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The World Health Organization (WHO) recognises dementia as a public health priority. Currently, more than 55 million people live with dementia, and this figure is expected to almost triple to 139 million by 2050. Alzheimer’s disease is the most common cause of dementia, and there is still no cure. Despite the availability of symptomatic and first disease-modifying treatments, effective treatment remains limited. This makes it even more important to be aware that it is estimated that nearly half of all dementia cases could be prevented by eliminating 14 major risk factors. Consequently, the role of these modifiable risk factors has been the subject of research to inform effective preventive strategies. This narrative review summarises the current evidence on the prevention of cognitive decline and dementia. First, we provide an overview of the current state on risk factors, multimodal clinical controlled trials for slowing down or preventing dementia and primordial, primary, secondary, tertiary and quaternary prevention of cognitive decline and dementia. Second, we evaluate knowledge and action gaps in the field. Finally, we discuss how to address these gaps and what the next steps should be. Overall, to accelerate progress, the following key calls to action are paramount: (1) making prevention of cognitive decline and dementia a priority; (2) promoting brain health throughout the lifespan through coordinated intersectoral action targeting key risk factors; (3) improving acces

<b>Background/Objectives:</b> There is still no clear consensus regarding the efficacy of exercise interventions in maintaining or improving cognitive function among independent older adults, as well as individuals with mild cognitive impairment (MCI) or dementia. This review explores the potential mechanisms underlying cognitive decline prevention and dementia mitigation from the perspective of motor learning theory, with a particular focus on aerobic-oriented open-skill exercise (OSE) and electronic sports (e-sports). <b>Methods:</b> Comprehensive literature searches were conducted using databases such as PubMed, Scopus, Web of Science, CiNii, and J-Stage (all available years) to identify studies examining the relationship between OSE, e-sports, and cognitive function. <b>Results:</b> Although various intervention studies have investigated aerobic exercise, resistance training, and other multifactorial exercise programs, a unified conclusion has not been reached regarding their effectiveness in enhancing cognitive function in the general elderly population or in patients with MCI or dementia. However, sports involving dynamic interaction with opponents (OSE) have shown a positive association with the maintenance and enhancement of cognitive abilities. Furthermore, e-sports present an accessible exercise modality, unrestricted by age, gender, time, or location, and are expected to support cognitive health in older adults. <b>Conclusions:</b> Aerobic-oriented OSE appears more

<h4>Objective</h4>To systematically review and synthesize the factors influencing subjective cognitive decline (SCD) in older adults based on the Health Ecological Model (HEM), and to provide direction for future research.<h4>Methods</h4>Relevant literature on factors influencing SCD in older adults was retrieved from five databases (CNKI, Wanfang, VIP, PubMed, and Web of Science) from database inception to October 18, 2025.<h4>Results</h4>A total of 33 articles were included, comprising 21 Chinese and 12 English articles, with sample sizes ranging from 212 to 74,472 participants. The influencing factors were diverse and complex. According to the HEM, these factors were categorized into four dimensions: personal characteristics, behavioral characteristics, interpersonal networks, and living and working conditions. Notably, none of the 33 studies addressed the fifth dimension-the policy environment-highlighting a significant research gap.<h4>Conclusion</h4>The reported prevalence of SCD varies considerably across assessment tools and geographic locations, particularly in rural areas and among older adults. Four dimensions of influencing factors were identified: personal characteristics, behavioral characteristics, interpersonal networks, and living and working conditions. None of the 33 included studies addressed the policy environment dimension, highlighting a significant research gap. Limitations include the predominant use of self-reported tools, reliance on cross-sectional

