Table of Contents
- Key Points
- Background: Why This Research Matters
- How the Research Was Conducted
- Characteristics of the Combination Trials
- Duration, Frequency, and Types of Intervention
- How Outcomes Were Measured
- Lifestyle Interventions Combined with Omega-3 Fatty Acids
- Lifestyle Intervention Combined with BBH-1001
- Other Combination Approaches
- What These Findings Mean for Patients
- Limitations of the Research
- Recommendations and Next Steps
- Frequently Asked Questions
- Source Information
Key Points
- A review of 12 randomized trials with 4,434 participants found no single trial showed a definitive benefit on its primary cognitive outcome.
- Some trials found positive results in specific subgroups, particularly people at higher risk of dementia, such as those with higher risk scores or amyloid plaques.
- Physical exercise appeared in all 12 trials; cognitive training and dietary guidance were also common components.
- Omega-3 supplementation had an excellent safety profile, but cognitive benefits were not consistently demonstrated across trials.
- Researchers recommend early, personalized interventions and refined trial methods, as no combination has yet proven definitively effective.
Background: Why This Research Matters
Alzheimer's disease (AD) and related dementias (ADRD) remain among the most pressing health challenges worldwide. Effective treatments are still not widely available. Researchers are working urgently to find new compounds, as well as to repurpose existing drugs, that might delay the onset of dementia, slow its progression, or ultimately prevent it altogether.
Recent progress with anti-amyloid beta monoclonal antibody therapies, including Lecanemab and Donanemab, has shown potential in slowing cognitive decline. However, current estimates indicate that fewer than 30% of Alzheimer's patients would be eligible for these therapies. This limited eligibility highlights the need for broader approaches.
Many single-target treatments, whether pharmacological (drug-based) or non-pharmacological, have failed in Alzheimer's disease trials. This failure underscores a fundamental limitation: targeting only one disease mechanism or one risk factor is not enough. The complexity of dementia demands strategies that address multiple risk factors and biological pathways at the same time.
Timing matters greatly. Early intervention in the Alzheimer's disease continuum appears crucial for achieving the best preventive effect. New multidomain therapeutic approaches could enhance treatment efficacy and allow prevention efforts to be personalized to each individual.
The Lancet Commission on Dementia Prevention, Intervention and Care recently updated its list of modifiable risk factors for dementia. The commission identified 14 factors, mostly based on observational studies:
- Low education
- Hearing and vision loss
- Traumatic brain injury
- Hypertension (high blood pressure)
- Excessive alcohol use
- Obesity
- Smoking
- Depression
- Social isolation
- Physical inactivity
- Air pollution
- Diabetes
- High levels of low-density lipoprotein (LDL) cholesterol
Modifying these factors could prevent or delay up to 45% of dementia cases. This is a substantial proportion, and it means that lifestyle and risk factor management have enormous potential for reducing the global burden of dementia.
The World Health Organization (WHO) guidelines for risk reduction of cognitive decline and dementia are based on a synthesis of findings from intervention trials. These guidelines recommend physical activity, a healthy balanced diet, cognitive training, and management of hypertension, diabetes, and dyslipidemia (abnormal cholesterol levels) for reducing the risk of cognitive decline. The WHO guidelines are currently being updated, and the new edition will include additional modifiable lifestyle factors and multidomain interventions.
Multidomain lifestyle interventions, such as the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), have reported promising cognitive benefits in older individuals at risk of dementia. This includes people with genetic susceptibility, specifically carriers of the APOE-ε4 allele (a genetic variant that increases Alzheimer's risk). The FINGER randomized controlled trial combined five components over a 2-year intervention period:
- Exercise
- Cognitive training
- Social engagement
- Dietary recommendations
- Vascular and metabolic risk factor management
The FINGER study is now a model for similar trials around the world. The World-Wide FINGERS (WW-FINGERS) network includes 70 member countries and offers a new paradigm to prevent cognitive decline.
Given the growing number of modifiable risk factors being identified for late-life dementia, there is an increasing need for novel multidomain combination trials. Integrating multidomain lifestyle interventions with pharmacological treatments, whether new or repurposed, holds promise for advancing precision medicine approaches. These approaches aim to prevent cognitive decline and dementia by tailoring interventions to individual needs. Existing strategies for cardiovascular and cancer treatment offer useful models for testing combination therapies in Alzheimer's disease and related dementias trials.
