Background/Objectives: Access to specialists and diagnostic resources continues to limit differential diagnosis of cognitive impairment in primary care. This pilot study examined the feasibility, usability, and clinical integration of a digitally supported Remote Cognitive Assessment (RCA) model embedded in general practice settings. Methods: A mixed-method design was used, combining structured quantitative surveys from patients (n = 10; mean age = 77.03; SD = 14.1) and neuropsychologists (10 RCAs completed by three neuropsychologists) with qualitative interviews from general practitioners (GP; n = 4). Patients were assessed remotely via a secure videoconference system operated by trained neuropsychologists. Assessments were conducted in the GP’s office, supported by local staff, to facilitate the process. Results: Patients reported high satisfaction with audio (M = 8; SD = 2.28) and video quality (M = 9.17; SD = 1.17) and expressed a strong willingness to recommend RCA (M = 8.83; SD = 1.17) on a 10-point Likert scale. Despite moderate scores for perceived simplicity (M = 5; SD = 3.41) and effectiveness (M = 5.83; SD = 2.14), overall acceptance (M = 8.33; SD = 0.82) was favorable, especially given the older age of participants. Neuropsychologists rated technical functionality positively (audio quality M = 8.17; SD = 1.18; video quality M = 8; SD = 1.67) but raised concerns about clinical utility and diagnostic depth (effectiveness M = 2.83; SD = 2.71). GPs highlighted the benefits of local facilitation, early screening, and improved access to specialist input while also noting space limitations, communication gaps, and the need for sustainable infrastructure. Conclusions: The RCA model was well accepted by patients and GPs, and technically feasible for neuropsychologists. However, neuropsychologists reported important reservations regarding usability and effectiveness. The results suggest an important mismatch between patient satisfaction and clinical confidence and RCA cannot yet be recommended for routine clinical implementations based on patient acceptability alone. This model holds promises for hybrid cognitive care, particularly in underserved or rural areas, but future development must prioritize diagnostic confidence and clinician workflow usability before scalable integration into rural cognitive care pathways can be established.

Early lifestyle interventions may reduce dementia-related cognitive decline, but individuals with cognitive impairment often face barriers to accessing and maintaining such interventions. Smartphone applications and wearables may offer low-burden, real-time support. This study examined the feasibility and acceptability of a two-week sensor-augmented just-in-time adaptive intervention (JITAI) delivered via smartphone-based conversational agents (CAs) and a wearable fitness tracker in older adults with mild cognitive impairment (MCI). In this single-arm, feasibility study, 24 MCI participants (mean age: 75.9 years) used the intervention with a rule-based CA delivering two daily JITAI interventions: (1) a sensor-informed primary physical-activity component, in which continuously collected step-count data from a wrist-worn fitness tracker (Garmin Vivoactive 6) were used to assess vulnerability against a personalized step goal and deliver tailored walking prompts; and (2) an ecological momentary assessment-based secondary health-promoting component targeting one of six additional health domains (hydration, nutrition, cognitive exercise, sleep, social engagement, movement), assessed via momentary self-report. Both components followed the same JITAI decision logic: vulnerability assessment in the afternoon, receptivity evaluation if vulnerable, tailored prompt delivery if receptive, and adherence assessment at an evening check-in. Post-intervention questionnaires assessed technology acceptance, usability, working alliances and qualitative feedback. Across the study period, engagement with the CA was high for both components. Afternoon response rates were 86.6% for the primary physical-activity component and 84.2% for the secondary health-promoting-activities component. Evening check-in response rates were 85.6% and 79.3%. Among all responses classified as vulnerable (38.7% and 32.1% of afternoon interactions on the physical-activity and secondary-activity components, respectively), 85.4% and 75.9% were receptive, of which 76.6% and 70.7% resulted in adherence at the evening check-in. On days satisfying the full JITAI chain for physical activity, participants exceeded their personalized step goal, reaching a mean of 170% of goal (SD ± 95) and a mean evening step count of 7,718 steps (SD ± 3,453). The wearable-based data acquisition pipeline was feasible and largely reliable under study conditions, with the Garmin device supplying step-count data in 80.8% of decision points, the smartphone in 17.4%, and manual self-report required in only 1.8% of cases. Participants rated the CA favorably across all technology acceptance and usability domains, with all mean scores above the neutral midpoint on seven-point Likert scales. Qualitative analysis described an intervention experienced as accessible and structuring. This pilot study supports the short-term feasibility and acceptability of integrating wearable-derived step data into a smartphone-based CA-delivered JITAI for older adults with MCI. Passive sensing may support personalized intervention delivery while reducing reliance on self-report. However, as a feasibility study, it was not designed to provide evidence of efficacy. Controlled studies with adaptive decision times, sensor-derived baselines, and more diverse samples are needed to evaluate efficacy and sustained behavioral benefits. NA

