Original Research Focus on Geriatric Psychiatry January 7, 2026

Effects of a Digital Multidomain Cognitive Intervention in Older People at High Risk of Dementia: A Randomized Clinical Trial

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J Clin Psychiatry 2026;87(1):25m15860

Abstract

Objective: To evaluate the effects of a 6-month digital multidomain cognitive intervention on cognitive function and psychosocial outcomes in older adults at high risk of dementia.

Methods: A 2-arm, randomized clinical trial was conducted at Fujian Provincial Hospital and 4 community health care centers (April 2024 to December 2024). Participants (N=166, aged ≥60 years, modified dementia risk score >79) were enrolled and randomized 1:1 to a 6-month digital multidomain cognitive intervention and control group. Primary outcomes included general cognitive function (Montreal Cognitive Assessment [MoCA]) scores; secondary outcomes covered memory (Rey-Osterrieth Complex Figure Test [ROCFT] and Auditory Verbal Learning Test), language (Verbal Fluency Test and Boston Naming Test), executive function and attention (Shape Trails Test), visuospatial skill (ROCFT), mobility (Activity of Daily Living and Berg Balance Scale), psychosocial status (15-item Geriatric Depression Scale, Zung Self-Rating Anxiety Scale, UCLA Loneliness Scale, and Quality of Life-Alzheimer’s Disease), and health-promoting behaviors (Health-Promoting Lifestyle Profile II and Self-Rated Abilities for Health Practices). Intention-to-treat analysis with random forest imputation was performed.

Results: A total of 154 participants (92.77%) completed the trial. Compared to the control group, the intervention group demonstrated significant improvements in general cognitive function, visuospatial memory, and loneliness, including MoCA (t=2.106, P=.037), ROCFT immediate and long-delay recall (Z=−2.789, P=.05; t=2.797, P=.05), and UCLA Loneliness Scale (Z=−2.641, P=.008). No statistically significant between-group differences emerged in other indicators.

Conclusion: A 6-month digital multidomain intervention significantly enhanced general cognitive function and visuospatial memory and reduced loneliness in older adults at high risk for dementia. These results highlight the potential of WeChat-based delivery models to provide feasible, acceptable, and widely applicable solutions for dementia risk reduction in aging populations.

Trial Registration: ClinicalTrials. gov identifier: NCT06442943.

J Clin Psychiatry 2026;87(1):25m15860

Author affiliations are listed at the end of this article.

