Interview with Jesús M. Cortés: LATAM-FINGERS and the Opportunity to Prevent Cognitive Decline in Latin America

LATAM-FINGERS has turned the prevention of cognitive decline into a regional, collaborative, and scientifically ambitious conversation. In this interview, Jesús M. Cortés examines why the initiative marks a before-and-after moment for Latin America and what role NeuronUP could explore as a technological and scientific partner.

A Dialogue Between Clinical Research and Digital Technology

In the field of neurorehabilitation, the prevention of cognitive decline through multidomain interventions has become one of the major challenges and hopes of current science.

The LATAM-FINGERS project has turned this prevention effort into a regional, collaborative, and scientifically ambitious conversation, marking a before-and-after moment for Latin America. To examine the implications of this milestone in depth, this interview presents a fundamental dialogue between two complementary perspectives: clinical research and technological innovation.

Our interviewee is Jesús M. Cortés, a prominent researcher and international expert in neuroscience and brain connectivity, currently Director of Research at NeuronUP. In this conversation, Cortés breaks down the results of the recent multicenter clinical trial published in The Lancet, explaining how an intervention based on nutrition, physical activity, cognitive training, risk-factor management, and socialization achieved measurable cognitive improvements in older adults at risk of decline.

Leading the interview is Lucía Fuente Pinillos, CMO of NeuronUP. With her deep understanding of the needs of professionals who conduct cognitive assessment and stimulation, Lucía guides the conversation to explore the role digital platforms could play in this new landscape. Throughout the interview, both experts analyze how tools such as NeuronUP can be integrated as technological and scientific partners to help standardize tasks, measure outcomes, and make cognitive-decline prevention more scalable and applicable to real life.

What Is LATAM-FINGERS, Why Is It Revolutionizing Brain Health, and What Results Has It Produced?

Lucía Fuente: Jesús, why does LATAM-FINGERS deserve so much attention right now?

Jesús M. Cortés: “Because LATAM-FINGERS has demonstrated something that until recently remained an unresolved challenge: that a multidomain intervention to prevent cognitive decline can be organized and sustained in Latin America with scientific rigor, cultural adaptation, and measurable outcomes.

The trial published in The Lancet shows that a systematic intervention based on nutrition, physical activity, cognitive training, vascular risk-factor management, and socialization was feasible and produced greater cognitive improvements than a flexible health-advice intervention in older adults at risk of cognitive decline (Crivelli et al., 2026).”

The LATAM-FINGERS Clinical Trial and the Future in Latin America

Lucía Fuente: For readers who are new to this topic, can you summarize exactly what the clinical trial published in The Lancet did, what it achieved, and what implications it may have for the future?

Jesús M. Cortés: “The trial in The Lancet is a multicenter, randomized, single-blind clinical study conducted in 11 Latin American countries with adults aged 60 to 77 who did not have dementia but were at elevated risk of cognitive decline. Over two years, it compared a systematic lifestyle intervention with a flexible health-advice intervention. The systematic intervention combined nutrition, physical activity, cognitive training, vascular and metabolic risk-factor management, and support for socialization.

The important point is that it was not only feasible: 82.3% of participants completed follow-up, mean adherence was 71.6%, and the systematic-intervention group improved more on the global cognitive composite than the flexible group. Benefits were also observed in episodic memory, executive function, and processing speed, with no serious adverse events related to the intervention.

The future implication is enormous: LATAM-FINGERS provides a foundation for designing scalable, culturally adapted prevention strategies applicable to real-world health systems in low- and middle-income countries. It also opens the door to new follow-up phases, biomarker research, and collaboration with digital tools that can help measure, personalize, and sustain the intervention (Crivelli et al., 2026).”

Lucía Fuente: What changes when a study like this is conducted in Latin America rather than simply imported from other contexts?

Lucía Fuentes: What changes when a study like this is conducted in Latin America rather than simply imported from other contexts?

