Researchers say faith-based programs are promising avenue to reduce dementia risk

Anna Maria Branciano, a professor of psychology at Harvard Medical School and director of the Center for Health Outcomes and Interdisciplinary Research at Massachusetts General Hospital, told the National Plan advisory council that about 45 percent of dementia cases "could be delayed or reduced by addressing modifiable risk factors across the lifespan." She urged testing prevention interventions in faith-based communities because of those institutions' deep community ties and existing infrastructures.

Branciano said faith-based organizations can reach underserved groups, align health messaging with spiritual values, and use existing meeting rhythms and volunteer networks to deliver multicomponent lifestyle interventions that target physical activity, diet, smoking cessation and engagement with medical care. "Faith based organizations are uniquely positioned to serve as effective settings for dementia prevention interventions due to many factors," she said, adding that such programs may be lower cost and better sustained than creating entirely new delivery systems.

The council heard that systematic reviews show preliminary benefits from lifestyle interventions but that direct evidence for preventing dementia is limited. Branciano summarized three recent systematic reviews and her group's 2024 review of 79 randomized trials of mindfulness-based lifestyle interventions, which found moderate improvements in targeted lifestyle factors but noted that most trials did not measure cognitive outcomes directly. She said most published trials are short, heterogeneous in design, and poorly representative: only 62 percent reported race and ethnicity, and most of those enrolled primarily white participants.

Speakers and participants discussed lessons from the reviews: interventions most often succeeded when clergy or lay leaders were engaged, programs were tailored to cultural and spiritual contexts, social support and peer leaders were used, and interventions were integrated into existing congregation activities. Branciano recommended that future studies measure cognition and dementia incidence directly, test theoretically driven mechanisms of behavior change, lengthen follow-up periods, enroll diverse populations (including immigrants, Latinos, rural residents and men), and study cost-effectiveness and sustainability.

During Q&A, council members pressed a funding question: where long-term cohort or intervention follow-up dollars might come from. Richard Hodes of the National Institute on Aging (NIA) urged investigators to consult NIH program officers, saying program staff are interested in these research areas and can advise on mechanisms. Branciano said grant structures such as R01s can be leveraged but that funding mechanisms that allow quicker transitions from pilot to longer follow-up would help.

Why this matters: Lifestyle interventions are low-cost, low-risk ways to reduce multiple dementia risk factors if they can be delivered at scale and sustained. The presenters emphasized that faith-based settings may help reach communities at higher risk, but they also cautioned that stronger, longer trials with direct cognitive outcomes and more diverse enrollment are needed before concluding dementia incidence can be reduced.

The risk-reduction subcommittee scheduled a final 1-hour session later in the year to focus on translating chronic-disease interventions from research into community practice.