By Marie
A major new clinical trial has replicated the finding that multidomain lifestyle interventions can protect against cognitive decline in older adults at risk for dementia, this time in a culturally and genetically distinct population across 11 Latin American countries.
The LatAm-FINGERS (Latin American Initiative for Lifestyle Intervention to Prevent Cognitive Decline) study, presented July 13 at the Alzheimer’s Association International Conference (AAIC) in London and published simultaneously in The Lancet, provides the strongest evidence yet that the approach works across diverse populations.
The replication chain
The original FINGER trial in Finland (2015) showed that a structured program combining dietary counseling, physical exercise, cognitive training, and vascular risk monitoring improved cognitive function in 1,260 at-risk older adults compared to general health advice.
The U.S. POINTER study, published in JAMA in July 2025, replicated and extended this result in 2,111 Americans from diverse backgrounds, finding that a structured lifestyle intervention produced greater cognitive benefit than a self-guided approach.
LatAm-FINGERS now extends the finding to 1,065 older adults across 12 sites in Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, the Dominican Republic, Ecuador, Mexico, Peru, and Uruguay.
The design
The trial was a single-blind, multicenter randomized controlled trial. Participants (mean age 67.5, 74.6% women, 70.7% self-identified as mestizo, indigenous, mulatto, mixed, or Black) were randomized to either a Systematic Lifestyle Intervention (SLI) or a Flexible Lifestyle Intervention (FLI) for two years.
The SLI group received a structured program adapted to local cultures: supervised physical activity 4 times per week incorporating salsa and tango; nutrition counseling based on local foods like avocado, quinoa, acai, and chia seeds rather than U.S. staples; computerized cognitive training; 38 group meetings over two years for accountability; and regular vascular monitoring.
The FLI group received general health education with only 4 group meetings over two years and no supervised exercise, cognitive training, or ongoing coaching.
The results
The SLI group showed a 55% greater improvement in global cognition compared to the FLI group. The between-group difference was 0.11 standard deviations per year (95% CI: 0.06-0.15, P < 0.001) in a global cognitive composite. Benefits were also significant in episodic memory (0.14 SD, P < 0.001), executive function (0.04 SD, P = 0.006), and processing speed (0.04 SD, P = 0.020).
Both groups improved over the two-year period, but the SLI group improved significantly more, effectively protecting cognition from age-related decline. Results were consistent across sensitivity analyses and across diverse education levels and socioeconomic statuses.
Why this matters
The replication is significant because it demonstrates that the intervention model works not only in Finland and the United States but in a region with fundamentally different diets, genetic backgrounds, health systems, and cultural norms.
“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,” said Laura D. Baker of Wake Forest University School of Medicine, the U.S. POINTER principal investigator.
Lucia Crivelli of Fleni in Buenos Aires, the LatAm-FINGERS lead author, emphasized that cultural adaptation was key: “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.”
What comes next
The Alzheimer’s Association, which has invested over $81 million across POINTER and LatAm-FINGERS, announced a new $100 million trial called PROTECT-Cog, which will test whether adding a GLP-1 receptor agonist to the POINTER lifestyle protocol produces even greater cognitive protection. That trial will enroll at-risk older adults and follow them for three years.
Emerging evidence from real-world datasets presented at AAIC suggests GLP-1 drugs may reduce dementia risk by 40-70% compared with other diabetes medications, raising the possibility that combining lifestyle and pharmacological interventions could produce additive or synergistic benefits.
A separate Lancet Commission update presented at the conference estimates that up to 40% of dementia cases may be preventable through modifiable risk factors, a number that grows with each replication of the FINGERS model.
Sources
Joseph A. “AAIC in 30: Dementia study replicates promising risk-reduction outcomes.” STAT News (July 13, 2026). https://www.statnews.com/2026/07/13/aaic-in-30-alzheimers-treatments-dementia-day-2-conference/
Crivelli L, et al. “LatAm-FINGERS: A randomized controlled trial of a multidomain lifestyle intervention to prevent cognitive decline in Latin America.” The Lancet (2026).
Alzheimer’s Association press release. “LatAm-FINGERS trial results presented at AAIC 2026.” July 13, 2026.