhong, G., Wang, Y., Zhang, Y., Guo, J. J., & Zhao, Y. (2015) · PLOS ONE · doi:10.1371/journal.pone.0118333 · Cited by 362 · see citing works
Dangour, A. D., Allen, E., Elbourne, D., Fasey, N., Fletcher, A. E., Hardy, P., Holder, G. E., Knight, R., Letley, L., Richards, M., et al. (2010) · The American Journal of Clinical Nutrition · doi:10.3945/ajcn.2009.29121 · Cited by 296 · see citing works
Soininen, H., Solomon, A., Visser, P. J., Hendrix, S. B., Blennow, K., Kivipelto, M., Hartmann, T., Hallikainen, I., Hallikainen, M., Helisalmi, S., et al. (2017) · The Lancet Neurology · doi:10.1016/s1474-4422(17)30332-0 · Cited by 241 · see citing works
Self-citationOverweight in midlife and risk of dementia: a 40-year follow-up study
Hassing, L. B., Dahl, A. K., Thorvaldsson, V, Berg, S., Gatz, M., Pedersen, N. L., & Johansson, B. (2009) · International Journal of Obesity · doi:10.1038/ijo.2009.104 · Cited by 197 · see citing works
Diamond, K., Mowszowski, L., Cockayne, N., Norrie, L., Paradise, M., Hermens, D. F., Lewis, S. J. G., Hickie, I. B., & Naismith, S. L. (2015) · Journal of Alzheimer’s Disease · doi:10.3233/jad-142061 · Cited by 95 · see citing works
Richard, E., Jongstra, S., Soininen, H., Brayne, C., Moll van Charante, E. P., Meiller, Y., van der Groep, B., Beishuizen, C. R. L., Mangialasche, F., Barbera, M., et al. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-010806 · Cited by 92 · see citing works
Self-citationIn-MINDD Team, O’Donnell, C. A., Browne, S., Pierce, M., McConnachie, A., Deckers, K., van Boxtel, M. P. J., Manera, V., Köhler, S., Redmond, M., et al. (2015) · Pilot and Feasibility Studies · doi:10.1186/s40814-015-0035-x · Cited by 31 · see citing works
Prevention Matters: Time for Global Action and Effective Implementation
Kulmala, J., Ngandu, T., & Kivipelto, M. (2018) · Journal of Alzheimer's Disease · doi:10.3233/jad-179919 · Cited by 26 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Scheltens, P., De Strooper, B., Kivipelto, M., Holstege, H., Chételat, G., Teunissen, C. E., Cummings, J., & van der Flier, W. M. (2021) · The Lancet · doi:10.1016/s0140-6736(20)32205-4 · Cited by 5,465 · see citing works
Self-citationBrain energy rescue: an emerging therapeutic concept for neurodegenerative disorders of ageing
Cunnane, S. C., Trushina, E., Morland, C., Prigione, A., Casadesus, G., Andrews, Z. B., Beal, M. F., Bergersen, L. H., Brinton, R. D., de la Monte, S., et al. (2020) · Nature Reviews Drug Discovery · doi:10.1038/s41573-020-0072-x · Cited by 1,003 · see citing works
Alzheimer's Disease: Treatment Strategies and Their Limitations.
Passeri, E., Elkhoury, K., Morsink, M., Broersen, K., Linder, M., Tamayol, A., Malaplate, C., Yen, F. T., & Arab-Tehrany, E. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms232213954 · Cited by 592 · see citing works
World‐Wide FINGERS Network: A global approach to risk reduction and prevention of dementia
Kivipelto, M., Mangialasche, F., Snyder, H. M., Allegri, R., Andrieu, S., Arai, H., Baker, L., Belleville, S., Brodaty, H., Brucki, S. M., et al. (2020) · Alzheimer's & Dementia · doi:10.1002/alz.12123 · Cited by 553 · see citing works
Self-citationReynolds, C. F., Jeste, D. V., Sachdev, P. S., & Blazer, D. G. (2022) · World Psychiatry · doi:10.1002/wps.20996 · Cited by 465 · see citing works
Alzheimer’s Disease and Vascular Aging
Cortes-Canteli, M., & Iadecola, C. (2020) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2019.10.062 · Cited by 400 · see citing works
Więckowska-Gacek, A., Mietelska-Porowska, A., Wydrych, M., & Wojda, U. (2021) · Ageing Research Reviews · doi:10.1016/j.arr.2021.101397 · Cited by 343 · see citing works
Liss, J. L., Seleri Assunção, S., Cummings, J., Atri, A., Geldmacher, D. S., Candela, S. F., Devanand, D. P., Fillit, H. M., Susman, J., Mintzer, J., et al. (2021) · Journal of Internal Medicine · doi:10.1111/joim.13244 · Cited by 312 · see citing works
Lactate and BDNF: Key Mediators of Exercise Induced Neuroplasticity?
