DIVERT-AD study

The DIVERT-AD study, supported by the European Union and coordinated by Erasmus MC in the Netherlands, ran for almost four years. It did not focus specifically on Alzheimer’s pathology, but on strategies to keep the brain healthy, such as sufficient sleep, education, and regular physical activity. These factors are likely directly related to brain resilience and vascular health.

The study showed that once dementia is present, lifestyle factors may have limited influence. They are, however, very helpful in preventing cognitive decline associated with aging. Regular high-quality sleep was positively correlated with certain biological markers of Alzheimer’s, especially in participants with a genetically increased risk.

FINGER study

The FINGER study (“Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability”) ran from 2009 to 2014, involving 1,260 participants aged 60–77 with increased genetic risk for dementia but no memory problems. Participants were divided into two groups: one received a lifestyle program including a healthy diet, regular physical activity (strength, balance, cardio), cognitive training, social engagement, and monitoring of vascular risk factors (cholesterol, blood pressure, blood sugar). The control group received standard medical advice (Ngandu Lancet 2015).

The results were very positive: both groups improved cognitively, but the lifestyle group performed significantly better (25% general cognitive improvement, 30% reduced risk of cognitive decline). The program also improved mobility, daily functioning, health-related quality of life, and reduced susceptibility to comorbid conditions by 60%. Fewer cerebrovascular events occurred, and post-analyses suggested the program is likely cost-effective and socially beneficial (Wimo et al., 2023).

The benefits are likely due to improved blood flow to the brain and reduced inflammation and oxidative stress, enhancing cognitive reserve (the brain’s ability to compensate for damage, built through lifelong mental, social, and physical activity).

Long-term follow-ups up to 11 years after the intervention showed that cognitive benefits were maintained, with participants strictly adhering to the program retaining cognitive advantages for up to 11 years (Lehtisalo, et al. 2023, Ngandu et al., 2022).

Global FINGERS network

Since 2017, this study concept has been rolled out in the Worldwide FINGERS network, now active in 71 countries. Ongoing studies include US POINTER (USA), AgeWell.de (Germany), LETHE (Europe), MET-FINGER (Finland, Sweden, UK), MIND-ADmini (Sweden, Finland, Germany, France), and the Chinese Multicomponent Trial (China). The Netherlands also participates, with follow-ups planned until April 2027. Other lifestyle interventions have followed worldwide, e.g., SMARRT, Intensive Lifestyle in MCI/AD (USA), preDIVA (Netherlands), LEISURE Study and Maintain Your Brain (Australia).

What can you do for a healthy lifestyle?

Start small: ride a route with Bike Labyrinth every day and make moving fun! Cycling is an excellent low-impact cardiovascular activity supporting brain health, heart health, and overall fitness. Even small daily rides can make a big difference.

Key takeaways:

• Focus on prevention: Research shifts from treatment to preventing dementia through lifestyle and environment.
• 14 modifiable risk factors: Nutrition, exercise, sleep, cognitive and social engagement can reduce risk (Livingston et al., 2024).
• DIVERT-AD study: Sleep, education, and physical activity support brain resilience and vascular health.
• FINGER study: Lifestyle interventions improved cognition, daily functioning, and reduced cerebrovascular events.
• Long-term effects: Cognitive benefits persisted up to 7–11 years.
• Global research: The FINGERS network now spans 71 countries.
• Take action yourself: Daily activities like cycling with Bike Labyrinth support healthy brain, heart, and fitness.