Over the past decade, combination trials in the Alzheimer's disease field have been initiated. These trials focus on combinations of multidomain non-pharmacological lifestyle interventions and pharmacological compounds. In this context, the authors conducted a systematic review to provide a comprehensive overview of such combination randomized controlled trials.
The review focused on key methodological aspects, including intervention and trial design, target populations, intervention duration, and adherence. The aim was to inform the design of future combination trials. This would be done by identifying common pitfalls. It would also explore how current and emerging trial evidence can be leveraged to optimize trial design. This can guide the development of more effective intervention strategies.
How the Research Was Conducted
The researchers followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. This is a widely accepted standard for conducting and reporting systematic reviews.
To identify combination therapy randomized controlled trials, the researchers searched records in Clinicaltrials.gov and euclinicaltrials.eu databases. They used the following search terms: "Alzheimer's disease," "mild cognitive impairment," "dementia," and "cognitive decline," combined with either "lifestyle intervention," "multidomain," or "multimodal." The search covered records from inception to May 30, 2025. PubMed and EMBASE were also searched with the same combination of terms to catch any studies that might have been missed. All searches were performed independently by two researchers.
The review used the Population/Intervention/Comparator/Outcomes (PICO) framework to define what studies to include. The review aimed to identify randomized controlled trials targeting adults with:
- Normal cognition
- Subjective cognitive decline (SCD), which is when a person notices memory or thinking problems but tests show normal function
- Mild cognitive impairment (MCI), which is a noticeable decline in thinking skills that is greater than expected for age but does not interfere significantly with daily life
- Prodromal Alzheimer's disease, which is the stage just before full dementia develops
The studies had to test lifestyle-based interventions that addressed at least 2 modifiable risk factors for dementia, or included at least 2 intervention components. These lifestyle interventions had to be combined with additional treatments, such as:
- Pharmacological treatments (drugs)
- Nutraceutical treatments (medical food or dietary supplements)
- Non-invasive devices (such as transcranial brain stimulation)
The studies also had to include appropriate comparators, such as placebo, standard care, or a lower-intensity intervention. They had to assess the intervention's effect on outcomes related to dementia and cognitive impairment.
Randomized controlled trials were included regardless of their current status (ongoing, completed, terminated, or unknown) or whether published results were available. The researchers excluded trials with interventions or treatments that lasted less than 6 months.
Studies were also excluded if they included participants with a suspected or known dementia diagnosis, or other major neurological or psychiatric disorders. Examples of excluded conditions included Parkinson's disease, stroke, major depression, multiple sclerosis, schizophrenia, and bipolar disorder. Studies were also excluded if participants had a history of substance abuse. Studies were also excluded if they focused on rehabilitation programs for recent cardiovascular, cerebrovascular, respiratory, or other medical events. An example of such a program is post-surgery rehabilitation.
The search was not limited by date of publication or geographical location. However, only records or publications in English were included.
The Covidence systematic review software was used to manage search results from Clinicaltrials.gov, PubMed, and EMBASE. Records derived from euclinicaltrials.eu were manually checked. After duplicates were removed, titles and abstracts were screened independently by two researchers. The full texts of potentially eligible studies were then obtained and further assessed. Any disagreement on inclusion was resolved by consensus within the research team.
For eligible randomized controlled trials, the researchers extracted a comprehensive set of data. This included:
- National Clinical Trial (NCT) number
- Study title and acronym
- Current status
- Number of trial arms
- Drug component and dose
- Lifestyle intervention domains
- Intervention intensity or modality
- Primary and secondary outcomes
- Trial duration
- Age for study inclusion
- Study population within the Alzheimer's disease continuum
- Trial sample size and timeframe
- Masking (blinding) approach
- Trial phase
- Sponsor
- Number of sites and countries
Characteristics of the Combination Trials
The search strategy initially identified 1,352 randomized controlled trials and 7,087 publications. After removing duplicates, 2,039 publications were screened to assess combinations of lifestyle interventions with pharmacological, nutraceutical, or other treatments. This screening process resulted in the identification of 12 combination randomized controlled trials as of May 30, 2025.
