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An online multidomain lifestyle intervention to prevent cognitive decline in at-risk older adults: a randomized controlled trial
Henry Brodaty, Tiffany Chau, Megan Heffernan, Jeewani A Ginige, Gavin Andrews, Michael Millard, Perminder S Sachdev, Kaarin J Anstey et al.. Nature medicine, 2025-01-28
Topic: Health services, long-term care and technology
Effective, scalable dementia prevention interventions are needed to address modifiable risk factors given global burden of dementia and challenges in developing disease-modifying treatments. A single-blind randomized controlled trial assessed an online multidomain lifestyle intervention to prevent cognitive decline over 3 years. Participants were dementia-free community-dwelling Australians aged 55-77 years with modifiable dementia risk factors. Eligible participants (n = 6,104, 64% female) were randomized 1:1 to a personalized schedule of online coaching in two to four modules (targeting physical activity, nutrition, cognitive activity and depression or anxiety) or a control group that received module-eligible information only. At 3 years, the mean change in a global cognitive composite, the primary outcome, was met. The mean changes in z scores were 0.28 (95% confidence interval (CI): 0.25-0.32) for intervention, 0.10 (95% CI: 0.07-0.13) for control and 0.18 (95% CI: 0.13-0.23, P < 0.001) for the between-group difference. Trial-related adverse events occurred in 19 (0.60%) intervention and 1 (0.03%) control participant. Randomization of this internet-delivered lifestyle intervention tailored to individual dementia risk factors resulted in significantly better cognition in older adults over 3 years. This intervention is scalable with the potential for population-level rollout that may delay cognitive decline in the general community. Australian New Zealand ClinicalTrials.gov registration: ACTRN12618000851268.
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APA 7th
Brodaty, H., Chau, T., Heffernan, M., Ginige, J. A., Andrews, G., Millard, M., et al. (2025). An online multidomain lifestyle intervention to prevent cognitive decline in at-risk older adults: a randomized controlled trial. Nature medicine. https://doi.org/10.1038/s41591-024-03351-6
Vancouver
Brodaty H, Chau T, Heffernan M, Ginige JA, Andrews G, Millard M, et al. An online multidomain lifestyle intervention to prevent cognitive decline in at-risk older adults: a randomized controlled trial. Nature medicine. 2025. doi:10.1038/s41591-024-03351-6. PMID: 39875685.
BibTeX
@article{brodaty2025-39875685,
author = {Brodaty, Henry and Chau, Tiffany and Heffernan, Megan and Ginige, Jeewani A and Andrews, Gavin and Millard, Michael and Sachdev, Perminder S and Anstey, Kaarin J and others},
title = {{An online multidomain lifestyle intervention to prevent cognitive decline in at-risk older adults: a randomized controlled trial}},
journal = {Nature medicine},
year = {2025},
doi = {10.1038/s41591-024-03351-6},
pmid = {39875685},
url = {https://doi.org/10.1038/s41591-024-03351-6}
}
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Key findings
- Randomization of this internet-delivered lifestyle intervention tailored to individual dementia risk factors resulted in significantly better cognition in older adults over 3 years.
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Study details
- Study designrandomized controlled trial
- Participants6,104
- Effect size0.60%; 0.03%
- Evidence strengthHigh
How this study scored 93/100
Published in a top-tier journal, and it is a randomised controlled trial. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record, multi-centre collaboration and free to read, so those were left out: it earned 52 of the 56 points we could judge it on, which is 93 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (Nature medicine) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 11 / 12 | A randomised controlled trial |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 3 / 4 | 6,104 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 2 / 2 | Randomised and blinded or placebo-controlled (as stated in the record) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 39875685) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 52 / 56 | Scored on 10 of 20 parts. We have no data for the rest, so they are left out: 52 of the 56 points we could judge it on is 93 out of 100. |
| Total | 93 / 100 | — |
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