[Prevention of cognitive impairment - from research to implementation]

Risk reduction and prevention of cognitive impairment and dementia have been highlighted as crucial to curb the expected rise of cases. Nearly half of all dementia cases can be linked to modifiable lifestyle, health and environmental factors, and encouraging evidence from multimodal interventions addressing many of these factors has shown the potential for brain health promotion. The FINGER trial outlined a successful multidomain intervention paradigm, reporting cognitive and additional health benefits in older adults at increased risk for dementia via a combination of healthy diet, physical activity, cognitive and social stimulation, and monitoring of cardiometabolic disorders. Global adaptation and enhancement of this multidomain model is promoted via the World-Wide FINGERS global network of trials for risk reduction of dementia, connecting researchers and clinics in over 70 countries with over 50 trials in different populations, cultures, and socioeconomic settings. Forthcoming preventive strategies will increasingly rely on tailored interventions based on individual risk profiles, including precision prevention and a combination of non-pharmacological and pharmacological interventions. In parallel, implementation activities in communities and clinical settings have been successfully developed in the Nordics (e.g., Swedish FINGER network of municipalities) and across Europe (e.g., Brain Health Services). Sustainability and success of these efforts rely on intersectoral collaboration and policy frameworks, which are being updated (e.g., Swedish national strategy for dementia) to effectively support prevention across the at-risk continuum of dementia.