Physical activity (PA) is a modifiable lifestyle behaviour associated with lower dementia risk; however, molecular pathways bridging PA-related dementia prevention are poorly understood. We leveraged large-scale plasma proteomics to identify biological signatures of objectively monitored PA and cognitive ageing in functionally intact older adults, cross-validated these signatures in independent exercise cohorts and tested associations with both symptomatic and presymptomatic stages of neurodegeneration across multiple Alzheimer's disease and related dementias (ADRD) cohorts. We analysed large-scale plasma proteomics data (SomaScan 7k) across three cohorts including naturalistic, objective PA monitoring (University of California, San Francisco Brain Aging Network for Cognitive Health cohort, <i>n</i> = 65), self-reported PA (Atherosclerosis Risk In Communities study, <i>n</i> = 10 644) and PA intervention (Health Risk Factors, Exercise Training and Genetics study, <i>n</i> = 654). Differential regression models examined individual protein correlates of PA, adjusting for age and sex. Weighted gene co-expression network analysis assembled proteins into unbiased modules of protein co-expression, which were annotated for gene ontology and cell-type enrichment. To test clinical relevance to ADRD, we examined PA-related protein levels across-cohorts of symptomatic Alzheimer's disease and Parkinson's disease (Stanford Alzheimer's Disease Research Center), as well as frontotemporal de

<h4>Background and objectives</h4>Cerebral "dirty-appearing" or "diffusely abnormal" white matter (DAWM) represents subtle white matter abnormalities that are associated with progression of cerebral small vessel disease (cSVD), but the association with cognitive function and dementia is unclear. Our aim was to study the association between DAWM and cognitive function, long-term cognitive decline, and long-term dementia risk in community-dwelling older adults with limited baseline cSVD burden.<h4>Methods</h4>Participants of the prospective Age-Gene/Environment Susceptibility-Reykjavik longitudinal cohort study underwent 1.5T brain MRI scans. DAWM was visually rated on baseline fluid-attenuated inversion recovery (FLAIR) MRI as a percentage of lobar white matter volume (0%, 0%-10%, 10%-25%, or >25% DAWM) per brain lobe. Baseline DAWM ratings and white matter hyperintensity (WMH) volumes were associated with memory, executive function, and processing speed cognitive domain <i>z</i>-scores at baseline and their change at follow-up (after 5.2 ± 0.2 years) and with dementia status assessed at long-term follow-up (after 10.3 ± 2.2 years). This was performed by statistical models adjusted for age, sex, vascular risk factors, and education (for the cognition analyses).<h4>Results</h4>From 4,163 included participants, 2,081 participants were selected based on limited baseline WMH volume on FLAIR MRI (determined by a median split) (mean age: 74.6 ± 4.9 years, 61% female). Baseline DAWM

<h4>Background</h4>Falls and physical inactivity are both linked to increased dementia risk, but their joint impact has not been well studied. It remains unclear whether physical activity can mitigate the elevated dementia risk after a fall and whether it also lowers the likelihood of future falls.<h4>Methods</h4>We used data from 44,488 adults aged ≥ 60 years in three cohorts. Falls and physical activity were self-reported. Incident dementia was tracked during follow-up. Cox proportional hazards models estimated the associations of falls with dementia and physical activity with dementia and falls, stratified by fall history.<h4>Results</h4>Over a median follow-up of 5.9-7.9 years, 3,492 dementia cases were identified. Falls were associated with a 70% higher risk of dementia (pooled HR = 1.70, 95% CI: 1.57-1.84). In the no-fall group, compared with inactivity, low, moderate, and high physical activity were progressively associated with lower risks of dementia (HRs = 0.63, 0.53, 0.43) and falls (HRs = 0.77, 0.68, 0.58). These protective effects were consistent among fallers, with similar dose-response gradients.<h4>Conclusions</h4>Falls substantially increased dementia risk. Higher levels of physical activity were linked to lower risks of both dementia and falls, regardless of fall history.