Jesús M. Cortés: “It changes a great deal. Latin America has a very particular combination of rapidly aging populations, social inequality, cultural diversity, varying educational levels, and a high prevalence of modifiable risk factors. The project’s early publications already highlighted this need: it was not enough to extrapolate data from other continents; it was necessary to test whether the model could be adapted to the Latin American reality (Crivelli et al., 2023; Duque Peñailillo, 2022).“

Lucía Fuente: How would you explain LATAM-FINGERS to someone without a scientific background?

Lucía Fuentes: How would you explain LATAM-FINGERS to someone without a scientific background?

Jesús M. Cortés: “I would describe it as a major regional initiative to protect brain health before dementia appears. It is not a pharmacological treatment or a miracle promise. It is a structured program that addresses several fronts at once: physical exercise, nutrition, cognitive stimulation, medical management of risk factors, and social life. The central idea is intuitive: if the risk of cognitive decline depends on many factors, prevention must also address several factors at the same time (Crivelli et al., 2023; Crivelli et al., 2026; León-Salas et al., 2024).“

Institutional Networks and Collaboration for the LATAM-FINGERS Trial

Lucía Fuente: Collaboration was an important part of the previous article. Which institutions made this initiative possible?

Lucía Fuentes: Collaboration was an important part of the previous article. Which institutions made this initiative possible?

Jesús M. Cortés: “That is one of the most powerful aspects of LATAM-FINGERS. We are not talking about an isolated center, but about a Latin American and international institutional network. The study includes institutions such as Fleni in Argentina; Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, and Universidade Federal de Minas Gerais in Brazil; Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez in Mexico; Universidad de Antioquia in Colombia; Hospital Clínico Universidad de Chile; Universidad Nacional Pedro Henríquez Ureña in the Dominican Republic; Hospital Clínica Bíblica in Costa Rica; Neuromedicenter in Ecuador; Centro Neurológico Mente Activa and Hospital de Clínicas in Bolivia; Instituto Peruano de Neurociencias; Hospital Británico and Universidad de la República in Uruguay; University of Puerto Rico; Alzheimer’s Association; Karolinska Institutet; University of Texas Health San Antonio; Alzheimer’s Therapeutic Research Institute at the University of Southern California; and Wake Forest University School of Medicine (Crivelli et al., 2026; Figueiredo et al., 2025; Friedlaender et al., 2025; Jeunon et al., 2025).“

Lucía Fuente: What do you find especially admirable about this collaboration?

Lucía Fuente: What do you find especially admirable about this collaboration?

Jesús M. Cortés: “I find it admirable that they managed to harmonize procedures without erasing local diversity. That is very difficult. The design and harmonization article describes a twofold task: on the one hand, maintaining continuity with the FINGER model and other international studies; on the other, adapting the protocol so that it was feasible and comparable across Latin American countries with very different realities (Duque Peñailillo, 2022).“

Key Cognitive Findings of the LATAM-FINGERS Trial

Lucía Fuente: What were the main results of the trial published in The Lancet?

Lucía Fuente: What were the main results of the trial published in The Lancet?

Jesús M. Cortés: “The trial assessed 1,719 people and ultimately included 1,065 participants in the analytic sample: 539 in the systematic intervention and 526 in the flexible intervention. The mean age was 67.5 years, and 82.3% completed the two-year follow-up. Mean adherence in the systematic group was 71.6%. For the primary cognitive outcome, the systematic group improved more: 0.31 standard deviations per year compared with 0.20 in the flexible group. Serious adverse events were not considered related to the intervention (Crivelli et al., 2026).”

A Closer Look at the Clinical Data: Genetics, Polypharmacy, and Cardiometabolic Risk

Lucía Fuente: What had the project’s previous publications shown before the results in The Lancet?

Lucía Fuente: What had the project’s previous publications shown before the results in The Lancet?

