What works
Evidence from trials and natural experiments
Randomized trials of lifestyle and medical approaches, and the strongest natural experiments, on preventing cognitive decline and dementia.
| Study | Intervention | Who | Result |
|---|---|---|---|
| FINGER (Finland) | Two-year multidomain lifestyle program: diet, exercise, cognitive training, vascular risk management | 1,260 at-risk adults aged 60–77 | Benefit Better overall cognition than general health advice over two years; a small but significant effect. |
| U.S. POINTER | Two-year structured versus self-guided lifestyle program | 2,111 sedentary adults aged 60–79 at risk | Benefit Both groups improved; the structured program improved global cognition more. ↗ |
| SPRINT MIND | Intensive blood pressure control (systolic under 120) versus standard (under 140) | Adults with high blood pressure | Partial benefit Fewer cases of mild cognitive impairment (14.6 vs 18.3 per 1,000 person-years); the drop in dementia was not statistically significant. The trial stopped early. |
| ACHIEVE | Hearing aids and counselling versus health education | 977 older adults with hearing loss | No overall benefit No slowing of cognitive decline over three years overall; in a higher-risk subgroup from the ARIC study, decline was about 48% slower. ↗ |
| Shingles vaccine, Wales | Natural experiment: vaccine eligibility set by date of birth | Older adults born either side of 2 September 1933 | Signal Vaccination reduced new dementia diagnoses by about 3.5 percentage points over seven years (about 20% relative). Older live vaccine; not a randomized trial. ↗ |
Benefits so far are on cognitive test scores or milder outcomes; no lifestyle trial has yet shown fewer dementia diagnoses as its main result.
This site is for education and is not medical advice. Talk with your doctor about your own risk and what is right for you.