These 12 trials used several classes of compounds combined with multidomain lifestyle interventions. The trials targeted individuals within the continuum of Alzheimer's disease and dementia risk. This included people with normal cognition but increased dementia risk due to risk factors that were not well controlled, identified via validated scores. It also included people with a diagnosis of subjective cognitive decline (SCD) or mild cognitive impairment (MCI), defined via different sets of diagnostic criteria, or prodromal Alzheimer's disease.
Two randomized controlled trials included both MCI and early-stage dementia. For some trials, participants' inclusion relied on cognitive screening and assessment of modifiable risk factors. Examples include the MET-FINGER trial and the Multidomain Alzheimer Preventive Trial (MAPT).
One trial specifically included participants with MCI who also had concomitant type 2 diabetes (T2D) or insulin resistance. Two studies adopted a precision medicine approach by enriching their study populations with individuals carrying the APOE-ε4 allele. This means they specifically recruited people with this genetic risk factor.
Seven randomized controlled trials targeted participants with prodromal Alzheimer's disease, mild cognitive impairment, or early dementia. Five trials focused on at-risk individuals or people with subjective cognitive decline.
Duration, Frequency, and Types of Intervention
A total of 4,434 participants were included in the eligible randomized controlled trials. The number of participants in each trial ranged from 35 to 1,680. Intervention length ranged from 6 to 36 months.
Two randomized controlled trials had been terminated early as a consequence of the SARS-CoV-2 pandemic. These were the IRMCI and SYNERGIC trials.
The trials varied in their design:
- Seven trials had 2 arms
- Two trials had either 3 or 4 arms
- One trial featured 5 study arms
Masking, also called blinding, is a method used in clinical trials to prevent bias. The trials used different levels of masking:
- Two studies opted for quadruple masking (participants, caregiver, investigator, and outcome assessor)
- Three studies used triple masking (participants, outcome assessor, and either investigator or caregiver)
- Two studies used double masking (participants and outcome assessor)
- Four studies used single masking (participants or outcome assessor)
- One trial opted for an open-label approach, meaning everyone knew which treatment was being given
Earlier trials incorporated 2 to 3 intervention domains. These typically combined physical exercise with either cognitive training or dietary guidance. Later studies expanded their multidomain approaches, integrating further domains such as social engagement, cardiovascular risk management, meditation, or sleep hygiene education.
Physical exercise emerged as the most frequently utilized component of intervention. It was present in all 12 randomized controlled trials. Most studies utilized moderate-to-high intensity progressive training approaches. Only 1 randomized controlled trial opted for low intensity.
Ten randomized controlled trials incorporated cognitive training in their intervention domains. The cognitive training varied in intensity and frequency. Dietary guidance was also included in most trials, varying between Mediterranean-like and ketogenic diets, or through general healthy dietary advice.
Five randomized controlled trials incorporated guidance on social activities. These ranged from suggestions such as dancing or participating in church events to integrating social engagement within physical exercise or cognitive training domains.
Six randomized controlled trials employed a combination of individual and group sessions for intervention domains. These included dietary guidance, physical exercise, and cognitive training. Personalized sessions were used to tailor the intervention, for example addressing weight loss or malnutrition. Group formats were used to foster socialization and peer support.
In contrast, 2 trials relied solely on group sessions. These excluded the individually tailored home-based exercises commonly included across studies. Three randomized controlled trials did not specify how the interventions were delivered.
Four trials explicitly targeted cardiovascular or metabolic risk factor management as a distinct intervention domain. Three trials included advice on sleep hygiene, stress management, or meditation.
Few randomized controlled trials, such as MET-FINGER, MAPT, and MIND-ADmini, specified that the different intervention components were gradually introduced to facilitate adherence. This information is not reported for other trials.
The transition toward targeting multiple risk factors through multidomain interventions reflects a growing emphasis on comprehensive, data-driven strategies to enhance cognitive health outcomes.
How Outcomes Were Measured
The heterogeneity of the interventions and the varying designs across the randomized controlled trials provided limited possibility to synthesize the outcomes. The trials differed in their target groups and outcome measures. Therefore, a narrative synthesis was chosen to describe the results.
One trial was the Multimodal Preventive Trial for Alzheimer's Disease (MIND-ADmini), which was a feasibility trial. Another was the Lifestyle Intervention Program for Cognitive Impairment randomized controlled trial. In that trial, change in retinal amyloid burden was the main outcome. All other trials had changes in cognitive measures as their primary outcome.
