A multimodal lifestyle intervention management system for people at risk of cognitive decline

Dementia stands as the primary reason for disability among older adults. Research indicates that dementia's risk factors are a blend of pathological, lifestyle, and genetic elements, with nearly 40% of the potential risk factors being modifiable. In the absence of a definitive cure, the foremost strategies for managing dementia involve its early detection and measures to decelerate its progression. In this regard, lifestyle multimodal preventive strategies have emerged, guiding precision prevention of dementia. Based on the LETHE clinical trial, a digitized version of the FINGER protocol, we present a novel digital lifestyle intervention framework, which operates within the LETHE Platform, with its primary purpose being the federation and classification of study participant's weekly performance on a wide spectrum of lifestyle behaviors including physical activity, cognitive exercise, diet, smoking, alcohol consumption. The system has been deployed and is currently being used for the explicit purpose of supporting the LETHE clinical trial. The present study reports on quantitative operational metrics of the digital intervention component of the LETHE platform, as well as illustrates initial aggregate results of the intervention with respect to path classification for the first year of the trial.Clinical Relevance-The observed adherence and engagement patterns confirm that structured digital guidance enhances engagement, reducing persistent low adherence, and promoting sustained lifestyle changes. Over 58 weeks, the intervention group maintained a higher proportion of green-path adherence, with nearly 40% of weekly classifications indicating sustained adherence compared to approximately 35% in the control group. The red path (persistent low adherence) was notably lower in the intervention group, representing 16% of weekly classifications compared to 25% in the control group. These findings highlight the efficacy and effectiveness of digital tools in preventive healthcare as well as the clinical relevance of structured digital guidance, emphasizing its potential to reduce disengagement and support long-term lifestyle improvements, ultimately contributing to dementia risk reduction.