<h4>Objectives</h4>Preventing cognitive decline is a major challenge in aging research. While mind-body exercises and cognitive training each enhance cognitive function, their combined impact on cognitively normal older adults remains unclear. This study examined whether Baduanjin exercise and cognitive training exert interactive effects on global and domain-specific cognitive function.<h4>Methods</h4>In a 12-week randomized controlled trial with a 2 × 2 factorial design, 162 community-dwelling adults aged 60-75 years with normal cognitive function were assigned to four groups: control (CON), Baduanjin (BG), cognitive training (CT), and combined intervention (BG + CT). Global cognition, memory, attention, executive function, language, and visuospatial ability were assessed at baseline and post-intervention. Changes within-group and main and interaction effects were analyzed.<h4>Results</h4>One hundred thirty-eight participants completed the intervention. All intervention groups showed significant cognitive improvements from baseline. BG + CT demonstrated the most consistent improvements, including unique significant gains in long-delay memory. Factorial analyses revealed significant main effects of both Baduanjin and cognitive training on global cognition and multiple cognitive domains (<i>p</i> < 0.05), with notable interaction effects between the two interventions. Simple effects analyses confirmed that BG + CT led to greater improvements than individual interventions, part

<h4>Introduction</h4>Previous studies have shown that physical activity (PA) can improve cognitive function (CF) and depressive symptoms in middle-aged and older adults, and that there is a bidirectional relationship between the two. However, there is a lack of research on the temporal sequence and potential mechanisms of these three factors. This study conducted a large-scale longitudinal study to explore the mediating role of PA in the bidirectional association between CF and depressive symptoms in middle-aged and older adults.<h4>Methods</h4>A longitudinal study was conducted using data from the English Longitudinal Study of Aging (ELSA) collected in 2014-2015 (T1), 2016-2017 (T2), and 2018-2019 (T3). PA, CF, and depressive symptoms were assessed via questionnaires, with Spearman's correlation analysis used to examine variable correlations. A Cross-Lagged Panel Model (CLPM) was constructed to test the longitudinal causal relationships among the three variables, and a longitudinal mediation model was developed to analyze the mediating role of PA.<h4>Results</h4>A total of 6,787 participants aged 50 years or older were included, comprising 3,777 women (55.7%) and 3,010 men (44.3%), with a median baseline age of 66 years. Spearman correlation analysis indicated a significant correlation among the three variables (rs=[-0.225, 0.447], P < 0.001). CLPM results showed that poorer CF predicted more severe depressive symptoms in the future (βT1-T2 = -0.038, P < 0.001; βT2-T3 = -0.0

Cognitive decline and dementia represent major and growing global health challenges, driven largely by population aging and increased longevity. Currently, more than 55 million people worldwide live with dementia, a figure projected to rise to approximately 153 million by 2050. Alzheimer's disease accounts for the majority of cases, and despite extensive research, effective disease-modifying therapies remain limited. Consequently, increasing attention has shifted toward prevention strategies targeting modifiable risk factors. Accumulating evidence indicates that dementia is not an inevitable consequence of aging and that up to 45 % of cases may be attributable to potentially modifiable lifestyle and environmental factors operating across the life course. Lifestyle behaviors-including diet, physical activity, smoking, alcohol consumption, sleep, and social and cognitive engagement-have emerged as key targets for intervention. In particular, adherence to healthy dietary patterns such as the Mediterranean, DASH, and MIND diets has been associated with better cognitive outcomes, while unhealthy dietary patterns may increase risk. However, findings across studies remain heterogeneous, and uncertainties persist regarding causality, optimal exposure timing, and specific lifestyle components. Recent large prospective cohorts, meta-analyses, umbrella reviews, and multidomain intervention trials have advanced understanding of these associations but have also highlighted important gaps,

