— July 13, 2026 · Lifestyle Program Slows Cognitive Decline in Latin America

Table of Contents

1. At a Glance
2. What Was Done
3. What Was Found, Number by Number
4. Feasibility and Safety
5. How a Lifestyle Programme Could Work
6. How It Fits With Earlier Research
7. What It Cannot Show
8. What the Researchers and Funder Said
9. What Remains Unknown
10. Sources and Primary Documents
11. Key Research Papers
12. Connections
13. Featured Videos

At a Glance

• Paper: Crivelli L, Suemoto CK, Sosa AL, et al., for the LatAm-FINGERS Study Group. “Multidomain lifestyle intervention for the prevention of cognitive decline in at-risk older adults in Latin America (LatAm-FINGERS): a single-blind, multicentre, randomised controlled trial.” The Lancet 2026;408(10553):417–429. Online July 13, 2026.
• Who: researchers at university hospitals, neurology institutes and research centres in Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, the Dominican Republic, Ecuador, Mexico, Peru and Uruguay, with collaborators in Sweden and the United States. Lead author: Lucia Crivelli, Department of Cognitive Neurology, Fleni, Buenos Aires.
• Design: single-blind (outcome assessors masked), multicentre, randomised controlled trial; 1:1 allocation; two years. Registered as NCT06492967.
• Size: 1,719 people assessed; 1,065 randomised and analysed (539 structured, 526 flexible); mean age 67.5; 75% women.
• Main result: global cognitive composite score rose 0.31 SD per year with the structured programme and 0.20 SD per year with flexible advice; difference 0.11 SD per year (95% CI 0.06–0.15; p<0.0001).
• Feasibility: 82.3% completed the two-year follow-up; average adherence to the structured programme was 71.6%.
• Safety: serious adverse events in 9% (structured) and 5% (flexible) of participants, none judged related to the programme; eight deaths, none related.
• Funding: the Alzheimer’s Association, a non-profit organisation.
• Not measured as an outcome: new diagnoses of dementia.

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What Was Done

Who could join. The trial enrolled adults aged 60 to 77 who carried a raised risk of dementia, defined by cardiovascular risk factors, age and a dementia risk score of 6 or more, and whose thinking-test results were somewhat below what is expected for their age. The 2023 design paper names the risk score as CAIDE (Cardiovascular Risk Factors, Aging and Dementia), the same score used in the original Finnish FINGER trial, and sets the cognitive threshold as a modestly low result on a screening test or on a word-list learning or recall task. People with dementia were not the target group; these were people at risk.

Who took part. Enrolment ran from October 27, 2021, to July 7, 2023, and the last participant finished follow-up on November 7, 2025. Of the 1,065 participants, 795 (75%) were women. By self-report, 59% were Mestizo, 27% White, 7% Mulatto, 2% mixed or other, 2% Black and 1% Indigenous; 2% did not report. The paper notes that populations from Latin America “remain under-represented in dementia prevention trials.”

How groups were formed. Participants were assigned at random, in equal numbers, within each study centre (permuted blocks of eight). Participants and the staff delivering the programmes knew which group a person was in, which is unavoidable in a lifestyle trial. The people who gave the thinking and memory tests did not know, throughout the trial.

The structured programme (SLI, systematic lifestyle intervention). The abstract describes it as “structured multidomain lifestyle interventions with supervised support and monitoring.” The Alzheimer’s Association’s release lists its parts as supervised exercise, nutrition counselling based on an adapted MIND diet, computerised cognitive training, cardiovascular risk monitoring and 38 group meetings over the two years. The 2023 design paper set out the planned detail:

• Exercise: supervised group sessions in five phases — warm-up; coordination, stretching and balance; resistance and muscle-strength training; aerobic exercise; and relaxation. According to the release, sites used locally familiar activities such as salsa and tango and outdoor group exercise in public parks.
• Diet: a “LatAm-MIND” version of the MIND diet (a blend of the Mediterranean and DASH patterns), with 16 meal alternatives built from regional foods. The release names avocado, quinoa, açaí, aguaymanto (the Andean golden berry), chia and pumpkin seeds as locally available choices.
• Brain training: a computerised training program of 13 exercises across attention, processing speed, memory, social skills, “intelligence” and visuospatial abilities, with at least four sessions of 25 minutes or more a week encouraged.
• Heart and blood-vessel risk: clinician-led monitoring of risk factors such as blood pressure.
• Social contact: regular group meetings for connection and accountability.

