Journal Article

An online multidomain lifestyle intervention to prevent cognitive decline in at-risk older adults: a randomized controlled trial

Jorm, Louisa, Lautenschlager, Nicola T., Anstey, Kaarin J., Lampit, Amit, McNeil, John J., San Jose, Juan Carlo, Radd-Vagenas, Sue, Almendrales Rangel, Carolina, Kochan, Nicole A., Barr, Polly, Maeder, Anthony, Sachdev, Perminder S., Brodaty, Henry, Heffernan, Megan, Ginige, Jeewani A., Millard, Michael, Briggs, Nancy E., Fiatarone Singh, Maria, Mavros, Yorgi, Noble, Yian, Welberry, Heidi, Walton, Courtney C., Andrews, Gavin, Valenzuela, Michael, Chau, Tiffany, Popovic, Gordana, Flood, Victoria M., O’Leary, Fiona

2025

Overview

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. Eligible participants ( n  = 6,104, 64% female) were randomized 1:1 to a personalized schedule of online coaching in two to four modules (targeting physical activity, nutrition, cognitive activity and depression or anxiety) or a control group that received module-eligible information only. At 3 years, the mean change in a global cognitive composite, the primary outcome, was met. The mean changes in z scores were 0.28 (95% confidence interval (CI): 0.25–0.32) for intervention, 0.10 (95% CI: 0.07–0.13) for control and 0.18 (95% CI: 0.13–0.23, P  < 0.001) for the between-group difference. Trial-related adverse events occurred in 19 (0.60%) intervention and 1 (0.03%) control participant. Randomization of this internet-delivered lifestyle intervention tailored to individual dementia risk factors resulted in significantly better cognition in older adults over 3 years. This intervention is scalable with the potential for population-level rollout that may delay cognitive decline in the general community. Australian New Zealand ClinicalTrials.gov registration: ACTRN12618000851268. An online tailored coaching intervention, delivered over 3 years, improved global cognition, dementia risk, physical activity, nutrition and depression in older dementia-free community-dwelling individuals.

• Publisher: Nature Publishing Group US,Nature Publishing Group
• Subject: 692/308/409 / 692/499 / 692/617/375/132 / 692/700/459/284 / Adults / Aged / Australia / Biomedical and Life Sciences / Biomedicine / Cancer Research / Clinical trials / Cognition / Cognition & reasoning / Cognitive ability / Cognitive Dysfunction - prevention & control / Dementia / Dementia - prevention & control / Dementia disorders / Disease control / Exercise / Female / Humans / Infectious Diseases / Internet / Intervention / Life Style / Lifestyles / Male / Mental depression / Metabolic Diseases / Middle Aged / Modules / Molecular Medicine / Neurosciences / Older people / Physical activity / Randomization / Risk Factors / Single-Blind Method