<h4>Background</h4>Cognitive decline is a common neurodegenerative disorder in older adults. However, few studies have examined the interrelationships between malnutrition, physical frailty, and cognitive decline.<h4>Methods</h4>A multi-stage cluster sampling approach was employed to recruit participants, namely older adults aged ≥65, from communities in Ningbo, China. The participants' cognitive decline was evaluated using the Brief Screening Scale for Dementia. Malnutrition and physical frailty were assessed using the Mini Nutritional Assessment - Short Form and the Fatigue, Resistance, Ambulation, Illnesses, and Loss of Weight scale. Logistic regression was conducted to examine the association between malnutrition and cognitive decline, and mediation analysis was performed to assess the mediating role of physical frailty in this association. The validity of the association was tested by performing 1:1 nearest-neighbor propensity score matching (PSM).<h4>Results</h4>The prevalence of malnutrition, physical frailty and cognitive decline were 17.04, 32.37 and 13.02%, respectively. The multivariate logistic regression indicated that malnutrition was significantly associated with physical frailty [odds ratio (OR): 1.45, 95% confidence interval (CI): 1.29-1.63] and cognitive decline (OR: 3.51, 95% CI: 3.06-4.03). Physical frailty was also significantly associated with cognitive decline (OR: 2.63, 95% CI: 2.31-3.00) and partially mediated the observed linkage between malnutrition

<h4>Background</h4>Cognitive function and quality of life (QoL) are closely linked in older adults, with accumulating evidence suggesting that cognitive performance is an important determinant of overall perceived QoL in older adults.<h4>Objectives</h4>To examine cognitive function and its association with multidimensional QOL among adults aged ≥60 years in the United Arab Emirates (UAE) and identify sociodemographic and lifestyle correlates.<h4>Methods</h4>A cross-sectional study of 606 community-dwelling older adults from the UAE (55.4% male; mean age 67.2 ± 5.8 years) assessed cognitive function (MoCA) and QOL (OPQoL-Brief). Associations were analyzed using correlation and multiple linear regression (p < 0.05) between the sociodemographic factors and cognitive function (MOCA) to QOL.<h4>Results</h4>Participants aged 60-87 years were predominantly Emirati (84.2%), married (77.6%), and living with family (96.7%). Cognitive impairment was present in 69.3% (40.9% mild, 24.8% moderate, 3.6% severe), with the lowest abstraction scores. Mean QOL was 4.21 ± 0.51/5, lowest in social engagement. Cognitive impairment independently predicted lower QOL (β = 0.138; 95%CI: 0.043-0.232; p = 0.001), along with female sex, older age, lower education or income, unmarried status, living alone, and low physical activity.<h4>Conclusion</h4>Cognitive function is a key determinant of QOL, supporting integrated, person-centered aging strategies in the UAE.

<h4>Introduction</h4>Obstructive sleep apnea (OSA) is associated with cognitive decline, but short-term studies show limited cognitive benefits of its treatment with continuous positive airway pressure (CPAP). We examined whether longer follow-up exhibits greater cognitive differences associated with CPAP use.<h4>Methods</h4>We analyzed 777 participants from the 2011 National Health and Aging Trends Study (NHATS) with linked Medicare claims, with one or more claims for OSA and no baseline cognitive impairment. CPAP treatment was defined by one or more CPAP claims. Cognitive trajectories from 2011 to 2021 were estimated using a factor score derived from annual cognitive performance assessments and compared by CPAP treatment status using adjusted generalized linear mixed models.<h4>Results</h4>Cognitive performance declined over follow-up. CPAP-treated participants declined by -0.03 standard deviation (SD) units per year (95% confidence interval [CI]: -0.04, -0.02). Untreated participants experienced a 69% faster decline (CPAP-by-time interaction: -0.02; 95% CI: -0.04, -0.001).<h4>Discussion</h4>CPAP therapy may slow cognitive decline in older adults with OSA.

<b>Background/Objectives</b>: Age-related hearing loss is one of the most prevalent chronic conditions in older adults and has emerged as a potentially modifiable risk factor for cognitive decline and dementia. Increasing evidence from epidemiological, neurobiological, and interventional studies has improved our understanding of the complex relationships between auditory dysfunction and cognitive aging. By highlighting findings in these areas, this review aims to aid clinicians and researchers gain a better understanding of the association between hearing loss, cognitive decline and dementia, and the importance of considering sensory decline during cognitive screening. <b>Methods</b>: This narrative review summarizes and integrates findings from epidemiological, neurobiological, and clinical studies examining relationships between hearing loss, cognitive decline, and dementia. Particular focus was placed on epidemiological associations, proposed mechanistic pathways, implications for screening and diagnostic assessment, and evidence regarding hearing rehabilitation interventions. <b>Results</b>: Accumulating evidence indicates that hearing loss is associated with accelerated cognitive decline and increased dementia risk. Proposed mechanisms include increased cognitive load, reduced sensory input, social isolation, depression, and shared neurodegenerative or vascular pathology, although causal pathways remain incompletely understood. Emerging evidence suggests that hearing reh