Jesús M. Cortés: “They showed that the project was developing very solidly. In 2022, LATAM-FINGERS was presented as part of World-Wide FINGERS, highlighting its five intervention pillars (Crivelli et al., 2023). In 2023, the study design, its harmonization strategy, and initial screening and randomization data were published (Duque Peñailillo, 2022). In Costa Rica, the local adaptation and extended follow-up were described (Crivelli et al., 2026); in Brazil, UFMG baseline data showed a high frequency of modifiable risk factors, such as hypertension, dyslipidemia, sedentary behavior, and obesity (Dutra Lima et al., 2023).”

Lucía Fuente: Several highly clinical abstracts appeared in 2025. What do they add?

Lucía Fuente: Several highly clinical abstracts appeared in 2025. What do they add?

Jesús M. Cortés: “They add depth. For example, anticholinergic burden was associated with poorer cognitive performance and a greater likelihood of a global CDR score of 0.5; each additional point on the anticholinergic burden scale increased that likelihood by 28% (Jeunon et al., 2025). The analysis of APOE and memory suggested that, in Latin America, sociodemographic factors may carry substantial weight in interpreting memory performance (Friedlaender et al., 2025). Dietary intake and body composition data from UFMG were also published, showing signals of elevated adiposity, cardiometabolic risk, and relevant nutrient deficiencies (Vieira et al., 2025).“

Lucía Fuente: And what do the data tell us about chronic diseases, polypharmacy, and genetics?

Lucía Fuente: And what do the data tell us about chronic diseases, polypharmacy, and genetics?

Jesús M. Cortés: “They tell us that LATAM-FINGERS is not limited to measuring cognition. It is building a much more complete picture of risk. In a Brazilian sample, the APOE E4 allele frequency was 25.5%, and differences were observed in executive-function tests and body mass index (Almeida et al., 2025). Another report, involving 1,243 participants, described hypertension in 44.6%, dyslipidemia in 42.8%, a mean of 2.58 medications, and polypharmacy in 18.4% (Figueiredo et al., 2025). This type of data is highly valuable for understanding prevention in real-world populations.“

Cognitive Stimulation and Digital Technology: Synergies with NeuronUP

Lucía Fuente: If we think about NeuronUP, where do you see the natural point of connection?

Lucía Fuente: If we think about NeuronUP, where do you see the natural point of connection?

Jesús M. Cortés: “NeuronUP works in an area that aligns very well with a central part of the model: structured, adaptable, and measurable cognitive training. In a multidomain intervention, the cognitive component needs tools that help standardize tasks, record use, support adherence, and enable clinical teams to monitor progress. A digital platform can be very useful there, provided it is integrated within clear scientific and ethical agreements.“

Lucía Fuente: How could NeuronUP participate?

Lucía Fuente: How could NeuronUP participate?

Jesús M. Cortés: “The collaboration could be structured through institutional agreements, research licenses, funded pilots, joint development of modules, cultural adaptation of exercises, methodological support, or projects with shared scientific objectives. What matters is that the framework be transparent: what each party contributes, what data are collected, how they are protected, how impact is evaluated, and what benefits the research, centers, and participants receive.“

Lucía Fuente: What could NeuronUP learn from such a collaboration?

Lucía Fuente: What could NeuronUP learn from such a collaboration?

Jesús M. Cortés: “A great deal. Participating in a Latin American initiative of this scale would make it possible to understand how digital cognitive interventions perform in real-world settings: varying educational levels, differences in digital access, cultural variability, heterogeneous clinical needs, and teams with different resources. This learning would help improve the platform and design more useful tools for prevention, rehabilitation, and monitoring.”

The Future of Scalable Prevention

Lucía Fuente: What final message would you like to leave us with?

Lucía Fuente: What final message would you like to leave us with?