Background Fear of falling (FoF) is common in assisted living facilities (ALFs) and contributes to reduced mobility and well-being. Cognitive Behavioral Therapy (CBT) and exercise interventions are effective, but no culturally adapted programs exist for German-speaking ALFs. Objectives To evaluate the feasibility of a CBT–exercise intervention, Aktiv Gegen Sturzangst (AGES), in ALFs and to generate preliminary outcome estimates to inform a future randomized controlled trial. Methods A single-arm pilot trial was conducted in three ALFs with 19 participants (mean age = 84 years). AGES comprised eight weekly group sessions led by trained leaders. Feasibility was assessed by recruitment, retention, fidelity, and outcome measure completion. Outcomes included Falls-efficacy scale international (FES-I), World Health Organisation 5 questionnaire (WHO-5), the Timed Up and Go test (TUG), and Lidar-based gait analysis. Results Feasibility was demonstrated by 100% retention and fidelity. FES-I and WHO-5 outcomes suggest trends towards improvement. A trial with at least 200 participants would be likely necessary for statistical certainty. TUG scores improved significantly (p = 0.032). Gait analysis showed small improvements in participants without walking aids. Conclusion AGES was feasible and well delivered in ALFs. Lessons learned include the need to strengthen recruitment, adapt psychological components, and refine gait analysis methods, to allow for measurements among walking aide users. A larger trial is warranted.

INTRODUCTION:Cognitive complaints are often considered early indicators of Alzheimer's disease (AD) and commonly lead to memory clinic consultations. Prior studies suggest stronger associations between cognitive complaints and mood than with objective cognition, but this interplay remains poorly understood. Using a machine learning-supported approach, we aimed to (1) identify key predictors of cognitive complaints, and (2) compare the value of gamified versus standard neuropsychological testing in detecting subtle deficits. METHODS:In this international multi-center study, 98 participants (57 females; mean age 71.9, range 55-86) from three memory clinics completed the Cognitive Failures Questionnaire (CFQ), mood and apathy questionnaires, the tablet-based gamified Adaptive Cognitive Evaluation Explorer (ACE-X), and standard neuropsychological tests. Predictors of CFQ scores were examined using elastic net regression and the Boruta algorithm, followed by linear mixed-effects modeling. RESULTS:Greater mood symptoms were associated with more cognitive complaints, whereas increasing age was linked to fewer complaints. Study center accounted for additional variance. The final model explained a substantial proportion of variance (conditional R2 = 0.48, marginal R2 = 0.33). Participants had lower z-scores on ACE-X compared to standard testing, but neither predicted the severity of cognitive complaints. DISCUSSION:Mood and age were main predictors of cognitive complaints in memory clinic patients. Although ACE-X yielded lower normative scores than standard tests, neither cognitive measure was linked to complaints. These findings highlight the importance of systematically assessing mood, adopting personalized approaches when evaluating subjective and objective cognition, and the potential value of gamified assessments for screening populations at risk of AD.

With an aging population, cognitive impairments and dementia pose significant challenges. Accurate diagnosis and treatment are crucial, yet access to specialized dementia screening clinics remains limited, especially in rural and remote areas. Telemedicine presents a promising solution by offering accessible opportunities for cognitive testing. This pilot study examines the subjective experiences of elderly with cognitive decline using telemedicine for an initial dementia screening, emphasizing their perceptions and feelings toward digital technology, particularly in the context of remote cognitive assessments as a patient-centered approach to dementia screening. This ongoing pilot study utilizes telemedicine to conduct remote cognitive assessments via videoconferencing platform, which is specifically designed to support a full range of neuropsychological tests, facilitating the early detection of cognitive decline and monitoring cognitive performance. Data are collected to evaluate acceptability and user experience, focusing on the subjective perceptions of both participants and clinicians in remote memory clinic settings. Acceptability and user experience are measured using questionnaires scored on a Likert scale (1-10) offering valuable insight into telemedicine experiences. Participants ( n  = 10) reported high satisfaction scores for overall experience (8.33), video quality (8.39), and audio quality (8.19). In contrast, clinicians highlighted challenges, particularly with technical setup (4.13) and interaction quality (5.5). Data collection is expected to conclude by June 2025, providing a more comprehensive dataset for further analysis. Preliminary findings from this pilot study emphasize the potential of video-supported remote diagnostics to expand access to dementia assessments in rural and underserved areas. High satisfaction ratings from participants demonstrate the feasibility of providing timely and comprehensive care while alleviating the need for long-distance travel. However, challenges reported by clinicians, highlight the need for further refinements to improve usability and enhance clinician-patient interactions. Future efforts should prioritize optimizing platform interactivity and streamlining the technical setup process to boost clinician satisfaction and minimize workflow disruptions. With these improvements, the system has the potential to address healthcare disparities in rural regions effectively.