The flexible programme (FLI, flexible lifestyle intervention). In the abstract’s words, the flexible programme “offered health advice.” The release describes four group meetings over two years with recommendations on diet, physical activity, mental and social engagement and vascular risk, without ongoing coaching or supervision. It was an active comparison, not a no-treatment group.

What was measured. The trial had two primary outcomes: feasibility, judged with parts of a public-health framework called RE-AIM (Reach, Implementation and Maintenance), and the change over two years in a global cognitive composite, a single score built from a battery of thinking and memory tests adapted for the region. Composite scores are expressed in standard-deviation (SD) units, a statistical yardstick that lets results from different tests be added together; such scores are mainly used to compare groups rather than to describe one person.

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What Was Found, Number by Number

Global cognition, the primary result. Scores rose over time in both groups. The mean annual change was:

• Structured programme: +0.31 SD per year (95% CI 0.28 to 0.34).
• Flexible advice: +0.20 SD per year (95% CI 0.17 to 0.23).
• Difference between groups: 0.11 SD per year (95% CI 0.06 to 0.15; p<0.0001).

The confidence interval for the difference stays well above zero, so chance alone is an unlikely explanation for the gap between the groups.

The “55%” figure. The Alzheimer’s Association’s release and most news coverage reported that the structured group showed “a 55% greater improvement on a composite measure of global cognition.” That is the ratio of the two yearly rates (0.31 divided by 0.20 is about 1.55). It is a relative comparison of test-score gains. It is not a 55% reduction in dementia risk; dementia diagnoses were not an outcome of the trial. The effect the paper states is the 0.11 SD per year difference.

Memory, executive function and processing speed. The release states that the structured group also showed “significantly greater improvements in memory, executive function and processing speed.” Healio’s report from the conference gives the yearly differences as 0.14 SD for episodic memory (95% CI 0.07 to 0.21), 0.04 SD for executive function (0.01 to 0.07) and 0.04 SD for processing speed (0.01 to 0.08). These domain results are secondary outcomes; they do not appear in the PubMed abstract, and the full paper is behind a paywall, so these figures are reported here as coverage of the paper rather than read in it directly. On those figures, memory carried the largest share of the difference.

Why both groups improved. A rise in both arms is common in prevention trials of this kind. In US POINTER and in the original FINGER trial, the comparison groups’ scores also rose. People become more familiar with tests they take repeatedly, and even light-touch health advice may change habits. Because LatAm-FINGERS had no group that received nothing, the rise within either group cannot be credited to either programme. Only the gap between the groups is a randomised result.

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Feasibility and Safety

Feasibility was a primary question because a programme that works in one country may fail when moved to places with different health systems, climates, foods and access to technology. The paper reports:

• Reach: 62.0% recruitment effectiveness.
• Implementation: mean adherence to the structured programme of 71.6% over the whole trial.
• Maintenance (complete thinking-test data): structured group 87.9% at 6 months, 85.3% at 12, 81.4% at 18 and 84.8% at 24 months; flexible group 86.3%, 78.9%, 73.4% and 79.8%.
• Completion: 877 of 1,065 participants (82.3%) completed the two-year follow-up.
• Dropouts: higher with flexible advice than with the structured programme (20.2% vs 15.2%; p=0.042).

Adverse events. 478 adverse events were reported: 412 in the structured group and 66 in the flexible group. The two most common were musculoskeletal symptoms (113 participants, 21%, in the structured group vs 13, 2%, in the flexible group) and upper respiratory infections (50, 9%, vs one, under 1%). Serious adverse events occurred in 50 participants (9%) in the structured group and 24 (5%) in the flexible group; the investigators judged none of them related to the programme. There were eight deaths, three in the structured group and five in the flexible group, none related to the programme.

The excess of muscle and joint complaints in the structured group matches the original FINGER trial, where musculoskeletal pain was also the most common adverse event (5% with the programme vs none in the control group). The abstract does not say how much of the overall gap in reported events reflects the exercise itself and how much reflects the structured group’s far more frequent contact with staff, which gives more occasions for events to be recorded.

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How a Lifestyle Programme Could Work

The idea behind the FINGER family of trials is that late-life dementia, including Alzheimer’s disease, usually has many contributing causes rather than one. The 2024 report of the Lancet standing Commission on dementia counts 14 risk factors that can in principle be changed across a lifetime: low education, hearing loss, high blood pressure, smoking, obesity, depression, physical inactivity, diabetes, excessive alcohol, traumatic brain injury, air pollution, social isolation, high LDL cholesterol in midlife and untreated vision loss. The Commission estimates that about 45% of dementia could in theory be prevented or delayed if all 14 were removed. If several causes add together, tackling several at once may do more than tackling any single one.