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  1. Chinese Dementia and Cognitive Impairment Guideline Writing Group, Cognitive Impairment Diseases Professional Committee of Chinese Society of Neurology, Chinese Medical Association. 2018 Chinese Guidelines for Diagnosis and Treatment of Dementia and Cognitive Impairment (I): Dementia and Its Classification Diagnostic Criteria. Chin Med J. 2018;98:965–970.
  2. Cahill S. WHO’s global action plan on the public health response to dementia: some challenges and opportunities. Aging Ment Health. 2020;24(2):197–199. PubMed CrossRef
  3. Parsons C, Hughes C, McGuinness B, et al. Withdrawal or continuation of cholinesterase inhibitors and/or memantine in patients with dementia. GroupCochrane Dementia and Cognitive Improvement Group. 2021. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.pub2/full.
  4. Ho RTH, Fong TCT, Chan WC, et al. Psychophysiological effects of dance movement therapy and physical exercise on older adults with mild dementia: a randomized controlled trial. J Gerontol B Psychol Sci Soc Sci. 2020;75(3):560–570. PubMed CrossRef
  5. Sun M, Mainland BJ, Ornstein TJ, et al. The association between cognitive fluctuations and activities of daily living and quality of life among institutionalized patients with dementia. Int J Geriat Psychiatry. 2018;33(2):e280–e285. PubMed CrossRef
  6. Chan JSY, Wu J, Deng K, et al. The effectiveness of dance interventions on cognition in patients with mild cognitive impairment: a meta-analysis of randomized controlled trials. Neurosci Biobehav Rev. 2020;118:80–88. PubMed CrossRef
  7. Cummings J, Aisen PS, DuBois B, et al. Drug development in Alzheimer’s disease: the path to 2025. Alzheimers Res Ther. 2016;8:39. PubMed CrossRef
  8. Tao D, Awan-Scully R, Ash GI, et al. Health policy considerations for combining exercise prescription into noncommunicable diseases treatment: a narrative literature review. Front Public Health. 2023;11:1219676. PubMed CrossRef
  9. Tao D, Awan-Scully R, Cole A, et al. Integration of exercise prescription into medical provision as a treatment for non-communicable diseases: a scoping review. Front Public Health. 2023;11:1126244. PubMed CrossRef
  10. Baker JS, Cole A, Tao D, et al. The preventive role of exercise on the physiological, psychological, and psychophysiological parameters of coronavirus 2 (SARS-CoV-2): a mini review. JRFM. 2021;14(10):476. CrossRef
  11. Stern Y. Cognitive reserve in ageing and Alzheimer’s disease. Lancet Neurol. 2012;11(11):1006–1012. PubMed CrossRef
  12. Stern C, Munn Z. Cognitive leisure activities and their role in preventing dementia: a systematic review. Int J Evid Based Healthc. 2010;8(1):2–17. PubMed CrossRef
  13. Dementia. Accessed January 31, 2025. https://www.who.int/news-room/fact-sheets/detail/dementia
  14. Hafdi M, Hoevenaar-Blom MP, Richard E. GroupMulti-domain interventions for the prevention of dementia and cognitive decline. Multi-domain interventions for the prevention of dementia and cognitive decline. Cochrane Dementia and Cognitive Improvement Group. 2020. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD013572.pub2/full.
  15. Stephan BCM, Siervo M, Brayne C. How can population-based studies best be utilized to reduce the global impact of dementia? Recommendations for researchers, funders, and policymakers. Alzheimers Dement. 2020;16(10):1448–1456. PubMed CrossRef
  16. Coyle H, Traynor V, Solowij N. Computerized and virtual reality cognitive training for individuals at high risk of cognitive decline: systematic review of the literature. Am J Geriatr Psychiatry. 2015;23(4):335–359. PubMed CrossRef
  17. Deckers K, Köhler S, Ngandu T, et al. Quantifying dementia prevention potential in the FINGER randomized controlled trial using the LIBRA prevention index. Alzheimers Dement. 2021;17(7):1205–1212. PubMed CrossRef
  18. Solomon A, Turunen H, Ngandu T, et al. Effect of the apolipoprotein E genotype on cognitive change during a multidomain lifestyle intervention: a subgroup analysis of a randomized clinical trial. JAMA Neurol. 2018;75(4):462–470. PubMed CrossRef
  19. Sindi S, Ngandu T, Hovatta I, et al. Baseline telomere length and effects of a multidomain lifestyle intervention on cognition: the FINGER randomized controlled trial. J Alzheimers Dis. 2017;59(4):1459–1470. PubMed CrossRef
  20. Stephen R, Liu Y, Ngandu T, et al. Brain volumes and cortical thickness on MRI in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). Alzheimers Res Ther. 2019;11(1):53. PubMed CrossRef
  21. Ngandu T, Lehtisalo J, Solomon A, et al. 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. Lancet. 2015;385(9984):2255–2263. PubMed CrossRef
  22. Rolland Y, Barreto PS, Maltais M, et al. Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain lifestyle intervention on muscle strength in older adults: secondary analysis of the Multidomain Alzheimer Preventive Trial (MAPT). Nutrients. 2019;11(8):1931. PubMed CrossRef