BACKGROUND:Socio-cognitive assessment in neurocognitive disorders (NCDs) is rare in clinical practice and no consensus exists as to a uniform operationalization of socio-cognitive measures for NCDs in memory clinics. The SIGNATURE initiative aims to optimize the use of socio-cognitive measures in memory clinics, defining expert recommendations. We report consortium guidelines for the use of socio-cognitive measures in NCDs based on available evidence from the literature and the current state of practices in memory clinics. METHODS:Using a Delphi consensus method supported by a literature review and the results of an international survey, 22 specialists defined recommendations for the context of use, relevance in NCD diagnosis, priorities for future research and facilitators/obstacles of socio-cognitive assessment in major and mild NCDs. RESULTS:Overall, panelists recommended social cognition testing in routine diagnostic assessment to evaluate both socio-cognitive and socio-behavioral alterations. A set of clinical, methodological, implementation and external factors facilitating or hampering the use of socio-cognitive tasks was identified. CONCLUSIONS:This is the first focused endeavor to favor the implementation of socio-cognitive assessment, which is required by DSM-5 but seldom performed despite clear evidence of its clinical relevance for diagnosis and care. Our results provide an initial set of recommendations, refinable through the future actions of the SIGNATURE initiative. Future collaborative clinical research projects should overcome current limitations and foster the use of ecological and cross-culturally validated measures in clinics.

Dementia diseases represent a major burden for the directly affected people, their relatives and modern society. Despite considerable efforts in recent years, early and accurate disease diagnosis and monitoring is still a challenge while no cure is available in most cases. New drugs, in particular disease-modifying therapies, and recent technological advancements offer promising perspectives. The integration of novel biomarkers, artificial intelligence and digital health tools has the potential to transform dementia care, making it more personalised, efficient and adapted to the living conditions and needs of older people. In November 2023, the 7th Dementia Summit convened a panel of experts from geriatrics, neurology, neuropsychology, psychiatry, ethics as well as general medicine to discuss interdisciplinary challenges, advancements and their implications for the future of dementia care in Switzerland. The conference underscored the importance of a multidisciplinary approach to successfully integrate new technologies in both clinical-translational research and dementia prevention, diagnosis and care. While recent innovations represent major steps forward, their implementation also comes with important challenges including questions on healthcare system preparedness and adaptation, ethical aspects, technology literacy, acceptance and appropriate use.

Non-pharmacological interventions are pivotal to reducing neuropsychiatric symptoms (NPS) in patients with cognitive impairment. This systematic review assessed the effectiveness of non-pharmacological interventions applicable by nursing staff to reduce NPS in older patients with cognitive impairment hospitalised for behavioural crises. Six databases were searched for randomised or non-randomised controlled trials. Two authors screened full-texts and assessed the quality of the studies using the Modified Downs and Black Checklist. Results were presented narratively using the PRISMA guideline. Only five studies could be included, all were conducted in geriatric psychiatry. Three studies showed significant effects on NPS. They tested physical exercise, behavioural activation for meaningful activity and listening to individualised music and were of good, moderate and low quality, respectively. The best evidence was found for physical exercise. Due to the small number of studies with heterogeneous quality, the results must be interpreted with caution, limiting the scope of conclusions. While more research is needed, we recommend that non-pharmacological interventions in clinical practice be adjusted to patient characteristics, contextual factors and existing care practices.

