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The Effects of a Multidomain Lifestyle Intervention on Brain Function and Its Relation with Immunometabolic Markers and Intestinal Health in Older Adults at Risk of Cognitive Decline: The HELI Randomised Controlled Trial
van Loenen MR, Zwart NR, Remie LB, van Trijp MP, Jansen MG, Marques JP, Claassen JA, Grootte Bromhaar MM et al.. medRxiv, 2026-07-29
Topic: Gut, metabolism and diet
We investigated brain, inflammation, cardiometabolic, and gut health changes associated with a six-month multidomain lifestyle intervention in Dutch older adults at risk for cognitive decline and dementia. Results A total of 102 participants were randomised into the intervention (n=53) or active control group (n=49), of which 86 participants completed the six-month multidomain lifestyle intervention. The intervention resulted in improved diet and sleep scores in the intervention group compared to the active control group (Beta 1.67, 95% CI 0.61;2.73, PFDR=0.01, and Beta −1.80, 95% CI −2.79;-0.81, PFDR=0.005, respectively). Within the intervention group, favourable reductions in lifestyle-modifiable cardiovascular risk factors, such as BMI and blood pressure, were observed, but these were not significantly different from changes in the active control group. The intervention did not result in significant changes over time between the intervention and control group in other primary and secondary outcomes. Conclusion The HELI multidomain lifestyle was able to reduce lifestyle-modifiable cardiovascular risk factors associated with dementia, although not significant compared to the active control group. We did not observe significant intervention effects on brain, cardiometabolic, inflammatory, and gut health outcomes. These results emphasize the complexity of exploring the role of lifestyle on neurobiological brain mechanisms associated with maintaining optimal cognitive functioning in aging and their underlying peripheral (to central) mechanisms.
Key findings
- We investigated brain, inflammation, cardiometabolic, and gut health changes associated with a six-month multidomain lifestyle intervention in Dutch older adults at risk for cognitive decline and dementia.
- Results A total of 102 participants were randomised into the intervention (n=53) or active control group (n=49), of which 86 participants completed the six-month multidomain lifestyle intervention.
- The intervention resulted in improved diet and sleep scores in the intervention group compared to the active control group (Beta 1.67, 95% CI 0.61;2.73, PFDR=0.01, and Beta −1.80, 95% CI −2.79;-0.81, PFDR=0.005, respectively).
- Within the intervention group, favourable reductions in lifestyle-modifiable cardiovascular risk factors, such as BMI and blood pressure, were observed, but these were not significantly different from changes in the active control group.
- The intervention did not result in significant changes over time between the intervention and control group in other primary and secondary outcomes.
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Study details
- Participants53
- Evidence strengthHigh
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 39 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for study design and effect reported because the record does not state it. We have no data on 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 and multi-centre collaboration, so those were left out: it earned 24 of the 62 points we could judge it on, which is 39 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (medRxiv) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 1 / 4 | 53 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 1 / 2 | Randomised (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 | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Points | 24 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 24 of the 62 points we could judge it on is 39 out of 100. |
| Total | 39 / 100 | Capped to 16 because this is not a peer-reviewed article. |
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APA 7th
van Loenen, M. R., Zwart, N. R., Remie, L. B., van Trijp, M. P., Jansen, M. G., Marques, J. P., et al. (2026). The Effects of a Multidomain Lifestyle Intervention on Brain Function and Its Relation with Immunometabolic Markers and Intestinal Health in Older Adults at Risk of Cognitive Decline: The HELI Randomised Controlled Trial. medRxiv. https://doi.org/10.64898/2026.07.28.26358647
Vancouver
van Loenen MR, Zwart NR, Remie LB, van Trijp MP, Jansen MG, Marques JP, et al. The Effects of a Multidomain Lifestyle Intervention on Brain Function and Its Relation with Immunometabolic Markers and Intestinal Health in Older Adults at Risk of Cognitive Decline: The HELI Randomised Controlled Trial. medRxiv. 2026. doi:10.64898/2026.07.28.26358647.
BibTeX
@article{vanloenen2026-1fa09c34,
author = {van Loenen, M. R. and Zwart, N. R. and Remie, L. B. and van Trijp, M. P. and Jansen, M. G. and Marques, J. P. and Claassen, J. A. and Grootte Bromhaar, M. M. and others},
title = {{The Effects of a Multidomain Lifestyle Intervention on Brain Function and Its Relation with Immunometabolic Markers and Intestinal Health in Older Adults at Risk of Cognitive Decline: The HELI Randomised Controlled Trial}},
journal = {medRxiv},
year = {2026},
doi = {10.64898/2026.07.28.26358647},
url = {https://doi.org/10.64898/2026.07.28.26358647}
}