  23. Andrieu S, Guyonnet S, Coley N, et al. Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): a randomised, placebo-controlled trial. Lancet Neurol. 2017;16(5):377–389. PubMed CrossRef
  24. Moll van Charante EP, Richard E, Eurelings LS, et al. Effectiveness of a 6-year multidomain vascular care intervention to prevent dementia (preDIVA): a cluster randomised controlled trial. Lancet. 2016;388(10046):797–805. PubMed CrossRef
  25. Wittmann FG, Pabst A, Zülke A, et al. Who benefited the most? effectiveness of a lifestyle intervention against cognitive decline in older women and men - secondary analysis of the AgeWell de-trial. J Prev Alzheimers Dis. 2024;11(2):348–355. PubMed CrossRef
  26. Clare L, Nelis SM, Jones IR, et al. The Agewell trial: a pilot randomised controlled trial of a behaviour change intervention to promote healthy ageing and reduce risk of dementia in later life. BMC Psychiatry. 2015;15:25. PubMed CrossRef
  27. Zülke AE, Pabst A, Luppa M, et al. Effects of a multidomain intervention against cognitive decline on dementia risk profiles - results from the AgeWell.de trial. Alzheimers Dement. 2024;20(8):5684–5694. PubMed
  28. Konstantinidis EI, Bamparopoulos G, Bamidis PD. Moving real exergaming engines on the web: the webFitForAll case study in an active and healthy ageing living lab environment. IEEE J Biomed Health Inf. 2017;21(3):859–866. PubMed CrossRef
  29. Richard E, Moll van Charante EP, Hoevenaar-Blom MP, et al. Healthy Ageing Through Internet Counselling in the Elderly (HATICE): a multinational, randomised controlled trial. Lancet Digit Health. 2019;1(8):e424–e434. PubMed CrossRef
  30. de Souto Barreto P, Pothier K, Soriano G, et al. A web-based multidomain lifestyle intervention for older adults: the eMIND randomized controlled trial. J Prev Alzheimers Dis. 2021;8(2):142–150. PubMed CrossRef
  31. McMaster M, Kim S, Clare L, et al. The feasibility of a multidomain dementia risk reduction randomised controlled trial for people experiencing cognitive decline: the Body, Brain, Life for Cognitive Decline (BBL-CD). Aging Ment Health. 2023;27(11):2111–2119. PubMed CrossRef
  32. McMaster M, Kim S, Clare L, et al. Lifestyle risk factors and cognitive outcomes from the multidomain dementia risk reduction randomized controlled trial, Body Brain Life for Cognitive Decline (BBL-CD). J Am Geriatr Soc. 2020;68(11):2629–2637. PubMed CrossRef
  33. Anstey KJ, Cherbuin N, Kim S, et al. An internet-based intervention augmented with a diet and physical activity consultation to decrease the risk of dementia in at risk adults in a primary care setting: pragmatic randomized controlled trial. J Med Internet Res. 2020;22(9):e19431. PubMed CrossRef
  34. Yang QH, Lyu X, Lin QR, et al. Effects of a multicomponent intervention to slow mild cognitive impairment progression: a randomized controlled trial. Int J Nurs Stud. 2022;125:104110. PubMed CrossRef
  35. Wang Y, Han X, Zhang X, et al. Health status and risk profiles for brain aging of rural-dwelling older adults: data from the interdisciplinary baseline assessments in MIND-China. Alzheimers Dement. 2022;8(1):e12254. PubMed CrossRef
  36. Geethadevi GM, Peel R, Bell JS, et al. Validity of three risk prediction models for dementia or cognitive impairment in Australia. Age Ageing. 2022;51(12):afac307. PubMed CrossRef
  37. Association of Lifestyle and Genetic Risk With Incidence of Dementia - PubMed. Accessed February 5, 2025. https://pubmed.ncbi.nlm.nih.gov/31302669/
  38. Livingston G, Huntley J, Sommerlad A, et al. Dementia Prevention, Intervention, and Care: 2020 Report of the Lancet Commission. Lancet. 2020;396(10248):413–446. PubMed CrossRef
  39. Kivimäki M, Singh-Manoux A, Pentti J, et al. Physical inactivity, cardiometabolic disease, and risk of dementia: an individual-participant meta-analysis. BMJ. 2019;365:l1495. PubMed
  40. Zhang Y, Chen SD, Deng YT, et al. Identifying modifiable factors and their joint effect on dementia risk in the UK Biobank. Nat Hum Behav. 2023;7(7):1185–1195. PubMed CrossRef
  41. Kim Y, Kim J, Lee J, et al. The efficacy of a mobile-based multidomain program on cognitive functioning of residents in assisted living facilities. Public Health Pract. 2024;8:100528. PubMed CrossRef
  42. Yan Y, Huang C, Lin R, et al. Effects of a nurse-led staged integral art-based cognitive intervention for older adults on the Alzheimer’s disease spectrum: a randomized controlled trial. Int J Nurs Stud. 2024;160:104902. PubMed CrossRef
  43. Lin R, Luo YT, Yan YJ, et al. Effects of an art-based intervention in older adults with mild cognitive impairment: a randomised controlled trial. Age Ageing. 2022;51(7):afac144. PubMed CrossRef
