LatAm-FINGERS: Can lifestyle intervention help prevent dementia?

Dementia is a progressive condition affecting a person’s cognition, behaviour and their ability to carry out their usual daily activities.¹ It affects the lives of one in two people, either directly, as a carer for someone with dementia, or both.²

In 2024, the number of people living with dementia in the UK was close to one million (982,000). By 2040, this is projected to reach around 1.4 million. So it’s clear that we need to act now to reduce this anticipated rise.²

A promising study carried out in South America, published in The Lancet³ and presented at the Alzheimer's Association International Conference in July 2026, has given hope that lifestyle interventions could play an important role in tackling dementia and reducing the projected increase in cases over the coming years.

The LatAm-FINGERS study

The LatAm-FINGERS study was a single-blind, multicentre randomised controlled trial carried out across 11 Latin American countries. The study aimed to investigate how culturally adapted, structured lifestyle intervention across different domains could influence cognitive health in adults at high risk of cognitive decline.

Eligibility

The study included individuals aged 60–77 years who were at high risk of dementia (cardiovascular risk factors, ageing and dementia risk score ≥ 6), and showed suboptimal cognitive performance.

Randomisation and masking

Participants were randomly assigned to one of two groups over a two-year period: a systematic lifestyle intervention (SLI) group or a flexible lifestyle intervention (FLI) group.

The SLI group received a structured, multidomain lifestyle intervention with supervised support and monitoring, whereas the FLI group received health advice only. Participants and intervention staff were aware of which group they had been allocated to; however, the individuals assessing the outcomes remained masked throughout the trial.

Study design

• A total of 1,065 participants were enrolled, with 539 assigned to the SLI group and 526 assigned to the FLI group.

• The lifestyle intervention in the SLI group consisted of several different components:

• Physical activity: Supervised exercise four days a week, incorporating aerobic exercise, resistance training, and coordination and balance training.

• Diet: Dietary counselling based on the MIND (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay) diet, alongside a dietitian review every six months.

• Cognitive training: Weekly, targeted brain exercises focusing on processing speed, attention, memory and executive functioning.

• Cardiovascular risk management: Monitoring of blood pressure, body weight, waist circumference, fasting glucose, glycated haemoglobin and lipid levels at baseline and every six months.

• Social engagement: 38 group meetings over the two years, providing peer support, coaching and accountability.

In comparison, the FLI group attended four one-hour team meetings over the 24-month period, where they received oral and written recommendations and guidance on healthy lifestyle interventions.

Outcomes

Cognition improved in both groups, but over two years participants in the SLI group showed a 55% greater improvement in global cognition than those in the FLI group, with the largest effect seen in episodic memory and significant gains in executive function and processing speed.

Adverse events were relatively uncommon, affecting only 2% of people in the SLI group and less than 1% of those in the FLI group. The most common adverse effects were musculoskeletal symptoms, which is perhaps unsurprising given the regular exercise component in the intervention group.

What does this mean for dementia prevention?

This study has successfully demonstrated how multidomain lifestyle interventions can help improve brain health among adults at high risk of cognitive decline. Importantly, the intervention did not focus on a single lifestyle factor but instead addressed several potentially modifiable risk factors simultaneously – physical activity, diet, cognitive stimulation and cardiovascular health.

The culturally specific element of the study also highlights how important culturally sensitive preventative programmes are when trying to achieve meaningful improvements in health outcomes. Interventions designed around the needs, lifestyles and environments of the populations they serve may be more effective and sustainable than a one-size-fits-all approach.

In line with one of the goals in NHS England’s 10 Year Health Plan: to shift from treating sickness to prevention, it will be interesting to see whether similar programmes could be integrated into the NHS as we move towards a more preventative model of healthcare.

What could primary care start doing now?

LatAm-FINGERS was delivered with resources most UK practices do not have: supervised exercise four days a week, six-monthly dietitian reviews and computerised cognitive training. But the components of the intervention map closely onto things primary care already does, or could do, with modest adjustment.

The first is recognising who the trial was for. Participants were aged 60 to 77 with cardiovascular risk factors and early signs of suboptimal cognition, not people with dementia. In UK terms this is the patient on a hypertension or diabetes register who mentions their memory is “not what it was”, and the NHS Health Check cohort. Framing these consultations around brain health, not just heart health, is a small change in language that costs nothing.

The second is treating vascular risk control as dementia prevention. Blood pressure, HbA1c, lipids, weight and waist circumference were monitored every six months in the trial. These are QOF measures already, and the 2024 Lancet Commission on dementia identifies hypertension, diabetes, obesity, physical inactivity, smoking and alcohol among the modifiable risk factors.⁴ Optimising them is dementia prevention, and working with patients through this lens may improve engagement.

The third is using what social prescribing already offers. The SLI arm included 38 group meetings for peer support and accountability, and the U.S. POINTER trial reached the same conclusion: structure and social contact drive adherence more than the advice itself. Link workers, local exercise referral schemes, walking groups, community cooking sessions and cognitive stimulation groups run by the voluntary sector are the closest existing NHS equivalents. Referral at the point of a “brain health” conversation, rather than waiting for a memory clinic referral, is where primary care can act today.

Finally, the trial reinforces the message that generic advice is not enough. The FLI arm received exactly the kind of “eat better, exercise more” guidance that fills a ten-minute consultation, and it was outperformed. Where structured programmes exist locally, prescribers should be encouraged to refer into them rather than just giving out leaflets.

With dementia cases projected to continue rising, studies such as LatAm-FINGERS provide an encouraging reminder that true prevention can make a significant impact on brain health and risk of dementia.

Citations

1. National Institute for Health and Care Excellence (NICE) (n.d.) Dementia: Background information – Definition. Clinical Knowledge Summaries. Available at: https://cks.nice.org.uk/topics/dementia/background-information/definition/ (Accessed: 13 September 2026).

2. Dementia Statistics (2024) Prevalence and incidence. Available at: Dementia Statistics – Prevalence and incidence (Accessed: 13 September 2026).

3. Crivelli, L., et al. (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), pp. 417–429. Available at: The Lancet – LatAm-FINGERS study (Accessed: 13 September 2026)

4. Livingston, G., et al. (2024) ‘Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission’, The Lancet, 404(10452), pp. 572–628.