The growing population of older cancer survivors faces an elevated risk of accelerated cognitive decline due to the combined effects of aging and cancer-related cognitive impairment. Loneliness and social isolation have also been linked to poorer cognitive outcomes and increased risk of Alzheimer's Disease and Related Dementias (ADRD). At the same time, regular physical activity and social support interventions may improve cognitive function and reduce risk of cognitive decline. Despite these parallel lines of evidence, few interventions have addressed these modifiable risk factors simultaneously, particularly among older cancer survivors. In this perspective, we propose that group-based exercise may provide synergistic benefits for cognitive health by addressing both physical activity and social engagement. We present a conceptual model in which participation in group exercise promotes exercise-induced neurobiological adaptations that support cognitive function while simultaneously enhancing social connectedness. These processes may reduce loneliness and social isolation, promoting cognitive engagement. We also highlight key considerations for future research, including the potential for virtual or remotely delivered group exercise to increase accessibility, the importance of group dynamics in fostering social support, and the need to incorporate validated measures of loneliness, social isolation, and cognitive function in intervention studies.

Dementia is a growing global health challenge, yet many determinants of late-life cognitive decline emerge decades before symptoms appear. Midlife is a practical window for prevention because hypertension, diabetes, obesity, dyslipidemia, smoking, physical inactivity, unhealthy diet, sleep disturbance, and social isolation can be identified and modified before substantial brain injury becomes apparent. This narrative review synthesizes evidence linking midlife vascular and lifestyle exposures to late-life cognitive impairment and dementia. The most consistent data support a life-course model in which cumulative vascular, metabolic, inflammatory, and behavioral risks interact with neurodegenerative pathology and cognitive reserve. Vascular and metabolic factors act largely through small-vessel disease, endothelial dysfunction, and inflammation, whereas physical activity, healthy diet, sleep, and social engagement may strengthen resilience. Although observational evidence is vulnerable to confounding and single-risk trials may underestimate cumulative benefit, multidomain prevention remains biologically plausible and clinically actionable, as recent trials reaffirm. These priorities are especially salient in the rapidly transitioning Gulf Cooperation Council (GCC) countries, where midlife cardiometabolic risk is high and local evidence is limited. Dementia prevention should be embedded in routine midlife care, with vascular risk management and sustained lifestyle support treate

<b>Objectives:</b> This study investigated how perceived social support, loneliness, and physical activity are related to cognitive performance among older adults with mild cognitive impairment. <b>Methods:</b> This cross-sectional investigation included 112 community-dwelling older adults with mild cognitive impairment. Perceived social support, loneliness, and physical activity were evaluated with the Multidimensional Scale of Perceived Social Support (MSPSS), UCLA Loneliness Scale, and International Physical Activity Questionnaire (IPAQ), respectively. Cognitive functioning was characterized through a battery comprising the Montreal Cognitive Assessment (MoCA), Isaac Set Test, Trail Making Test Parts A and B (TMT-A and TMT-B), Digit Symbol Substitution Test (DSST), and d2 Attention Test. Relationships among the study variables were examined through correlation and multivariable linear regression analyses, with age, sex, and educational level included as covariates. To address multiplicity, Benjamini-Hochberg false discovery rate (FDR) adjustment was conducted independently for the predefined families of correlations, main-effect regression coefficients, and interaction terms. <b>Results:</b> Significant bivariate relationships with cognitive performance were observed for perceived social support, loneliness, and physical activity, with all 18 correlations retaining significance following FDR adjustment. After covariate adjustment, 12 of the 36 main-effect coefficients met