Cognitive assessment tools ranged from various validated rating scales to composite scores commonly used in clinical practice. These included:
- Alzheimer's Disease Assessment Scale - Cognitive (ADAS-Cog)
- Neuropsychological Test Battery (NTB)
- Clinical Dementia Rating scale (CDR)
- Montreal Cognitive Assessment (MoCA)
- Mini Mental State Examination (MMSE)
- Alzheimer Disease Cooperative Study Preclinical Alzheimer Cognitive Composite (ADCS-PACC)
- Rey Auditory Verbal Learning Test (RAVLT)
- Stroop Color and Word Test (SCWT)
Despite variability in these cognitive assessment tools, core domains were consistently evaluated. These domains included memory, attention, language, executive function, processing speed, and orientation. This offered a comprehensive view of cognitive function in individuals at risk for dementia.
In addition to cognitive outcomes, structural and functional neuroimaging, blood-based biomarkers, and changes in lifestyle indices were often employed as secondary outcome measures. These provided a multidimensional evaluation of intervention effects.
Lifestyle Interventions Combined with Omega-3 Fatty Acids
Omega-3 polyunsaturated fatty acids (PUFA) have been tested in randomized controlled trials with cognitive endpoints in older individuals with or without an established dementia diagnosis. For some studies, findings pointed toward beneficial effects on cognitive symptoms.
Supplementation with omega-3 polyunsaturated fatty acids was among the first combination trials conducted. This may be due to their excellent safety profile, ease of administration, and high combination potential with multiple domains of lifestyle intervention.
The Multidomain Alzheimer Preventive Trial (MAPT, clinicaltrials.gov registration number NCT00672685) was the largest 4-arm superiority combination, phase III randomized controlled trial. It included 1,680 participants, aged 70 years and older, with subjective cognitive complaints.
Participants were randomized to 1 of 4 groups:
- Lifestyle intervention (physical activity advice, cognitive training, and nutritional consultations) plus omega-3 supplementation (daily dose of 800 mg DHA and 250 mg EPA)
- Lifestyle intervention plus placebo
- Lifestyle control (information sessions on lifestyle) plus omega-3 supplementation
- Lifestyle control plus placebo
The primary efficacy outcome was change in the composite Z score. This score was calculated from a combination of tests. The tests were the Free and Cued Selective Reminding Test, 10 MMSE orientation items, the Digit Symbol Substitution Test score from the Wechsler Adult Intelligence Scale, and the Category Naming Test.
No significant intervention effect on the primary outcome was reported. However, positive results were found in subgroup and post-hoc analyses. These positive results were particularly seen in individuals with higher dementia risk, as measured by the increased Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) dementia risk score. Positive results were also seen in participants classified as amyloid-beta-positive via brain PET scan with florbetapir. Cognitive benefits were also seen when pooling all participants who received the multidomain intervention.
A smaller randomized controlled trial enrolled 45 patients with mild cognitive impairment. This was a substudy within a larger study (clinicaltrials.gov ID NCT01219244). It assessed the combined effect of lifestyle intervention (physical and cognitive domains) with omega-3 supplementation (daily dose of 880 mg DHA and 1,320 mg EPA supplemented with 15 mg vitamin E).
Participants were assessed over 6 months. Changes in composite z scores of executive function, memory, sensorimotor speed, and attention were assessed. These assessments were based on the Auditory Verbal Learning Test, forward and backward digit spans, verbal fluency, Trail Making Test part A and B, and the Stroop Color-Word Test. No significant differences were found among the study arms.
However, this pilot study found significantly reduced atrophy (shrinkage) in frontal, parietal, and cingulate cortices following combined intervention compared with the control arm. The control arm received omega-3 fatty acid supplementation and non-aerobic exercise.
No significant changes were found in cognitive performances after a 6-month or a 36-month intervention with omega-3 fatty acids combined with multidomain lifestyle intervention. Despite this, these trials have provided important knowledge. They highlight the need to establish the right window of opportunity for such interventions, the right target populations, and the determination of the optimal dose and treatment duration.
Lifestyle Intervention Combined with BBH-1001
BBH-1001 is a brain health supplement containing a combination of various nutrients. The specific composition includes:
- Turmeric (125 mg)
- Fisetin (16.65 mg)
- Green tea leaf extract (17.5 mg)
- EPA (75 mg)
- DHA (150 mg)
- Vitamin D3 (250 IU)
This supplement was tested in combination with a multidomain lifestyle intervention. The article text provided in this source is truncated at this point, so further details about the BBH-1001 trial results are not available in the provided material.
