TL;Dr.: In a study published in JAMA, Baker and colleagues compared the cognitive impact of two 2-year lifestyle interventions in older adults at risk of cognitive decline and dementia. The trial was conducted at five clinical sites in the United States, and involved 2,111 participants aged 60 to 79 with sedentary lifestyles (mean age, 68.2; 68.9% female). Participants were randomly assigned to a structured or self-guided intervention, with both interventions encouraging physical activity, cognitive activity, healthy diet, social engagement and cardiovascular health monitoring, though they differed in terms of intensity, structure and accountability. 89% of participants completed the 2-year assessment, with results showing improvements in the mean global cognitive composite z score from baseline with both interventions; the mean rate of increase per year was significantly greater for the structured group. Fewer adverse events were reported in the structured group.