This lifestyle program improved cognition 55% more than basic health advice

The Alzheimer's Association-funded study, known as the Latin American Initiative for Lifestyle Intervention to Prevent Cognitive Decline (LatAm-FINGERS), followed participants for two years.

The findings were presented at the Alzheimer's Association International Conference (AAIC) 2026 in London. They build on results from the U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER), showing that programs combining physical activity, healthy eating, cognitive training and social engagement can be adapted for different cultures, health systems and communities. The study was also published in The Lancet.

Adapting Brain Health Programs to Local Cultures

"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.

"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.

To make the intervention work across many different settings, multinational working groups included representatives from every participating country. They determined which parts of the program needed to stay 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 and tango, along with outdoor group workouts in public parks. Nutrition guidance also modified the MIND diet to better fit regional eating habits and food availability. Foods including avocado, quinoa, açaí, aguaymanto, chia, and pumpkin seeds were incorporated as locally accessible options. Study materials were translated and adjusted for local communities, and extra assistance was provided to people with limited experience using digital technology.

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."

"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," Baker said.

Researchers believe programs that address several risk factors at once may offer greater benefits because Alzheimer's disease and other dementias are affected by multiple aspects of health and lifestyle. With dementia becoming more common around the world, the results point to the potential value of practical, affordable, and adaptable lifestyle programs for reducing risk, including in 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 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 risk."

Comparing Structured Support With General Advice

The analysis included 1,065 people enrolled at 12 study sites in Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Dominican Republic, Ecuador, Mexico, Peru and Uruguay. Participants were randomly placed into one of two groups that differed in how intensive and structured the intervention was and how much ongoing support participants received.

The Systematic Lifestyle Intervention (SLI) group included 539 participants. They received continuous coaching and support through supervised exercise, nutrition counseling based on a modified MIND diet, computerized cognitive training, cardiovascular risk monitoring, and 38 group meetings designed to encourage social connection and accountability.

The Flexible Lifestyle Intervention (FLI) group included 526 participants. They received periodic health education along with broad lifestyle recommendations. During the two-year study, these participants attended four group meetings covering diet, physical activity, cognitive and social engagement, and vascular risk management. Unlike the SLI group, they did not receive continuing coaching or supervision.

55% Greater Improvement in Overall Cognition

After two years, the more structured SLI program produced significantly stronger cognitive gains than the FLI approach.

Participants in the SLI group had a 55% greater improvement on a composite measure of global cognition compared with participants in the FLI group. They also experienced significantly larger improvements in memory, executive function, and processing speed.

LatAm-FINGERS and U.S. POINTER are part of the World-Wide FINGERS network. The international effort grew out of the original Finnish FINGER trial, which found that interventions targeting several lifestyle factors at the same time may help preserve cognitive function in older adults at risk of decline.