Culturally Adapted Lifestyle Program Boosts Cognition 55% More in Older Adults at Risk of Dementia

A culturally tailored, two-year lifestyle program produced significantly greater cognitive improvement than flexible health guidance alone among older adults at risk of dementia (搜索)搜索该疾病 across 11 Latin American countries. The findings, from the Alzheimer's Association查看公司主页-funded Latin American Initiative for Lifestyle Intervention to Prevent Cognitive Decline (LatAm-FINGERS), were presented at the Alzheimer's Association International Conference (AAIC) 2026 in London and published simultaneously in The Lancet.

The trial tested two programs combining physical activity, healthier eating, cognitive training, and social engagement. Both were associated with better overall cognitive function, but the more intensive intervention produced stronger results. "The results demonstrate for the first time in Latin America that culturally adapted lifestyle interventions can be successfully implemented across diverse countries and communities, and deliver cognitive benefits for populations that are often underrepresented in clinical research," said Lucia Crivelli, Ph.D., lead author of the study and principal investigator at Fleni, a neurological institute in Buenos Aires, Argentina.

Adapting the Program to Local Cultures

Rather than simply translating an existing model, the investigators adapted the intervention to regional cultures and habits while preserving its core elements. "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 program practical, affordable and feasible as a public health strategy," Crivelli added.

Multinational working groups representing every participating country determined which components of the intervention had to remain consistent and which could be adjusted according to local culture, climate, available foods, access to technology, and participant preferences. Exercise options included familiar activities such as salsa, tango, and group workouts in public parks. Nutrition counseling modified the MIND diet to reflect regional eating habits, incorporating accessible foods such as avocado, quinoa, açaí, aguaymanto, chia, and pumpkin seeds. Study materials were translated and culturally adapted, and participants with limited experience using digital technology received additional assistance.

Benefits Across Diverse Communities

"LatAm-FINGERS included significant racial and ethnic diversity, and a wide range in education and socioeconomic status (SES). The results demonstrate that brain health can be improved across diverse communities representing different cultures and with varying access to resources," said Laura D. Baker, Ph.D., professor of gerontology and geriatrics, internal medicine, at Wake Forest University School of Medicine and Advocate Health, and U.S. POINTER principal investigator. "We now have a second strong finding in a completely different part of the world, which suggests that the U.S. POINTER formula can be adapted for anybody."

Baker added, "I am confident that we can successfully use the U.S. POINTER structured intervention to expand our tools and resources to further engage Latino and Hispanic communities in the U.S. — and beyond that to other communities — and the program will be equally effective."

Structure and Social Support Matter

Because Alzheimer's disease (搜索)搜索该疾病 and other dementias are shaped by numerous health and lifestyle factors, researchers believe that addressing several risks simultaneously may provide greater benefits for brain health than focusing on only one. With dementia (搜索)搜索该疾病 becoming more common worldwide, accessible lifestyle-based programs could offer practical ways to reduce risk, particularly in regions that include low- and middle-income countries.

"The LatAm-FINGERS results add to U.S. POINTER findings by extending the evidence to Latin America and strengthening the case that these behavioral and lifestyle interventions can be adapted for diverse populations and communities worldwide," said Heather M. Snyder, Ph.D., Alzheimer's Association查看公司主页 senior vice president of medical and scientific relations.

"A key message from this study is that structure and social support matter," Snyder continued. "Addressing multiple lifestyle factors can positively impact brain health and may eventually be combined with emerging drug therapies to reduce cognitive decline and dementia (搜索)搜索该疾病 risk."

Comparing Structured Support With General Advice

The analysis included 1,065 people enrolled at 12 study sites across Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Peru, and Uruguay. Participants were randomly assigned to one of two groups that differed in intensity, organization, and continuing support.

The Systematic Lifestyle Intervention (SLI) group included 539 participants who received sustained coaching and supervision. The program comprised guided exercise, nutrition counseling based on a locally adapted MIND diet, computerized cognitive training, monitoring of cardiovascular risks, and 38 group meetings designed to provide social connection and accountability.

The Flexible Lifestyle Intervention (FLI) group included 526 participants who received general lifestyle guidance and periodic health education. During the two-year study, these participants attended four group meetings covering diet, physical activity, cognitive and social engagement, and vascular risk management, without ongoing coaching or supervised sessions.

55% Greater Improvement in Overall Cognition

After two years, cognitive improvement was significantly greater in the SLI group. On a combined measure of overall cognition, participants receiving the structured intervention improved 55% more than those in the flexible program. They also showed significantly larger gains in memory, executive function, and processing speed.

LatAm-FINGERS and U.S. POINTER are part of the World-Wide FINGERS network, an international effort that grew out of the original Finnish FINGER trial, which found that multidomain lifestyle interventions may help protect cognitive function in older adults at risk for decline.