Sensor-based surveillance technology (SST) is increasingly employed in the care of people with dementia (PwD) in hospitals, nursing homes, and home care. With improved functionality and availability of SST, there will likely be a growing utilization in clinical settings. In the context of staff shortage, the expected resource-efficient safety benefits are attractive but must be critically balanced against concerns that basic ethical principles are violated. In this discussion paper, we provide a brief overview of frequently used SST and discuss ethical issues associated with their use. We identify intrusion into privacy and the complex interaction between stakeholders as the biggest challenges. Moreover, the frequent lack of decision-making capacity in PwD poses particular ethical challenges. Evidence concerning safety benefits exists mostly for the detection of patients leaving the intended area (i.e., getting up, leaving the premises) or occurring falls. The level of privacy intrusion to detect occurring falls varies widely between different sensor systems. Finally, we propose best practice recommendations for the clinical implementation of SST in the care of PwD, and we address the circumstances under which the use of sensors can be ethically justified despite the absence of legally valid informed consent.

Background: Alzheimer's disease (AD) clinically manifests in cognitive decline and frequent neuropsychiatric symptoms (NPS). Objective: The Omics-AD study's scope is to perform an in-depth multi-modal and longitudinal characterization of people with early AD to a) better understand pathophysiological changes of AD and b) identify new biomarkers for AD and AD-related clinical manifestation and progression, with a focus on NPS. Methods: Participants in this prospective study were recruited at four Swiss memory-clinics. Comprehensive cognitive and neuropsychiatric assessments were performed at baseline and follow-up. Paired blood and cerebrospinal fluid (CSF) samples along with structural MRI were obtained at baseline. Established CSF AD biomarkers were analyzed. Untargeted omics and targeted molecular analyses will be performed and integrated in multi-modal, multi-omics data analysis. Results: We included 456 participants (mean age 71.2 years, 55.1% female), of which 48.5% were cognitively unimpaired (with no cognitive complains, NC, or with subjective cognitive decline, SCD) and 51.5% cognitively impaired (mild cognitive impairment, MCI, or mild clinical AD dementia). Half of the participants presented with NPS as measured by the Neuropsychiatric Inventory Questionnaire (48.5%) or the Mild Behavioral Impairment Checklist (52.7%). The most common symptoms were irritability (18%) and depression (17%). In total, 41.0% (n = 155) of participants were amyloid positive (20.6% of CN, 21.7% of SCD, 55.4% of MCI, and 72.4% of clinical AD dementia). Conclusions: This multi-centric well-characterized cohort allows for single-and multi-omics analyses to investigate in depth molecular and biological pathway alterations in AD and their relationships with clinical manifestation and progression, with a particular focus on NPS.

Background: Dementia is projected to impact 152 million people by 2050, making it one of the most pressing global health challenges. The neurodegenerative process initiates well before clinical symptoms manifest, advancing from subjective cognitive decline (SCD) to mild cognitive impairment (MCI) and ultimately to dementia. Despite the growing prevalence, awareness of dementia prevention is limited, and many individuals express a desire to cease living upon diagnosis. Lifestyle interventions can mitigate cognitive decline, but there is a need for effective, scalable approaches to deliver these interventions to older adults. Digital health interventions, such as app-based just-in-time adaptive interventions, offer a promising solution, but their application in cognitively impaired older populations remains underexplored. Objective: This formative study evaluated the plausibility, acceptability, and adherence to a smartphone-based just-in-time adaptive digital lifestyle intervention delivered by a rule-based conversational agent (CA) among older adults with SCD or MCI. The primary focus was on adherence to the CA-initiated conversational turns (measured objectively via interaction logs), and secondary objectives included perceptions of technology acceptance, working alliance with the CA, self-reported adherence to the suggested health-promoting activity, and feedback for future improvements (through a questionnaire and short interview). Methods: This monocentric study investigated 15 participants (mean age 70.3, SD 5.01; 10 female and 5 male participants) with SCD (n=12) or MCI (n=3). Participants used the study app that delivered daily health-promoting activities through a CA over 2 weeks. Participants received notifications to engage in 7 health-related activities, and adherence to the activities was self-reported. Post intervention, participants rated their experience with the app and assessed their working alliance with the CA through the 6-item session alliance inventory. Data on smartphone use, demographic information, and cognitive performance (via Montreal Cognitive Assessment) were collected during a preintervention visit. Results: Participants rated the study app positively, especially regarding ease of use and a subset of the working alliance. Adherence to the CA-initiated conversational turn was measured at an average of 81% across 14 days. In total, 27% (mean 4.07, SD 2.27) of participants indicated being vulnerable, and 100% then responded with their state of receptivity, of which 83% (mean 3.14, SD 1.61) were receptive to completing the activity, and 69% (mean 2.86, SD 1.70) self-reported adherence to the activity. There was no significant decline in adherence across the study period. Qualitative results support these findings and present two emerging themes: app enjoyment and enhancing engagement. Conclusions: This study demonstrates that smartphone-based just-in-time adaptive interventions are feasible and generally well-accepted by older adults with SCD or MCI. However, the findings underscore the need for robust technological infrastructure and potential personal assistance to optimize adherence. Future interventions could benefit from integrating wearables to improve real-time engagement and accurately monitor adherence, ultimately supporting healthy aging and cognitive health in older populations.