Other Combination Approaches
The review identified 12 combination randomized controlled trials in total. These trials combined multidomain lifestyle interventions with various pharmacological components. The pharmacological components included:
- Omega-3 fatty acids
- Tramiprosate
- Vitamin D
- BBH-1001
- Epigallocatechin gallate (EGCG)
- Souvenaid (a medical food)
- Metformin
The specific results of trials testing these other compounds are not fully detailed in the provided article text. However, the overall findings suggest that well-designed interventions, tailored to the right individuals and implemented at the optimal time, may effectively improve cognition.
What These Findings Mean for Patients
The results of this systematic review carry several important messages for patients and their families.
First, combining multiple lifestyle changes with medications or supplements is a promising strategy for preventing cognitive decline. No single approach works for everyone, and no single risk factor tells the whole story. Addressing multiple factors at once appears more likely to help than targeting just one.
Second, timing is critical. The trials that showed the most promise tended to intervene early in the disease process, before significant cognitive decline had occurred. This means that people with risk factors for dementia, or those with subjective cognitive decline or mild cognitive impairment, may benefit most from early intervention.
Third, personalization matters. The trials that found positive results often did so in specific subgroups. For example, the MAPT trial found benefits in people with higher dementia risk scores and in those with amyloid-beta plaques visible on brain scans. This suggests that precision medicine approaches, which tailor interventions to individual characteristics, may be more effective than one-size-fits-all strategies.
Fourth, physical exercise was the most common component across all trials. This reinforces the importance of regular physical activity as a foundation for brain health. Cognitive training and dietary guidance were also common components.
Fifth, the safety of omega-3 fatty acid supplementation was noted as excellent. This makes omega-3 a potentially attractive option for combination with lifestyle interventions, though the cognitive benefits in these trials were not consistently demonstrated.
Limitations of the Research
The authors identified several limitations in the current body of research on combination trials for dementia prevention.
The heterogeneity of the interventions and the varying designs across the randomized controlled trials provided limited possibility to synthesize the outcomes. The trials differed in their target groups, intervention components, and outcome measures. This made it difficult to draw firm conclusions about which combinations work best.
Many trials did not show significant effects on their primary cognitive outcomes. This does not necessarily mean the interventions were ineffective. It may mean that the right populations, the right timing, or the right outcome measures have not yet been identified.
Two trials were terminated early due to the SARS-CoV-2 pandemic. This reduced the amount of data available for analysis.
Some trials did not specify how the interventions were delivered. This lack of detail makes it harder to replicate successful approaches or understand why some trials failed.
The authors note that further refinement of randomized controlled trial methodology is warranted. The methodology needs to better align with the multifaceted nature of dementia prevention and management.
Recommendations and Next Steps
Based on their findings, the authors make several recommendations for future research and clinical practice.
Future combination trials should be designed with greater attention to:
- Identifying the right target populations, including using precision medicine approaches such as genetic screening for APOE-ε4 carriers
- Determining the optimal window of opportunity for intervention, with early intervention appearing most promising
- Establishing the optimal dose and treatment duration for both lifestyle and pharmacological components
- Standardizing outcome measures to allow better comparison across trials
- Gradually introducing intervention components to facilitate adherence
- Using appropriate masking (blinding) methods to reduce bias
The authors emphasize that integrating multidomain lifestyle interventions with pharmacological treatments holds promise for advancing precision medicine approaches. These approaches aim to prevent cognitive decline and dementia by tailoring interventions to individual needs.
Existing strategies for cardiovascular and cancer treatment offer useful models for testing combination therapies in Alzheimer's disease and related dementias trials. The success of combination therapy in those fields provides a roadmap for dementia prevention research.
The World-Wide FINGERS (WW-FINGERS) network, which includes 70 member countries, offers a new paradigm to prevent cognitive decline. This global collaboration allows researchers to test multidomain interventions across diverse populations and settings.
For patients and families, the key takeaway is that no single combination has yet proven definitively effective. The strategy of addressing multiple risk factors through lifestyle changes remains the most promising path forward. This strategy is combined with targeted pharmacological or nutraceutical support. Early action, personalized to individual risk profiles, appears to offer the best chance of preserving cognitive health.
