With many societies around the globe experiencing increasing longevity, one challenging research question of our times is how to reduce the risk of cognitive decline in old age. Modifiable risk or protective factors for Alzheimer disease (AD) are of specific interest, because probably up to half of AD cases worldwide are potentially attributable to modifiable factors.1 It has been estimated, for example, that up to 1 million AD cases could be prevented globally if a 25% reduction in physical inactivity could be achieved in the world population.1 Although the body of literature on this topic is substantial, randomized controlled trials (RCTs) involving older adults at increased risk of cognitive decline are still quite sparse, and RCTs that combine more than a single protective lifestyle factor in their intervention are even less common.
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