Each part of the LatAm-FINGERS programme lines up with one or more of those factors:

• Exercise addresses physical inactivity, one of the Commission’s 14 factors. See Exercise.
• Diet counselling used the MIND pattern, which the 2023 MIND diet trial describes as a hybrid of the Mediterranean and DASH diets “with modifications to include foods that have been putatively associated with a decreased risk of dementia.” That paper notes that observational studies suggest dietary patterns “may offer protective benefits against cognitive decline” (see also Walnuts and Cognitive Aging).
• Vascular risk monitoring targets high blood pressure, diabetes and cholesterol. Damage to blood vessels in the brain underlies vascular dementia.
• Cognitive training gives regular, graded mental challenge.
• Group meetings address social isolation (see Loneliness) and provide the accountability that, on the investigators’ account, separates a structured programme from advice alone.

The trial was not designed to show which part did the work, and the abstract reports no brain scans or blood biomarkers that would show a biological mechanism. What it tests is the package as a whole against advice. Heather Snyder of the Alzheimer’s Association, the trial’s funder, summarised the result as showing that “structure and social support matter.”

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How It Fits With Earlier Research

FINGER, Finland (2015). The model for LatAm-FINGERS was the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability, published in The Lancet in 2015. It randomised 1,260 adults aged 60 to 77 with a CAIDE score of 6 or more to a two-year programme of diet, exercise, cognitive training and vascular risk monitoring, or to general health advice. The difference in yearly change on its test battery was 0.022 (95% CI 0.002 to 0.042; p=0.030). Both groups improved (0.20 vs 0.16 over two years). Its authors concluded that a multidomain intervention “could improve or maintain cognitive functioning in at-risk elderly people from the general population.”

World-Wide FINGERS (2020 onward). FINGER led to the World-Wide FINGERS network, described in a 2020 paper in Alzheimer’s & Dementia, which aims to “adapt, test, and optimize the FINGER model” in different geographical, cultural and economic settings and to harmonise methods so results can be pooled. LatAm-FINGERS is one of these trials; its 2023 design paper describes how 12 sites in 11 countries kept the core FINGER design while adapting foods, exercise and materials.

US POINTER (2025). The closest comparison is US POINTER, published in JAMA in 2025. It randomised 2,111 adults aged 60 to 79 at five US sites to a structured or a self-guided programme. Scores rose in both groups: 0.243 SD per year structured vs 0.213 self-guided, a difference of 0.029 SD per year (95% CI 0.008 to 0.050; P=.008). The benefit was similar in carriers and non-carriers of the APOE ε4 gene variant and appeared larger in people who started with lower scores. LatAm-FINGERS used the same structured-versus-flexible comparison. Its difference (0.11 SD per year) is several times larger, but the trials used different test batteries and entry criteria (LatAm-FINGERS required below-expected test scores at entry; the US POINTER criteria listed in its abstract do not include one) and ran in different settings, so the two numbers are not directly comparable.

Single-factor trials. Trials that change one factor alone have given mixed results. In SPRINT MIND (2019, JAMA; 9,361 adults with high blood pressure), aiming for a systolic pressure under 120 mm Hg instead of 140 did not significantly reduce probable dementia (hazard ratio 0.83, 95% CI 0.67 to 1.04) but did reduce mild cognitive impairment (0.81, 0.69 to 0.95); the authors note the trial stopped early and may have been underpowered for dementia. In the 2023 MIND diet trial (New England Journal of Medicine; 604 adults, three years), the MIND diet and a control diet, both with mild calorie restriction, produced similar gains in cognition (difference 0.035, 95% CI −0.022 to 0.092; P=0.23). Seen alongside FINGER, US POINTER and now LatAm-FINGERS, these results fit the view that combined programmes may show effects that single changes do not, though no trial has yet tested that comparison head to head.

Risk-factor estimates. The 2024 Lancet Commission’s 45% estimate comes from population studies of risk factors, not from trials. Trials such as LatAm-FINGERS are part of how that estimate is being tested in practice.

