Older Adults in Latin America Gained More on Thinking Tests From a Coached Program Than From Advice

CATEGORY: HEALTHY AGING & LONGEVITY

In twelve clinics spread across eleven countries, from Mexico to Uruguay, 1,065 adults ages 60 to 77 spent two years working on the same four things: exercise, brain-healthy eating, computer memory training, and keeping watch on blood pressure. The half who got a coached, scheduled version of that program gained about 55% more on tests of memory and thinking than the half who pursued the same goals with occasional guidance, in a two-year randomized trial in The Lancet.¹ Both groups improved. The coached group simply improved more.

Thirty-Eight Meetings Versus Four

Everyone enrolled carried risk factors for cognitive decline, and nobody picked their own program. A computer draw sorted each person into one of two versions of the same plan. The coached version ran on a calendar: supervised exercise sessions, nutrition counseling built around an adapted MIND diet, computer-based brain training, regular checks on blood pressure and other heart numbers, and 38 group meetings over the two years. The MIND diet is an eating pattern built on leafy greens, berries, beans, fish and olive oil, designed with the aging brain in mind. The flexible version set the same four targets but left the pace to each person, with general recommendations and just four meetings. Think of the gap as owning a gym membership versus holding a standing appointment with a trainer. The exercise, the food and the brain games were available to everyone. What differed was the schedule, and the people keeping it. About 82% of participants stayed to the end.

Memory Carried the Result

Scores on the trial’s combined measure of thinking rose in both groups over the two years. That’s expected. Repeat a test often enough and you get better at the test. So the honest comparison is between the groups, not within them. The coached group’s yearly gain was about 55% larger, a real but modest edge.¹ Among the separate skills tested, episodic memory, the ability to recall recent events and new information, moved the most. Planning skills and mental speed improved by smaller margins. The researchers’ own question went beyond the scores. They built the trial to learn whether a model born in Finland and proven in the United States could be rebuilt for Latin America, with its different foods, languages and clinic budgets, and they didn’t simply translate it. Local teams adapted the diet and the delivery. On their feasibility question, the answer was yes: four in five participants finished, and no serious harms were tied to the program.

What a Higher Test Score Can’t Promise

A structured program built on the same four targets outperformed self-guided change in 2,111 older Americans last year, so two large trials on two continents now point the same way.² The caution sits one step further out. Better test scores aren’t fewer dementia diagnoses, and two years can’t tell us whether one leads to the other. When two earlier European lifestyle trials covering 5,205 older adults were pooled and followed for up to 12 years, dementia diagnoses didn’t fall.³ A package of habits also can’t say which ingredient did the work. What this trial does show is narrower and still useful: structure, supervision and company made the same healthy intentions produce measurably more on thinking tests, in settings far from the wealthy research centers where such programs were invented.

Key Takeaways

• A coached, scheduled lifestyle program produced about 55% more improvement on combined thinking scores over two years than flexible advice toward the same goals, with memory for recent events showing the largest gain.¹
• Scores rose in both groups, and some of that rise is practice with the tests. The gap between the groups is the trial’s finding.
• Higher scores aren’t the same as less dementia. Earlier pooled trials of similar programs found no drop in diagnoses over 12 years, and this trial is far too short to answer that question.³

References

1. Crivelli L, Suemoto CK, Sosa AL, et al. Multidomain lifestyle intervention for the prevention of cognitive decline in at-risk older adults in Latin America (LatAm-FINGERS): a single-blind, multicentre, randomised controlled trial. The Lancet. 2026;408(10553):417–429. link
2. Baker LD, Espeland MA, Whitmer RA, et al. Structured vs Self-Guided Multidomain Lifestyle Interventions for Global Cognitive Function: The US POINTER Randomized Clinical Trial. JAMA. 2025;334(8):681–691. link
3. Coley N, Hoevenaar-Blom MP, Shourick J, et al. Searching for responders to multidomain dementia prevention in late life: a pooled analysis of individual participant data from the MAPT and preDIVA trials. Alzheimer’s & Dementia. 2025;21(2):e14472. link