Tailored Exercise Interventions for Dementia Prevention: bridging research evidence and primary care practice.

Dementia is a major cause of disability worldwide. The TEIDe project aims to prevent dementia by combining the following different approaches I) Predictive Medicine; At present models to predict dementia risk are based on factors like sociodemographic, cognitive, imaging, biomedical, and genetic variables. However, many scores are difficult to use in primary healthcare and have limitations such as lack of external validation and specificity. The goal of this project is to implement scalable preventive screenings and shift the paradigm in dementia care. II) Precision Medicine; Research shows that up to 40% of dementia cases could be prevented by targeting key risk factors, including physical inactivity. TEIDe will identify the optimal doses and types of exercise that confer cognitive benefits based on individual patient characteristics, which will facilitate prescription of tailored exercise interventions in primary healthcare. III) Mechanistic Approach; The limited understanding of the mechanisms by which exercise impacts brain health in late adulthood hinders the widespread use of exercise as a therapeutic or preventive approach for dementia. TEIDe will investigate how different types of exercise improve cognitive function, helping to use exercise more effectively as a preventive measure. IV) Clinical Approach; TEIDe will test the feasibility of screening patients at high risk of dementia, prescribing tailored exercise for at-risk patients, and implementing in-person exercise interventions based on defined prescription in real-life healthcare settings.

Dementia is a leading cause of disability globally. TEIDe will combine predictive, precision, mechanistic, and clinical application approaches for the effective prevention of dementia. Predictive medicine; At present models to predict dementia risk are based on factors like sociodemographic, cognitive, imaging, biomedical, and genetic variables. However, many scores are difficult to use in primary healthcare and have limitations such as lack of external validation and specificity. The goal of this project is to implement scalable preventive screenings and shift the paradigm in dementia care by (i) identify scores for all-cause and specific types of dementia using accessible data; (ii) validate these scores in different populations; and (iii) assess their feasibility for screening high-risk individuals in primary care. Precision medicine: Up to 40% of dementia cases may be prevented by targeting 12 key risk factors, including physical inactivity. However, research is needed to identify the optimal doses and types of exercise that confer cognitive benefits based on individual patient characteristics, which will facilitate the rapid prescription of tailored exercise interventions in primary healthcare. Mechanistic approach; The limited understanding of the mechanisms by which exercise impacts brain health in late adulthood hinders the widespread use of exercise as a therapeutic or preventive approach for dementia. Thus, research is needed to elucidate the mechanisms by which resistance or aerobic exercise improves cognition. Clinical approach: There is a need to establish the real-life applications of these potential screening strategies and exercise interventions. TEIDe will test the feasibility of: (i) screening patients at high risk of dementia; (ii) prescribing tailored exercise for at-risk patients; and, (iii) implementing in-person exercise interventions based on defined prescription.