Background:Therapeutic drug monitoring (TDM) is an important tool to personalize psychopharmacotherapy, thereby optimizing its effectiveness and tolerability. Despite consensus on medications, indications, and implementation of TDM, reports indicate a substantial gap between theory and practice. To further investigate this gap, the current application of TDM was assessed in the adult inpatient settings of the University Hospital of Psychiatry and Psychotherapy of Bern, Switzerland. Methods:To assess current practice in TDM, drug level measurements were analyzed in 2022. In parallel, an online survey as well as standardized interviews were conducted with the clinic's physicians. To improve TDM applications, a handout was designed with the core items of the TDM guidelines, revised the orders for TDM in the hospital information system, and held an internal lecture on TDM. Results:In clinical practice, TDM was primarily used for clozapine, lithium, and valproate. Other drugs appear to be underrepresented. Although physicians generally rated their knowledge of TDM as good, they identified the need for improvement in medical knowledge. The main source of error in TDM was the incorrect timing of blood samples. There was disagreement among the physicians about the number of TDMs. Conclusion:Therapeutic drug monitoring is well established for clozapine, lithium, and valproate. Compared to the international consensus, physicians applied TDM to a narrower spectrum of psychotropic drugs. Efforts are needed to improve TDM. To optimize TDM, a handout was created, and the TDM request was adapted in the hospital according to guidelines recommendations based on findings of TDM requests, the survey, and interviews.

PURPOSE:Negotiating the balance between clinical residents' roles as health care practitioners and learners is a struggle in postgraduate medical education. Although ad hoc entrustment has been studied in this context, little is known about residents' perceptions of ad hoc over- and underentrustment, the need for supervision, and their coping strategies. Therefore, this study explored residents' perspectives concerning these topics. METHOD:The authors conducted semistructured, in-depth interviews with 12 purposively sampled residents in the graduate medical educational phase of residency who were involved in geriatric psychiatry rotations from different training sites and settings in Switzerland. The interviews were conducted between January and March 2022. Researchers used a thematic analysis to explore and interpret the data within a constructivist research paradigm. RESULTS:Four overarching themes were identified: ad hoc and default entrustment in the workplace, perceptions of supervision, applied coping strategies to over- and underentrustment, and suggestions for improvement. Residents described entrustment decisions in the workplace as a default, often covert process and as an explicit, ad hoc delegation of clinical tasks. Perceived optimal supervision entailed sufficient time, frequency, and availability of the supervision, supervisors referring to scientific evidence in their reasoning, trustworthiness, and a psychologically safe learning environment. Residents described suboptimal supervision as lacking appropriate feedback timing, having little or nonexistent time in general, using an ambivalent communication style, and clinical decision-making by the supervisor that is not explicit. Residents applied instrumental, appraisal-focused, and emotion-focused coping strategies. Their suggestions for improvement included instructional design of the workplace-based curriculum, supervision, teaching content, and contextual factors. CONCLUSIONS:Within postgraduate training, addressing the organizational and contextual factors of entrustment and resident supervision is essential. Default entrustment decisions need to be explored and explicitly addressed to prevent overentrustment, meet residents' need for supervision, and effectively coach residents to maintain their well-being.

Introduction Computerized cognitive training (CCT) represents promising solutions for remote training of cognitive abilities in older people with cognitive decline. In the present article, we tested the feasibility and acceptability of a CCT performed at home via a telehealth platform, with participants connected remotely to a clinician, in comparison to an in-person CCT. Methods Thirty participants took part in the study. Twelve participants opted for classical in-person training and met a neuropsychologist twice a week for 12 weeks, for a total of 24 30-minute sessions. Eighteen participants opted for the remote home-based training and met with the clinician virtually via a telehealth system at the same frequency and duration. The intervention consisted of a serious-game platform training memory, spatial abilities, and executive functions. All participants underwent a neuropsychological and clinical assessment before and after the training. Results Results showed a high adherence to training and a strong acceptability in both the remote and the in-person groups. A significant improvement in mental flexibility and planning abilities was observed in both groups (as measured by the Zoo planning test), but no other neuropsychological tests showed improvement. Discussion This non-randomized study suggests the feasibility and acceptability of the telehealth CCT intervention. When participants are able to select their preferred intervention modality, training adherence and efficacy are comparable between remote and in-person delivery. Future studies should be performed to verify which are the most effective intervention parameters, such as training frequency and duration.

