Combating Cognitive Decline

Jaser Ahmed Pallikonda Latheef, jpalliko@purdue.edu

May 26th, 2025

Edited by the YNPS Publications Team.

Specific Aims 

Cognitive decline has become a significant problem due to the growing geriatric population globally [1]. Despite advancements in the current understanding of this phenomenon, data on curing and preventing it is still lacking. This research proposal will draw on the 2014 FINGER trial as the foundation to identify knowledge gaps that can be explored and addressed in the future, and propose multidisciplinary solutions to these gaps. 

Aim 1: Tailor lifestyle interventions across distinct cultures–  

Assess the effectiveness of lifestyle interventions, specifically tailored to diverse ethnic and socioeconomic groups. The follow-up period to determine long-term effectiveness can be anywhere from 5 to 10 years, depending on the scope of the study. 

Methods: Obtain a group of subjects from different countries, implement culturally adapted and personalized diets, and track cognitive health over an extended period of time. 

Aim 2: Develop early diagnostic tools for finding cognitive decline–  

Equip subjects with wearable technology to monitor their cognitive health and identify biomarkers of cognitive decline ahead of time to prevent progression of neurodegenerative diseases like Alzheimer’s. 

Methods: Development of wearable technology for subjects that record data, which can be analyzed to derive patterns that precede cognitive decline. 

Aim 3: Analyze the effects of psychological well-being on cognitive health– 

Evaluate how an individual’s state of mind or mental health can affect cognitive health and neurodegenerative disease progression. 

Methods: Implementation of stress management techniques like biofeedback and assessing impact using control and experimental groups. 

Impact 

This research will broaden the current understanding of cognitive health, what techniques are effective in slowing it, and the development of early diagnostic tools for neurodegenerative diseases. It also integrates mental health approaches to assess the impact of psychological well-being on maintaining cognitive health. Through addressing these areas, this paper aims to improve the quality of life of the elderly and reduce the societal and economic burdens fueled by cognitive diseases. 

Abstract 

Cognitive decline is the gradual loss of cognitive abilities such as learning, remembering, paying attention, and reasoning [2]. It usually leads to difficulties navigating and solving common problems, expressing oneself in conversation, or behaving outside of social rules. 

It is an issue prevalent in the geriatric population and can also be a consequence of neurological disorders such as Alzheimer’s. As society has advanced to a point where lifespans have increased immensely, a new need has emerged to develop solutions to geriatric health problems [3].

In the past few decades, studies like the FINGER trial [4] have identified that a multifaceted approach involving nutrition, exercise, and cognitive training could drastically lower the risk of cognitive decline in at-risk older populations. 

The FINGER trial, which stands for Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability, was the first large-scale effort to maintain and reduce cognitive decline in the elderly. It made its participants adopt a healthier lifestyle and monitor their diet, exercise, cognitive ability, and other health conditions [5]. The trial was considerably successful, and the majority of the participants saw long-term improvement in health. 

Still, the trial has flaws and left many questions unanswered. FINGER mostly studied participants from Finland who did not have substantial cognitive decline. It did not consider individuals from different ethnic and socioeconomic backgrounds who have varying or more extreme cases of cognitive decline. While FINGER thoroughly monitored the health patterns of its participants, it did not follow up with them for more than 2 years, after which the state of their health could have significantly changed. FINGER also did not measure the subjects’ psychological well-being during the study, which could act as a factor in the rate of cognitive decline. 

Early diagnosis is still difficult [6]. For diseases like Alzheimer’s, current diagnostic techniques usually detect the disease only after cognitive functions have already significantly deteriorated. There is a need for more research that offers interventions like FINGER, which work on the gaps identified above, to have more accurate and directly applicable data on cognitive decline. 

Although FINGER is a step in the right direction, there are a lot of components relating to cognitive decline that it has failed to acknowledge. Similar but more ambitious studies unveiling the mechanisms behind cognitive decline have the potential to revolutionize how healthcare systems approach treating cognitive decline.

If these gaps get closed, it would also become possible to potentially mitigate the effects of cognitive decline completely, and also draw away the negative stigma tied to the elderly, subsequently reducing their economic and societal burdens. 

This paper will address the gaps left by the FINGER trial and suggest how a future study could fill these gaps and obtain new, reliable, and applicable data on cognitive decline. 

Future Directions 

These future directions are proposed for a study in the future, similar to the FINGER trial. 

Future direction 1: Study the longitudinal impact of lifestyle changes across ethnically and socioeconomically diverse populations of various ages. 