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What It Cannot Show

• Dementia itself. The outcome was a change in test scores over two years. The trial does not show that the programme prevents or delays dementia, and the abstract reports no dementia diagnoses.
• Which part worked. All parts were delivered together, so the trial cannot separate the effect of exercise, diet, brain training, risk-factor care or the extra social contact.
• Unmasked participants. Participants knew which programme they were in. Assessors were masked, but people who know they are in the more intensive arm may try harder on tests.
• An active comparison. The flexible group also received advice and meetings, so the result is the added value of structure and support over advice, not of lifestyle change over nothing.
• Uneven dropout. More people left the flexible group (20.2% vs 15.2%), and completeness of thinking-test data was lower in the flexible group at 12, 18 and 24 months. If those who left differed in health or ability, this could shift the comparison; the abstract does not report how missing data affected the result.
• Adherence. Average adherence to the structured programme was 71.6%, so the average participant received part, not all, of what was offered.
• Who it applies to. Three quarters of participants were women, and recruitment effectiveness (Reach) was 62.0%. Volunteers for a two-year programme may be more motivated than the general population. The trial included only people aged 60 to 77 with specific risk criteria.
• Size of the effect for one person. A difference of 0.11 SD a year is clearly detectable across hundreds of people. The abstract does not translate it into effects on everyday function such as managing money, medicines or household tasks.

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What the Researchers and Funder Said

The statements below come from the Alzheimer’s Association’s AAIC 2026 release of July 13, 2026. The Association funded the trial, and two of the people quoted, Laura Baker and Heather Snyder, are co-authors of the Lancet paper, so these are statements from the study team and its funder rather than independent assessments.

• Lucia Crivelli, lead author, Fleni, Buenos Aires: “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.”
• Lucia 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 program practical, affordable and feasible as a public health strategy.”
• Laura D. Baker, Wake Forest University School of Medicine, principal investigator of US POINTER: “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.”
• Heather M. Snyder, senior vice president of medical and scientific relations, Alzheimer’s Association: “A key message from this study is that structure and social support matter. Addressing multiple lifestyle factors can positively impact brain health and may eventually be combined with emerging drug therapies to reduce cognitive decline and dementia risk.”

The paper’s own interpretation is more measured. It concludes that the culturally adapted programme “was feasible across Latin America and resulted in greater cognitive improvements than a flexible health-advice intervention in older adults at risk of cognitive decline,” and that the findings extend the evidence base “to populations historically under-represented in dementia research.”

No accompanying Lancet editorial was found in the search for this report. The declarations section lists industry consulting fees, lecture fees or advisory roles for several individual authors; the trial itself was funded by a non-profit organisation.

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What Remains Unknown

• Long-term effect. Whether the gap between groups widens, holds or closes after the programme ends, and whether it eventually means fewer dementia diagnoses.
• Everyday function. Whether test-score gains translate into keeping independence, a question US POINTER’s authors also list as open (“functional outcomes, biomarkers, and ongoing extended follow-up”).
• Biology. Whether the programme changes blood or imaging markers of Alzheimer’s disease or blood-vessel damage in the brain.
• Active ingredients and dose. Which components, and how much contact, produce the effect, and whether a lighter version would work.
• Cost and scale. The lead author describes the programme as “practical, affordable and feasible as a public health strategy.” The abstract does not report a cost analysis.
• Other factors. The abstract reports no results on hearing, vision or sleep, so the trial says nothing about whether addressing them adds to the effect. Hearing loss and untreated vision loss are two of the Commission’s 14 factors.
• Pooled evidence. As more World-Wide FINGERS trials report, pooled analyses may show how consistent the effect is across countries and which groups gain most.

Since then. The paper appeared in the August 1, 2026 print issue of The Lancet (volume 408, issue 10553, pages 417–429). The trial registration on ClinicalTrials.gov lists the study as completed, with 1,065 participants, a start date of October 27, 2021 and a completion date of November 7, 2025.

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Sources and Primary Documents

Figures attributed to the trial above come from the paper’s abstract as indexed in PubMed, its trial registration and its 2023 design paper. The full text is paywalled; figures that appear only in coverage are labelled as such in the text.