Subjective cognitive decline (SCD) and Mild Cognitive Impairment (MCI) have predictive value towards Alzheimer's Disease and lend themselves as target for non-pharmacological preventive interventions such as serious game-based computerized cognitive training (CCT). However, investigations of CCT show heterogenous results in slowing age-and disease-related cognitive decline and adherence to training protocols remain a challenge. The aim of this RCT was to comprehensively evaluate CCTs’ effectiveness, integrating control conditions and neurophysiological as well as blood-based biomarkers. In this bi-centric RCT with parallel groups, 155 participants (mean age 72.2) with cognitive impairment ranging from SCD to MCI were randomized to three arms, comparing CCT to an active control condition (watching documentaries) and a waitlist control condition. Both active arms entailed a three-month intervention period comprising a total of 60 at-home sessions (5 sessions per week) and weekly on-site group meetings. To assess longitudinal effects, the intervention group only completed additional 6 months of at-home training with monthly on-site booster sessions. Biological effects were measured by amyloid blood markers and magnetic resonance imaging obtained before and after training. Significant improvement over time was observed in aggregated domain specific composite scores of episodic and semantic memory and spatial abilities. However, there was no significant interaction between groups and timepoints. Adherence to the training protocol was consistently high across timepoints and groups (4.87 sessions per week). Voxel-based morphometry revealed no significant changes in grey matter volume following CCT, nor did amyloid levels moderate its effectiveness. Significant cognitive and subjective improvements were observed after long-term training. This RCT indicates no specific advantages of a three-month CCT intervention on cognitive or biological outcomes. However, the consistently high adherence rates observed in this study highlight the importance of designing interventions that align with personal relevance and individual values, particularly in subjects with SCD and MCI who demonstrated high motivation to engage in healthy aging behaviors. Further, positive effects were observed subjectively and after long-term CCT, warranting the inclusion of CCT in multicomponent interventions.

Dementia represents a significant global health challenge, necessitating innovative prevention strategies. Lifestyles aimed at reducing dementia risk typically combine physical and cognitive training, nutritional adaptations, and social engagement. However, sustainable lifestyle changes require robust motivation and volition. Acting in accordance with one's values enhances motivation, as values are intrinsically rewarding and create stable behavior-outcome relationships. Despite the efficacy of well-structured interventions like FINGER, long-term adherence remains a challenge, with fewer than half of participants completing all intervention components. We developed a value-based motivational framework integrated with digital tools, including smartphone-based reminders, ecological momentary assessments, and just-in-time adaptive interventions (JITAIs). Further, we assessed feasibility of digital tools in older adults with subjective or mild cognitive decline in a feasibility study ( n  = 15). Our framework is designed to align individual preferences and values with lifestyle goals, employing motivational interviewing and SMART goal-setting techniques. We previously implemented this approach as a manualized consultation in the memory clinic and now evaluate the effects of smartphone-delivered personalized, value-based communication styles compared to neutrally framed statements on the intended adherence to dementia preventive behaviors. The feasibility pilot demonstrates that smartphone-based JITAIs are feasible, well adhered to and generally well-accepted by the target population. Preliminary findings of the in-clinic consultations indicate the potential of value-based motivational strategies to improve intended adherence to lifestyle changes. The quantitative assessment of the impact of positively framed value-based motivational strategies on participants' adherence to a dementia-preventive lifestyle is currently ongoing. Value-based motivational strategies, supported by digital tools and positively-framed communication, hold high potential for fostering adherence to dementia-preventive lifestyle changes. These approaches are clinically relevant and resource-efficient, making them suitable for integration into large-scale prevention programs. By leveraging motivation and volition, this framework addresses key barriers to long-term behavior change and contributes to healthy aging. The anticipated findings will provide valuable insights into effective strategies for promoting healthy aging and may inform future public health interventions aimed at this vulnerable population.