Could an online program help protect your brain? New research shows that a personalized digital intervention targeting diet, exercise, and mental well-being can slow cognitive decline and reduce dementia risk in at-risk older adults.

Study: An online multidomain lifestyle intervention to prevent cognitive decline in at-risk older adults: a randomized controlled trial. Image Credit: pathdoc / Shutterstock

With dementia cases projected to triple by 2050, researchers are exploring innovative ways to protect brain health. In a recent study published in the journal Nature Medicine, a research team in Australia investigated whether a personalized web-based lifestyle intervention called Maintain Your Brain (MYB) can help older adults improve cognition by targeting modifiable risk factors for dementia.

Dementia

Dementia is a growing global concern, affecting millions and burdening healthcare systems. While aging is the strongest risk factor, research shows that lifestyle choices, such as diet, physical activity, and mental engagement, play a critical role in cognitive health. Studies have identified twelve modifiable risk factors, including physical inactivity, obesity, poor diet, and depression, which together contribute to about 40% of dementia cases.

Previous studies on lifestyle-based interventions, such as the Finnish Geriatric Intervention Study (FINGER trial), have demonstrated that a structured, multidomain lifestyle program can enhance cognitive function. However, long-term digital solutions remain underexplored. Given the widespread access to the internet, researchers are now testing whether an individualized, online, scalable intervention could impact the trajectory of cognitive decline in older adults with dementia risk factors.

Current Study

This three-year, single-blind, randomized controlled trial, conducted in Australia, assessed whether an online multidomain lifestyle intervention could slow cognitive decline in dementia-free adults aged 55–77 with at least two modifiable dementia risk factors.

Over 6,104 participants with internet and computer access were enrolled and randomly assigned in a 1:1 ratio to either the MYB intervention group or an active control group. Those in the intervention group received personalized online coaching in four key areas: physical activity, nutrition, cognitive training, and mental well-being (targeting depression or anxiety, if applicable). The control group received only general health information related to these areas.

Participants engaged with the online program over one year, with follow-ups continuing for an additional two years. The researchers provided the intervention group with structured, goal-oriented activities, such as exercise programs, diet plans, and brain-training exercises, tailored to their specific dementia risk factors. Not all participants received all four interventions—modules were assigned based on individual risk profiles. The program also provided booster sessions to reinforce healthy behaviors. In contrast, the control group received publicly available health information without interactive engagement.

Cognitive function, measured using a global cognitive composite (GCC) score, was the primary outcome. This score was derived from a validated battery of neuropsychological tests. Secondary outcomes included changes in individual cognitive domains (such as memory and executive function), lifestyle behaviors, and mental health measures.

Key Findings

The results suggested that a structured, personalized online intervention could significantly improve cognitive function in older adults. Over three years, the participants in the intervention group showed a 0.28-point increase in their GCC score, compared to a 0.10-point increase in the control group. The between-group difference of 0.18 points was statistically significant (p

Further analysis revealed that all three measured cognitive domains—complex attention (0.16-point improvement), executive function (0.07-point improvement), and memory (0.19-point improvement)—showed statistically significant improvements favoring the intervention group (p

Beyond cognition, the study also demonstrated significant lifestyle changes in the intervention group. Participants reported increased levels of physical activity (1.29 times more aerobic exercise and 1.17 times more strength training than controls), greater adherence to a Mediterranean-style diet (MediCul score increase of 8.72 points), and reduced psychological distress (K10 score reduction of 0.32 points, all p

Importantly, the MYB program also led to a modest but statistically significant reduction in dementia risk as measured by a validated dementia risk index (ANU-ADRI-SF), with the intervention group showing a −0.53 point reduction compared to controls (p = 0.004).

The study also confirmed a strong dose-response effect: Participants who completed at least 60% of their assigned activities had significantly greater cognitive benefits than those who engaged less (0.81-point GCC improvement vs. non-completers, p

Engagement Challenges and Control Group Improvements

While the intervention was effective, engagement with the program declined over time. About one-third of participants completed most assigned activities, one-third completed some (1–59%), and one-third completed none. This trend is consistent with other digital health interventions.

The study also noted that the control group showed a small but measurable cognitive improvement. Researchers suggest that this could be due to exposure to general health information, which might have encouraged some participants to modify their behavior. Thus, the observed effects of the intervention may be slightly conservative compared to a completely inactive control group.

Limitations and Future Directions

While the study showed cognitive benefits and reduced dementia risk, it did not measure actual dementia incidence over time. Longer follow-up is needed to determine whether these cognitive improvements translate into lower dementia rates.

Additionally, the study sample was predominantly Caucasian and more educated than the general population, which may limit generalizability. Future studies should explore how well digital dementia prevention programs work in diverse populations, including those with lower socioeconomic status and limited internet access.

Conclusions

In summary, the study provided strong evidence that a personalized, web-based lifestyle intervention can improve cognitive function and reduce dementia risk in older adults at risk for cognitive decline. By targeting multiple risk factors through an accessible, scalable digital platform, the MYB program offers a promising tool for population-wide dementia prevention efforts. While long-term effects on dementia incidence remain unknown, these findings highlight the potential of online interventions in promoting brain health at scale.