Hypothesis: Diverse lifestyle interventions adapted for different ethnic groups and backgrounds can significantly reduce the rate of cognitive decline. 

Possible tests: 

Long-term follow-up: Extend the follow-up period from 2 years in the FINGER trial to 10 or at least 5 years to observe the long-term consequences better. 

Development of inclusively tailored intervention programs: Consult nutritionists to create diet plans for people, tailored to their unique backgrounds and cultures, to maximize ease and satisfaction among subjects. Subjects from different countries will likely have unique dietary needs and genetic restrictions [7]. By doing this, the data obtained can be more standardized and applicable to a larger range of aging populations, while also making the tests easier for the subjects to follow. 

Future direction 2: Development of early diagnostic tools for cognitive decline. 

Hypothesis: Data obtained from a longitudinal study of subjects with cognitive decline can be applied in developing tools for early diagnosis of neurodegenerative diseases. 

Possible tests: 

Longitudinal biomarker identification: Identify biomarkers [8] that predict cognitive decline – they can be used in the future development of diagnostic tools. 

Wearable technology for continuous monitoring: Have subjects wear technology that monitors and records their physiological and cognitive states for future reference. There are wearable sensors such as force sensors, inertial sensors, electromyography, electroencephalography, acoustic sensors, optical fiber sensors, and global positioning systems that can monitor any progression of neurodegenerative diseases [9]. 

By doing this, the data can be actively applied to develop early diagnostic tools to detect neurodegenerative diseases like Alzheimer’s in the early stages. 

Future direction 3: Analysis on the impact of psychological well-being on cognitive health.

Hypothesis: Regularly monitoring and ensuring psychological well-being contributes to improvement in cognitive health and decreases the rate of cognitive decline.

Possible tests: 

Regular implementation of stress management techniques: Implement stress management techniques like meditation and biofeedback [10] in a group of subjects, and compare their cognitive health to a control group that does not receive the same interventions. 

Study of highly stressed individuals: Identify individuals living with high-stress conditions and introduce them to more intensive stress-management workshops, and compare their cognitive health before and after the intervention. 

By doing this, it can be deduced whether or not psychological well-being plays a major role in the rate of cognitive decline. 

Citations

[1] 

United Nations, Department of Economic and Social Affairs. (2023). World Social Report 2023: Leaving no one behind in an ageing world. 

World social report 2023: leaving no one behind in an ageing world 

[2] 

Varma, A. (2024, November 4). Understanding cognitive decline: How your brain changes as you age. Medically reviewed by Avi Varma, MD, MPH, AAHIVS, FAAFP; Written by Rebecca Joy Stanborough, MFA. 

Understanding Cognitive Decline: How Your Brain Changes as You Age 

[3]

Cleveland Clinic. (2023, May 9). Mild cognitive impairment. 

Mild Cognitive Impairment (MCI): Symptoms & Treatment 

[4] 

Ngandu, Tiia et al. The Lancet, Volume 385, Issue 9984, 2255 – 2263. 

A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial 

[5] 

Alzheimer’s Research and Prevention Foundation. (n.d.). A multidomain two-year randomized controlled trial to prevent cognitive impairment—The FINGER study (Special Report). Retrieved from https://alzheimersprevention.org/downloadables/FINGER-study-report-by-ARPF.pdf 

[6] 

Giorelli M. Current and future perspectives of an early diagnosis of cognitive impairment. Front Neurol. 2023 Apr 5;14:1171681. doi: 10.3389/fneur.2023.1171681. PMID: 37090988; PMCID: PMC10113481. Current and future perspectives of an early diagnosis of cognitive impairment – PMC 

[7] 

Zoppi, L. (2019, February 27). Genetic factors impacting nutritional requirement. News-Medical.net. Genetic Factors Impacting Nutritional Requirement 

[8] 

National Institute of Environmental Health Sciences. (n.d.). Biomarkers. Retrieved from Biomarkers

[9] 

Zhao H, Cao J, Xie J, Liao WH, Lei Y, Cao H, Qu Q, Bowen C. Wearable sensors and features for diagnosis of neurodegenerative diseases: A systematic review. Digit Health. 2023 May 16;9:20552076231173569. doi: 10.1177/20552076231173569. PMID: 37214662; PMCID: PMC10192816. 

Wearable sensors and features for diagnosis of neurodegenerative diseases: A systematic review – PMC 

[10] 

NCERT. (2015). Psychology for Class – 12. 

Meeting Life Challenges