A recent clinical trial conducted by researchers at the University of New South Wales has demonstrated that an internet-delivered lifestyle intervention can significantly enhance cognitive functions in older adults. This groundbreaking study, titled "Maintain Your Brain," is notable for being the largest internet-based trial aimed at preventing cognitive decline and dementia, specifically targeting individuals with identifiable risk factors for these conditions.

Study Overview

The trial recruited over 6,000 participants, aged between 55 and 77 years, through the Sax Institute's 45 and Up Study. Each participant was selected for displaying at least two of the major risk factors associated with dementia. Notably, none of the participants had been formally diagnosed with dementia at the study's inception.

Intervention Techniques

Participants were divided into two groups, with half receiving an active intervention comprising personalized coaching across various lifestyle modules, and the other half forming a control group that accessed publicly available information. The intervention targeted multiple areas:

  • Physical Activity: Guidance included 300 minutes of moderate intensity or 150 minutes of vigorous intensity exercise per week, along with daily balance training.
  • Nutrition: Participants were encouraged to adopt a Mediterranean diet rich in unprocessed plant foods and limited meat and dairy intake.
  • Brain Training: Cognitive training exercises focused on improving key cognitive domains through structured sessions.
  • Mental Health: Participants received tools to help combat anxiety and depression, utilizing a digital mental health program based on cognitive behavioral therapy principles.

Results and Findings

The results, published in Nature Medicine, revealed a marked improvement in cognition scores among the intervention group compared to the control group, underscoring the effectiveness of personalized, broad-spectrum interventions in combating cognitive decline. Below is a summary of key improvements noted by the researchers:

Aspect of Improvement Intervention Group Control Group
Physical Activity Increased aerobic and strength training engagement Minimal change
Dietary Changes Adherence to Mediterranean dietary principles Limited modifications
Cognitive Function Significant improvements in cognitive tests Some improvements
Mental Health Improved depression and anxiety scores Stable mental health metrics

Broader Implications

Professor Henry Brodaty, the lead researcher, indicated that the success of this intervention suggests a scalable model that holds the potential for population-level implementation to mitigate cognitive decline globally. According to Brodaty:

“This intervention is scalable with the potential for population-level roll out that may delay cognitive decline in the general community.”

Future Directions

The trial's findings emphasize the necessity of tailored prevention strategies that address multiple modifiable risk factors rather than a singular approach. The researchers advocate for the establishment of national dementia prevention programs, akin to previous successful public health initiatives in Australia, addressing smoking and skin cancer prevention. According to Ita Buttrose, Chair of CHeBA's Advisory Committee:

“This evidence demonstrates significant benefits to improving cognition and potentially delaying the onset of dementia. It is now time for Australia to think seriously about long term goals.”

Challenges and Considerations

Despite the promising results, the trial's limitations include a participant pool that was largely homogenous in terms of education and socio-economic background, potentially limiting the generalizability of the findings. The researchers suggest further studies focusing on cultural adaptations to reach broader demographics, particularly targeting underrepresented groups in terms of education and socio-economic status.

Conclusion

This trial provides a beacon of hope in the ongoing battle against dementia, highlighting the benefits of proactive engagement in lifestyle changes. The promising results suggest that incorporating varied, tailored lifestyle interventions can yield significant cognitive benefits and potentially delay the onset of dementia in older adults.

References

[1] Brodaty, H. et al. An online multidomain lifestyle intervention to prevent cognitive decline in at-risk older adults: a randomized controlled trial. Nature Medicine (2025).