Müller, P., Duderstadt, Y., Lessmann, V., & Müller, N. G. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9041136 · Cited by 241 · see citing works
Microbiota from Alzheimer’s patients induce deficits in cognition and hippocampal neurogenesis
Grabrucker, S., Marizzoni, M., Silajdžić, E., Lopizzo, N., Mombelli, E., Nicolas, S., Dohm-Hansen, S., Scassellati, C., Moretti, D. V., Rosa, M., et al. (2023) · Brain · doi:10.1093/brain/awad303 · Cited by 236 · see citing works
Prevention of dementia in an ageing world: Evidence and biological rationale
Grande, G., Qiu, C., & Fratiglioni, L. (2020) · Ageing Research Reviews · doi:10.1016/j.arr.2020.101045 · Cited by 229 · see citing works
Blood–Brain Barrier Breakdown in Alzheimer’s Disease: Mechanisms and Targeted Strategies
Alkhalifa, A. E., Al-Ghraiybah, N. F., Odum, J., Shunnarah, J. G., Austin, N., & Kaddoumi, A. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms242216288 · Cited by 212 · see citing works
Designing the next-generation clinical care pathway for Alzheimer’s disease
Hampel, H., Au, R., Mattke, S., van der Flier, W. M., Aisen, P., Apostolova, L., Chen, C., Cho, M., De Santi, S., Gao, P., et al. (2022) · Nature Aging · doi:10.1038/s43587-022-00269-x · Cited by 191 · see citing works
Sabia, S., Fayosse, A., Dumurgier, J., Schnitzler, A., Empana, J.-P., Ebmeier, K. P., Dugravot, A., Kivimäki, M., & Singh-Manoux, A. (2019) · BMJ · doi:10.1136/bmj.l4414 · Cited by 205 · see citing works
Lee, M., Whitsel, E., Avery, C., Hughes, T. M., Griswold, M. E., Sedaghat, S., Gottesman, R. F., Mosley, T. H., Heiss, G., & Lutsey, P. L. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.19672 · Cited by 179 · see citing works
Da Mesquita, S., Herz, J., Wall, M., Dykstra, T., de Lima, K. A., Norris, G. T., Dabhi, N., Kennedy, T., Baker, W., & Kipnis, J. (2021) · Science Advances · doi:10.1126/sciadv.abe4601 · Cited by 172 · see citing works
Arnoriaga-Rodríguez, M., Mayneris-Perxachs, J., Burokas, A., Contreras-Rodríguez, O., Blasco, G., Coll, C., Biarnés, C., Miranda-Olivos, R., Latorre, J., Moreno-Navarrete, J.-M., et al. (2020) · Cell Metabolism · doi:10.1016/j.cmet.2020.09.002 · Cited by 157 · see citing works
Investigational BACE inhibitors for the treatment of Alzheimer’s disease
Imbimbo, B. P., & Watling, M. (2019) · Expert Opinion on Investigational Drugs · doi:10.1080/13543784.2019.1683160 · Cited by 132 · see citing works
Protective actions of exercise-related FNDC5/irisin in memory and Alzheimer's disease
de Freitas, G. B., Lourenco, M. V., & De Felice, F. G. (2020) · Journal of Neurochemistry · doi:10.1111/jnc.15039 · Cited by 120 · see citing works
A Primary Care Agenda for Brain Health: A Scientific Statement From the American Heart Association
Lazar, R. M., Howard, V. J., Kernan, W. N., Aparicio, H. J., Levine, D. A., Viera, A. J., Jordan, L. C., Nyenhuis, D. L., Possin, K. L., Sorond, F. A., et al. (2021) · Stroke · doi:10.1161/str.0000000000000367 · Cited by 109 · see citing works
The effect of adherence on cognition in a multidomain lifestyle intervention (FINGER)
Ngandu, T., Lehtisalo, J., Korkki, S., Solomon, A., Coley, N., Antikainen, R., Bäckman, L., Hänninen, T., Lindström, J., Laatikainen, T., et al. (2022) · Alzheimer's & Dementia · doi:10.1002/alz.12492 · Cited by 101 · see citing works
Self-citationZhu, G., Zhao, J., Wang, G., & Chen, W. (2023) · Journal of Agricultural and Food Chemistry · doi:10.1021/acs.jafc.3c00652 · Cited by 84 · see citing works
Frisoni, G. B., Molinuevo, J. L., Altomare, D., Carrera, E., Barkhof, F., Berkhof, J., Delrieu, J., Dubois, B., Kivipelto, M., Nordberg, A., et al. (2020) · Alzheimer's & Dementia · doi:10.1002/alz.12132 · Cited by 78 · see citing works
Self-citationLi, Q., Jia, M., Yan, Z., Li, Q., Sun, F., He, C., Li, Y., Zhou, X., Zhang, H., Liu, X., et al. (2021) · Journal of the American Heart Association · doi:10.1161/jaha.120.020734 · Cited by 77 · see citing works
Raising awareness for dementia risk reduction through a public health campaign: a pre-post study
Heger, I., Köhler, S., van Boxtel, M., de Vugt, M., Hajema, K., Verhey, F., & Deckers, K. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-041211 · Cited by 68 · see citing works
