A decade of difference: cross-continental patterns of functional performance in Brazil and Europe within the WHO ICOPE framework.

The estimated that 14 modifiable risk factors account for almost 45% of dementia cases worldwide. Over the past decade, large‐scale randomized controlled trials on dementia prevention have been conducted in populations at risk for Alzheimer's disease and related dementias. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) was the first to demonstrate that a 2‐year multidomain lifestyle intervention—combining cognitive training, physical activity, nutritional counseling, and vascular risk monitoring—can preserve cognitive function in older adults at risk for dementia. Although the results of other large‐scale multidomain lifestyle intervention trials are mixed,, , , , the U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER) demonstrated that FINGER's results generalize to a larger, more diverse U.S. population. Furthermore, targeted short‐term cognitive training alone has been shown to produce durable improvements in trained abilities and to help maintain daily functioning over a decade., Meta‐analytical evidence supports the feasibility and efficacy of cognitive training to enhance cognition in older adults., Together these studies underscored a paradigm shift and established a blueprint for prevention trials grounded in modifiable risk reduction and cognitive enhancement for those at‐risk for dementia to maintain cognitive health and delay clinical progression., The potential and necessity of dementia prevention has also been recognized for Lewy body diseases (LBDs), including Parkinson's disease (PD). Cognitive decline is a frequent and debilitating non‐motor symptom for people living with PD, and up to 74% of individuals develop dementia within 20 years of PD diagnosis. The relevance of lifestyle interventions for symptom management in PD has recently been emphasized in a comprehensive review. To date, the strongest evidence for positive effects on both motor and non‐motor domains and potential disease‐modifying effects in PD has been reported for physical activity, particularly moderate‐ to high‐intensity aerobic exercise. However, interventional evidence in non‐PD LBD remains sparse and, of note, the cognitive domain is overall strongly underrepresented—both as an outcome and as an intervention target., Meta‐analyses have already demonstrated that cognitive training can yield measurable and lasting improvements in cognitive performance among people living with PD., , Digital cognitive training approaches are usually administered over short periods of 5–6 weeks, with most studies evaluating adaptive, multi‐domain cognitive training. Effects tend to be small for global cognition, but may be more pronounced for higher‐order cognitive functions such as fluid reasoning. Potential mechanisms underlying cognitive training responsiveness may include neuroplastic changes and enhanced compensatory processes, potentially contributing to cognitive reserve and resilience against neurodegeneration.