Frequently Asked Questions
Can combining lifestyle changes with medications or supplements prevent Alzheimer's disease?
No combination has yet proven definitively effective. In a review of 12 randomized trials with 4,434 participants, no single trial showed a definitive benefit on its primary cognitive outcome. Some trials found positive results in specific subgroups, particularly people at higher dementia risk. Researchers conclude that well-designed combination interventions, tailored to the right individuals at the optimal time, may effectively improve cognition.
Who might benefit most from these combination approaches?
Trials that showed promise tended to intervene early, before significant cognitive decline. Participants included people with normal cognition but increased dementia risk, subjective cognitive decline, mild cognitive impairment, or prodromal Alzheimer's disease. In the MAPT trial of 1,680 participants, positive results appeared in those with higher dementia risk scores and those with amyloid-beta plaques on brain scans, suggesting personalization matters.
What lifestyle components were tested in these combination trials?
Physical exercise appeared in all 12 trials, most using moderate-to-high intensity progressive training. Ten trials included cognitive training, and most included dietary guidance, varying between Mediterranean-like and ketogenic diets or general healthy eating advice. Five trials added social activity guidance. Four targeted cardiovascular or metabolic risk management, and three included sleep hygiene, stress management, or meditation advice.
Are omega-3 supplements safe to combine with lifestyle changes?
Omega-3 polyunsaturated fatty acid supplementation was noted as having an excellent safety profile, making it a potentially attractive option for combination with lifestyle interventions. However, cognitive benefits were not consistently demonstrated. In the MAPT trial of 1,680 participants, no significant effect on the primary cognitive outcome was reported, though positive results appeared in some subgroup analyses.
How long did these combination trials last, and how many people took part?
The 12 randomized controlled trials enrolled a total of 4,434 participants, with individual trials ranging from 35 to 1,680 people. Intervention periods lasted from 6 to 36 months. Two trials, IRMCI and SYNERGIC, were terminated early because of the SARS-CoV-2 pandemic, which reduced the amount of data available for analysis.
What does it mean that many trials found no significant effect on their primary cognitive outcome?
It does not necessarily mean the interventions were ineffective. It may mean the right populations, timing, or outcome measures have not yet been identified. The trials differed in target groups, intervention components, and outcome measures, which limited the ability to synthesize results. Researchers say trial methods need further refinement to better match the multifaceted nature of dementia prevention.
What are the next steps researchers recommend for combination trials?
Future trials should identify the right target populations, including genetic screening for APOE-ε4 carriers, determine the optimal window of opportunity with early intervention appearing most promising, and establish optimal dose and treatment duration. They should also standardize outcome measures, gradually introduce intervention components to support adherence, and use appropriate masking methods to reduce bias.
If I have mild cognitive impairment or a higher dementia risk score, when should I seek a second opinion about combining lifestyle changes with medications or supplements?
A second opinion is worth considering when you have subjective cognitive decline, mild cognitive impairment, or a higher dementia risk score, since trials such as MAPT showed cognitive benefits mainly in higher-risk subgroups and in people with amyloid-beta plaques on PET scans. Timing matters: interventions appear most promising when started early, before significant decline. Because no single combination has proven definitively effective, an independent review can clarify whether a proposed combination fits your risk profile. Diagnostic Detectives Network provides independent expert second opinions.
Source Information
Original article title: Risk reduction and precision prevention across the Alzheimer's disease continuum: a systematic review of clinical trials combining multidomain lifestyle interventions and pharmacological or nutraceutical approaches.
Authors: Bereczki E, Mangialasche F, Barbera M, Padilla P, Hara Y, Fillit H, Solomon A, Kivipelto M.
Publication: The Journal of Prevention of Alzheimer's Disease, Volume 12, 2025, Article 100367
DOI: https://doi.org/10.1016/j.tjpad.2025.100367
Received: July 9, 2025; Revised: September 2, 2025; Accepted: September 2, 2025; Available online: October 27, 2025
Author affiliations: FINGERS Brain Health Institute, Karolinska Institutet, Karolinska University Hospital, University of Eastern Finland, Imperial College London, Alzheimer's Drug Discovery Foundation, Stockholms Sjukhem
Note: This patient-friendly article is based on peer-reviewed research. The original article is an open-access publication distributed under the terms of the Creative Commons CC BY license.