Jesús M. Cortés: “LATAM-FINGERS is one of those initiatives that broadens the horizon. It has shown that Latin America can generate high-quality evidence on the prevention of cognitive decline, through regional collaboration, international harmonization, and clinically relevant outcomes. For NeuronUP, the opportunity lies in joining with humility and ambition: contributing useful cognitive technology, learning from the centers, and helping make cognitive-decline prevention more measurable, scalable, and closer to real life.“

References

• Almeida, L. C. B., Zima, G. F., Studart-Neto, A., Takada, L. T., Nitrini, R., & Brucki, S. M. D. (2025). Prevalence of apolipoprotein E genotypes in Brazilian sample in LATAM-FINGERS study. São Paulo Medical Journal, 143(Suppl 2), 55-56. https://doi.org/10.5327/1516-3180.CPN.1403
• Crivelli, L., Calandri, I. L., Suemoto, C. K., et al. (2023). Latin American Initiative for Lifestyle Intervention to Prevent Cognitive Decline (LATAM-FINGERS): Study design and harmonization. Alzheimer’s & Dementia, 19, 4046-4060. https://doi.org/10.1002/alz.13101
• Crivelli, L., Suemoto, C. K., Sosa, A. L., et al. (2026). Multidomain lifestyle intervention for the prevention of cognitive decline in at-risk older adults in Latin America (LATAM-FINGERS): a single-blind, multicentre, randomised controlled trial. The Lancet. Advance online publication. https://doi.org/10.1016/S0140-6736(26)01278-X
• Duque Peñailillo, L. (2022). LATAM-FINGERS: a major global initiative for dementia prevention. MetroCiencia, 30(3), 89-92. https://doi.org/10.47464/MetroCiencia/vol30/3/2022/89-92
• Duque Peñailillo, L. (2025). LATAM-FINGERS: a major global initiative for dementia prevention. Current status. MetroCiencia, 33(2), 125-127. https://doi.org/10.47464/MetroCiencia/vol33/2/2025/125-127
• Dutra Lima, D. M., Soares Figueiredo, L., Pedrosa de Menezes, A. L., et al. (2023). Latin american initiative for lifestyle interventions to prevent cognitive decline (latam-fingers): baseline characteristics of participants at UFMG, Brazil. Dementia & Neuropsychologia, 17(Suppl 2), 7. https://doi.org/10.22491/19805764/018
• Figueiredo, L. S., Jeunon, V. R., Dutra Lima, D. M., et al. (2025). Prevalence of chronic diseases and polypharmacy among older adults in latin america: the LATAM-FINGERS study. Dementia & Neuropsychologia, 19(Suppl 2), 61. https://doi.org/10.5327/RPDA25184
• Friedlaender, C. V., Cruz de Souza, L., Barbosa, M. T., et al. (2025). APOE and memory in latin america: Baseline Findings from the LATAM-FINGERS trial. Dementia & Neuropsychologia, 19(Suppl 2), 78. https://doi.org/10.5327/RPDA25234
• Jeunon, V. R., Figueiredo, L. S., Dutra, D. M., et al. (2025). Anticholinergic burden is associated with cognitive impairment in older adults at risk for dementia in latin america: the LATAM-FINGERS study. Dementia & Neuropsychologia, 19(Suppl 2), 53-54. https://doi.org/10.5327/RPDA25160
• León-Salas, J. M., Quesada-Villaseñor, R., Arguedas-Chacón, S., Quesada-Loría, D., & Zavaleta-Monestel, E. (2024). Advances in Alzheimer’s Prevention and Treatment: Costa Rican participation in the LATAM FINGERS study. Crónicas Científicas, XXVII, 7-10. https://doi.org/10.55139/ynzu1938
• Sevlever, G. E., Crivelli, L., Salinas, R. M., Charamelo, A., & Delgado, C. (2024). S4: The LATAM-FINGERS Initiative: The First Non-Pharmacological Randomized Controlled Trial to Prevent Cognitive Decline Across Latin America. International Psychogeriatrics. https://doi.org/10.1017/S1041610224001029
• Vieira, V. S., Tosatti, J. A. G., Pereira, J. D., et al. (2025). Assessment of dietary intake and body composition of Universidade Federal de Minas Gerais participants in the LATAM-FINGERS study. Dementia & Neuropsychologia, 19(Suppl 2), 59-60. https://doi.org/10.5327/RPDA25178

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