Multidomain Lifestyle Intervention Slows Cognitive Decline in Latin American Older Adults
A 2-year RCT across 11 Latin American countries shows structured lifestyle intervention meaningfully improves cognition in at-risk older adults.
Summary
The LatAm-FINGERS trial tested whether a culturally adapted, structured lifestyle intervention could protect cognition in older adults at high dementia risk across Latin America. Over 1,000 participants aged 60–77 were randomized to either a systematic multidomain program — covering exercise, diet, cognitive training, and vascular risk management — or flexible health advice. After two years, the structured group improved cognitive scores significantly faster than the advice group, with a between-group difference of 0.11 SD per year. Recruitment and adherence were strong, and dropout rates were lower in the structured group. The findings confirm that multidomain lifestyle interventions work in diverse, under-represented Latin American populations, offering a scalable, low-cost strategy to combat the region's rapidly rising dementia burden.
Detailed Summary
Dementia rates are rising fastest in low- and middle-income countries, yet most prevention trials have focused on high-income, predominantly white populations. Latin America carries a disproportionate dementia burden, with high rates of cardiovascular risk factors and limited representation in major trials — making this study urgently needed.
LatAm-FINGERS was a single-blind, multicenter randomized controlled trial conducted across 11 Latin American countries. Adults aged 60–77 with elevated dementia risk (CAIDE score ≥6) and suboptimal cognitive performance were enrolled and randomized 1:1 to either a systematic lifestyle intervention (SLI) — a structured, supervised, multidomain program addressing exercise, nutrition, cognitive engagement, and vascular risk monitoring — or a flexible lifestyle intervention (FLI) offering general health advice. The primary outcomes were feasibility metrics and change in a global cognitive composite score over 24 months.
Of 1,065 participants included in the analytic sample (75% women, mean age 67.5), 82.3% completed two years of follow-up. The SLI group showed cognitive composite score gains of 0.31 SD per year versus 0.20 SD per year in the FLI group — a statistically significant difference of 0.11 SD per year (p<0.0001). Recruitment effectiveness was 62%, adherence to the SLI was 71.6%, and dropout was lower in the SLI group (15.2% vs. 20.2%). Adverse events were mostly musculoskeletal and respiratory, none of which were intervention-related.
These results are clinically meaningful: they demonstrate that structured lifestyle programs can be successfully implemented and are effective in culturally diverse, historically underserved populations. The effect size mirrors findings from the landmark Finnish FINGER trial, extending its generalizability.
Caveats include that this summary is based on the abstract only; full methodology, subgroup analyses, and secondary outcome data are not yet available. Both groups improved, raising questions about active ingredient specificity, and the relatively short 2-year window may not capture long-term dementia incidence.
Key Findings
- Structured multidomain lifestyle intervention improved global cognition 0.11 SD/year faster than health advice alone (p<0.0001).
- 82.3% of participants completed the 2-year trial, with lower dropout in the intervention group (15.2% vs. 20.2%).
- Adherence to the structured intervention was 71.6% over 24 months across 11 diverse Latin American countries.
- 75% of participants were women, providing robust data for a historically under-represented demographic in dementia trials.
- No serious adverse events were related to the intervention; musculoskeletal symptoms were the most common side effect.
Methodology
Single-blind, multicenter RCT across 11 Latin American countries, randomizing 1,065 at-risk adults (aged 60–77) 1:1 to systematic multidomain lifestyle intervention vs. flexible health advice over 24 months. Randomization was stratified by center using permuted blocks of eight. Outcome assessors were masked to group assignment throughout.
Study Limitations
This summary is based on the abstract only, as the full paper is not open access; complete methodology, secondary outcomes, and subgroup data are unavailable. Both groups showed cognitive improvement, which may partially reflect practice effects or regression to the mean. The 2-year follow-up is insufficient to determine whether cognitive gains translate into reduced dementia incidence.
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