1. Crivelli L, Suemoto CK, Sosa AL, Lopera F, Aguillón D, Allegri RF, et al.; LatAm-FINGERS Study Group (2026). Multidomain lifestyle intervention for the prevention of cognitive decline in at-risk older adults in Latin America (LatAm-FINGERS): a single-blind, multicentre, randomised controlled trial. The Lancet 408(10553):417-429. Epub July 13, 2026. — doi:10.1016/S0140-6736(26)01278-X · PubMed PMID: 42442374
2. ClinicalTrials.gov record NCT06492967, “LatAm-FINGERS Initiative for Cognitive Change” (status: completed; enrolment 1,065). — ClinicalTrials.gov NCT06492967
3. Crivelli L, Calandri IL, Suemoto CK, Salinas RM, Velilla LM, Yassuda MS, et al. (2023). Latin American Initiative for Lifestyle Intervention to Prevent Cognitive Decline (LatAm-FINGERS): Study design and harmonization. Alzheimer’s & Dementia 19(9):4046-4060. — PubMed PMID: 37204054
4. Alzheimer’s Association, AAIC 2026 press release, July 13, 2026: “Lifestyle Program Improves Brain Health Among Older Adults at Risk for Dementia Across Latin America.” — aaic.alz.org release

Coverage read for this report: Healio, July 13, 2026 (secondary-outcome figures); Alzheimer Europe (trial summary); Alzheimer Europe on the 2024 Lancet Commission (14 risk factors and the 45% estimate).

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Key Research Papers

Background papers for this story. Each entry was checked against PubMed before it was written down.

1. Ngandu T, Lehtisalo J, Solomon A, Levälahti E, Ahtiluoto S, Antikainen R, et al. (2015). A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. The Lancet 385(9984):2255-2263. — PubMed PMID: 25771249
2. Baker LD, Espeland MA, Whitmer RA, Snyder HM, Leng X, Lovato L, et al. (2025). Structured vs Self-Guided Multidomain Lifestyle Interventions for Global Cognitive Function: The US POINTER Randomized Clinical Trial. JAMA 334(8):681-691. — PubMed PMID: 40720610
3. Kivipelto M, Mangialasche F, Snyder HM, Allegri R, Andrieu S, Arai H, et al. (2020). World-Wide FINGERS Network: A global approach to risk reduction and prevention of dementia. Alzheimer’s & Dementia 16(7):1078-1094. — PubMed PMID: 32627328
4. Livingston G, Huntley J, Liu KY, Costafreda SG, Selbæk G, Alladi S, et al. (2024). Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet 404(10452):572-628. — PubMed PMID: 39096926
5. Williamson JD, Pajewski NM, Auchus AP, Bryan RN, Chelune G, Cheung AK, et al. (2019). Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia: A Randomized Clinical Trial. JAMA 321(6):553-561. — PubMed PMID: 30688979
6. Barnes LL, Dhana K, Liu X, Carey VJ, Ventrelle J, Johnson K, et al. (2023). Trial of the MIND Diet for Prevention of Cognitive Decline in Older Persons. New England Journal of Medicine 389(7):602-611. — PubMed PMID: 37466280
7. Crivelli L, Calandri IL, Suemoto CK, Salinas RM, Velilla LM, Yassuda MS, et al. (2023). Latin American Initiative for Lifestyle Intervention to Prevent Cognitive Decline (LatAm-FINGERS): Study design and harmonization. Alzheimer’s & Dementia 19(9):4046-4060. — PubMed PMID: 37204054

PubMed Topic Searches

1. PubMed: Multidomain lifestyle interventions and cognitive decline
2. PubMed: The FINGER model and dementia prevention
3. PubMed: The MIND diet and cognition
4. PubMed: Blood pressure control and dementia
5. PubMed: Exercise trials and cognition in older adults

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Connections

• News Archive
• Dementia — types, risk factors and research
• Alzheimer’s Disease — the most common cause of dementia
• Vascular Dementia — dementia from blood-vessel damage in the brain
• Brain Aging — mechanisms, biomarkers and the research on slowing it
• Exercise — the research on physical activity and health
• Mediterranean Diet — the eating pattern behind the MIND diet
• Walnuts and Cognitive Aging — the WAHA trial
• Hypertension — high blood pressure, a Lancet Commission risk factor
• Cholesterol Management — LDL cholesterol, added to the Commission’s list in 2024
• Loneliness — social isolation and its cognitive consequences
• Hearing Loss — another modifiable dementia risk factor
• Sleep Hygiene — the research on restorative sleep
• Avocado — one of the regional foods in the LatAm-MIND diet
• Quinoa — the Andean grain used in the adapted diet
• Chia Seeds — another locally available food in the adapted diet
• Alzheimer’s Blood Test Reaches the Clinic — earlier news on Alzheimer’s diagnosis
• Longevity & Healthy Aging — the site’s section on ageing research

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