Udeh-Momoh, C., & Watermeyer, T. (2021) · Ageing Research Reviews · doi:10.1016/j.arr.2021.101459 · Cited by 67 · see citing works
Fuller, O. K., Whitham, M., Mathivanan, S., & Febbraio, M. A. (2020) · Cells · doi:10.3390/cells9102182 · Cited by 60 · see citing works
Coley, N., Giulioli, C., Aisen, P. S., Vellas, B., & Andrieu, S. (2022) · Ageing Research Reviews · doi:10.1016/j.arr.2022.101777 · Cited by 62 · see citing works
Guo, J., Brickman, A. M., Manly, J. J., Reitz, C., Schupf, N., Mayeux, R. P., & Gu, Y. (2021) · Alzheimer's & Dementia · doi:10.1002/alz.12359 · Cited by 56 · see citing works
Leveraging technology to personalize cognitive enhancement methods in aging
Ziegler, D. A., Anguera, J. A., Gallen, C. L., Hsu, W.-Y., Wais, P. E., & Gazzaley, A. (2022) · Nature Aging · doi:10.1038/s43587-022-00237-5 · Cited by 50 · see citing works
Eggink, E., Hafdi, M., Hoevenaar-Blom, M. P., Song, M., Andrieu, S., Barnes, L. E., Birck, C., Brooks, R. L., Coley, N., Ford, E., et al. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-049762 · Cited by 37 · see citing works
Chen, Y., Sun, Y., Luo, Z., Chen, X., Wang, Y., Qi, B., Lin, J., Lin, W.-W., Sun, C., Zhou, Y., et al. (2022) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2022.881488 · Cited by 40 · see citing works
Li, W., Yue, L., & Xiao, S. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.886974 · Cited by 30 · see citing works
Gul, R., Jan, H., Lalay, G., Andleeb, A., Usman, H., Zainab, R., Qamar, Z., Hano, C., & Abbasi, B. H. (2021) · Coatings · doi:10.3390/coatings11060717 · Cited by 33 · see citing works
Revisiting atherosclerosis and dementia
Iadecola, C. (2020) · Nature Neuroscience · doi:10.1038/s41593-020-0626-6 · Cited by 32 · see citing works
Bridging neurotrophic factors and bioactive peptides to Alzheimer’s disease
Wei, M., Wu, T., & Chen, N. (2024) · Ageing Research Reviews · doi:10.1016/j.arr.2023.102177 · Cited by 31 · see citing works
Cortical excitability and the aging brain: toward a biomarker of cognitive resilience
Palermo, S., Di Fazio, C., Scaliti, E., Stanziano, M., Nigri, A., & Tamietto, M. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1542880 · Cited by 24 · see citing works
Young adult brain capital: a new opportunity for dementia prevention
Farina, F. R., Booi, L., Occhipinti, J.-A., Quoidbach, V., Destrebecq, F., Muniz-Terrera, G., & Eyre, H. A. (2023) · Journal of Alzheimer's Disease · doi:10.3233/jad-230260 · Cited by 17 · see citing works
Heneghan, A., Deng, F., Wells, K., Ritchie, K., Muniz-Terrera, G., Ritchie, C. W., Lawlor, B., & Naci, L. (2023) · Journal of Alzheimer s Disease · doi:10.3233/jad-220267 · Cited by 18 · see citing works
Gray, M., Madero, E. N., Gills, J. L., Paulson, S., Jones, M. D., Campitelli, A., Myers, J., Bott, N. T., & Glenn, J. M. (2022) · JMIR Research Protocols · doi:10.2196/31841 · Cited by 15 · see citing works
How useful are biomarkers for the diagnosis of Alzheimer’s disease and especially for its therapy?
Valenza, M., & Scuderi, C. (2022) · Neural Regeneration Research · doi:10.4103/1673-5374.335791 · Cited by 14 · see citing works
- Authors
- Kivipelto, M., Mangialasche, F., & Ngandu, T.
- Affiliations
- University of Eastern Finland (FI)
- Stockholm University (SE)
- Karolinska Institutet (SE)
- Corresponding author
- Kivipelto, Miia
- Venue
- Nature Reviews Neurology
- Published
- 2018-10-05
- Volume
- 14
- Issue
- 11
- Pages
- 653-666
- ISSN
- 1759-4758 (ISSN-L)
- 1759-4766
- OpenAlex
- W2895292592
- Cited by
- 1,173
- References
- 17
- Citations by year
- 2026: 116 · 2025: 155 · 2024: 199 · 2023: 190 · 2022: 168 · 2021: 143 · 2020: 121 · 2019: 74 · 2018: 6
- FWCI
- 13.02
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Reviews Neurology (publishedVersion)
- PubMed (publishedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- WOS
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- dementia prevention, Alzheimer's disease, lifestyle intervention, cognitive decline, dementia risk factors, multidomain intervention, FINGER trial, hypertension, diabetes mellitus, physical inactivity, depression
- MeSH terms
- Alzheimer Disease, Animals, Dementia, Humans, Life Style, Risk Factors, Cognitive Dysfunction
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