Background: Currently, there is no pharmaceutical intervention to treat or delay pathological cognitive decline or Alzheimer’s disease and related dementias (ADRD). Multidomain lifestyle interventions are increasingly being studied as a non-pharmacological solution to enhance cognitive reserve, maintain cognition, and reduce the risk of or delay ADRD. Review of completed and prospective face-to-face (FTF) and digital multidomain interventions provides an opportunity to compare studies and informs future interventions and study design. Methods: Electronic databases (PubMed, PsycINFO, and NIH RePORTER) were searched for multidomain lifestyle programs. Studies were included if the program (1) included a control group, (2) included at least 3 interventions, (3) were at least 6 months in duration, and (4) included measurement of cognitive performance as an outcome. Results: In total, 17 multidomain lifestyle programs aimed at enhancing cognitive reserve and reducing risk of ADRD were found. Thirteen programs are FTF in intervention delivery, with 3 FTF programs replicating the FINGER protocol as part of the World Wide Fingers Consortium. Four programs are delivered digitally (website, Web application, or mobile app). Program characteristics (e.g., target population, duration, frequency, outcomes, and availability) and results of completed and prospective studies are reviewed and discussed. Conclusion: This review updates and discusses completed and current multidomain lifestyle interventions aimed at enhancing cognitive reserve and reducing risk of ADRD. A growing number of international studies are investigating the efficacy and utility of these programs in both FTF and digital contexts. While a diversity of study designs and interventions exist, FTF and digital programs that build upon the foundational work of the FINGER protocol have significant potential to enhance cognitive reserve and reduce risk of ADRD.

Alzheimer's disease (AD) affects the memory and cognitive function of approximately 5.7 million Americans. Early detection subsequently allows for earlier treatment and improves outcomes. Currently, there exists a validated 30-min eye-tracking cognitive assessment (VPC-30) for predicting AD risk. However, a shorter assessment would improve user experience and improve scalability. Thus, the purposes were to (1) determine convergent validity between the 5-min web camera-based eyetracking task (VPC-5) and VPC-30, (2) examine the relationship between VPC-5 and gold-standard cognitive tests, and (3) determine the reliability and stability of VPC-5. This prospective study included two healthy cohorts: older adults (65+ years, n = 20) and younger adults (18-46 years, n = 24). Participants were tested on two separate occasions. Visit 1 included the Montreal Cognitive Assessment (Mo-CA), Digit Symbol Coding test (DSC), NIH Toolbox Cognitive Battery (NIHTB-CB), VPC-30, and VPC-5. Visit 2 occurred at least 14 days later; participants completed the VPC-5, DSC, NIHTB-CB, and dual-task walking assessments (DT). VPC-30 significantly correlated with VPC-5 at the first (p < .001) and second (p = .001) time points. VPC-5 and DSC (p < .01) and Pattern Comparison Processing Speed Test (PSPAC) (p = .01) were also correlated on day 1. Significant associations existed between VPC-5 and DSC (p < .001), Flanker Inhibitory Control Test (p = .05), PSPAC (p < .001), and Picture Sequence Memory Test (p = .02) during day 14 testing session. The test retest reliability of VPC-5 was significant (p < .001). VPC-5 displayed moderate convergent validity with the VPC-30 and gold-standard measures of cognition, while demonstrating strong stability, suggesting it is a valuable assessment for monitoring memory function.

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Citrulline-malate (CM) purportedly increases exercise performance through increased nitric oxide production. The effects of CM on muscular strength performance are well-documented; however, the benefits of CM on aerobic and anaerobic biking performance are not well researched. Therefore, the present investigation examined the acute CM supplementation effects on aerobic and anaerobic cycling performance in recreationally active males. Methods: 28 recreationally active males (20.9 ± 2.8 years) completed randomized, double-blind, crossover trials consuming CM (12g dextrose + 8g CM) or a placebo (12g dextrose). Participants performed an aerobic cycling protocol (time-to-exhaustion [TTE]), followed by a subsequent 30second Wingate cycling test, 60-minutes after supplement consumption. Results: Dependent t-tests showed no significant differences (p > 0.05) for TTE (PLA: 315.4 s ± 137.7 s; CM: 314.1 s ± 107.1 s) and Total Work Completed (TWC) (PLA: 74.7 ± 34.1 kilojoules (kJ); CM: 74.1 ± 26.4 kJ) during the aerobic cycling protocol. Dependent t-tests also showed no significant differences (p > 0.05) for mean watts (PLA: 586.1 ± 87.7 Watts (W); CM: 588.0 ± 93.0 W), peak watts (PLA: 773.0 ± 136.7 W; CM: 786.7 ± 133.0 W), and fatigue index (PLA: 12.9 ± 6.4 FI; CM: 14.3 ± 7.2 FI) during the Wingate protocol. Repeated-measures ANOVA results indicated a significant effect between each 5 s interval (p < 0.001), but no differences were observed between trials (p > 0.05). Conclusion: Acute CM supplementation in recreationally active males provides no ergogenic benefit in aerobic cycling performance followed by an anaerobic cycling test.

Background In the United States, more than 6 million adults live with Alzheimer disease (AD) that affects 1 out of every 3 older adults. Although there is no cure for AD currently, lifestyle-based interventions aimed at slowing the rate of cognitive decline or delaying the onset of AD have shown promising results. However, most studies primarily focus on older adults (>55 years) and use in-person interventions. Objective The aim of this study is to determine the effects of a 2-year digital lifestyle intervention on AD risk among at-risk middle-aged and older adults (45-75 years) compared with a health education control. Methods The lifestyle intervention consists of a digitally delivered, personalized health coaching program that directly targets the modifiable risk factors for AD. The primary outcome measure is AD risk as determined by the Australian National University-Alzheimer Disease Risk Index; secondary outcome measures are functional fitness, blood biomarkers (inflammation, glucose, cholesterol, and triglycerides), and cognitive function (Repeatable Battery for the Assessment of Neuropsychological Status and Neurotrack Cognitive Battery). Screening commenced in January 2021 and was completed in June 2021. Results Baseline characteristics indicate no difference between the intervention and control groups for AD risk (mean −1.68, SD 7.31; P=.90). Conclusions The intervention in the Digital, Cognitive, Multi-domain Alzheimer Risk Velocity is uniquely designed to reduce the risk of AD through a web-based health coaching experience that addresses the modifiable lifestyle-based risk factors. Trial Registration ClinicalTrials.gov NCT04559789; https://clinicaltrials.gov/show/NCT04559789 International Registered Report Identifier (IRRID) DERR1-10.2196/31841