  44. Luo Y, Lin R, Yan Y, et al. Effects of remote expressive arts program in older adults with mild cognitive impairment: a randomized controlled trial. JAD. 2023;91(2):815–831. PubMed CrossRef
  45. Risk reduction of cognitive decline and dementia: WHO guidelines. Accessed January 31, 2025. https://www.who.int/publications/i/item/9789241550543
  46. Global status report on the public health response to dementia. Accessed January 31, 2025. https://www.who.int/publications/i/item/9789240033245
  47. Be healthy. Be mobile. A handbook on how to implement mDementia. https://who.int/publications/i/item/9789240019966. Accessed January 31, 2025
  48. Social isolation and loneliness among older people: advocacy brief. Accessed January 31, 2025. https://www.who.int/publications/i/item/9789240030749
  49. Chinese Expert Consensus Group on Brain Cognitive Health Management. Editorial Board of Chinese Journal of Health Management. Chinese Expert Consensus on Brain Cognitive Health Management (2023). Chin J Health Management. 2023;17:881–892.
  50. Neuropsychology and Behavioral Neurology Group of Chinese Society of Neurology, Chinese Medical Association; Neurodegenerative Diseases Professional Committee of Chinese Microcirculation Society. Neurorehabilitation Group of Chinese Society of Neurology, Chinese Medical Association. Chinese Expert Consensus on Rehabilitation Management for Alzheimer’s Disease (2019). Chin J Geriatrics. 2020;39:9–19.
  51. China Elderly Care Nursing Alliance, Xiangya Nursing College of Central South University, Xiangya Hospital of Central South University, et al. Clinical Practice Guidelines for Non-pharmacological Interventions in Elderly with Cognitive Decline: Physical Activity. Chin Gen Pract. 2023;26:1927–1938.
  52. Jun Huaguang X, Yin H. Active brain health to improve cognitive reserve. Chin J Health Management. 2021;15:113–116.
  53. Chinese Dementia and Cognitive Impairment Guideline Writing Group, Cognitive Impairment Diseases Professional Committee of Chinese Society of Neurology, Chinese Medical Association. Chinese Guideline for Primary Prevention of Alzheimer’s Disease. Chin Med J 2020;100:2721–2735.
  54. Dou K, Lan T, Jintai Y. Risk factors and prevention of Alzheimer’s disease. Chin J Behav Med Brain Sci. 2019;28:305–310.
  55. National Center for Neurological Disorders, Xuanwu Hospital Capital Medical University, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, National Health Commission Capacity Building and Continuing Education Center, et al. Chinese Alzheimer’s Disease Blue Paper (Abbreviated Version). Zhonghua Yi Xue Za Zhi. 2024;104(29):2701–2727. PubMed CrossRef
  56. Chinese Rehabilitation Medical Association Science and Technology Management and Evaluation Committee. China Anti-aging Promotion Association Rehabilitation Branch, Rehabilitation Assessment Subgroup of Physical Medicine and Rehabilitation Branch of Chinese Medical Association, et al. Chinese Expert Consensus on Cognitive Frailty Rehabilitation 2023. Chin J Medicat. 2023;58:949–953.
  57. Yong X, Qi T, Sun H, et al. Suggestions of Chinese guidelines for early prevention strategies of Alzheimer’s disease. J Alzheimer’s Dis Relat Disord. 2018;1:1–4.
  58. Zhang Y, Jintai Y. Evidence-based Prevention International Guidelines for Alzheimer’s Disease. Sci Technol Rev. 2021;39:110–115.
  59. Gang W, Qi J, Liu X, et al. China Alzheimer’s Disease Report 2024. J Diagnostics Concepts Pract. 2024;23:219–256.
  60. Gangqiang D, Aiguo M, eds. Dietary Guidelines for Chinese Residents: Scientific Research Report. People’s Medical Publishing House. Press; 2021. l.
  61. Geriatric Nutrition Branch of Chinese Nutrition Society. In: Dietary Guidelines for Chinese Elderly. Shandong Fine Arts Publishing House. Press; 2010.
  62. Xueping W, ed. Daily Exercise Guidelines for Elderly. Science Press; 2021.
  63. Writing Committee of Chinese Physical Activity Guidelines for Populations. Zhao Wenhua, Li Keji. Chinese Physical Activity Guidelines for populations (2021). Chin J Prev Control Chronic Dis. 2022;30:1–2.
  64. Aging Health Service and Standardization Branch of Chinese Geriatrics Health Study Association, Editorial Board of Chinese Geriatrics Health Study. (2018). Expert Consensus on motor function assessment and intervention for elderly at home. Chin Geriatr Health Study. 2018;16:52–56.
  65. Chambers N, De Vries PJ, Wetherby AM. Feasibility of the autism navigator® JumpStart to coaching in everyday activities course in South Africa. Autism. 2024;28(9):2232–2243. PubMed CrossRef
  66. Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695–699. PubMed CrossRef
  67. Zhao Q, Lv Y, Zhou Y, et al. Short-term delayed recall of auditory verbal learning test is equivalent to long-term delayed recall for identifying amnestic mild cognitive impairment. PLoS One. 2012;7(12):e51157. PubMed CrossRef
  68. Shin M-S, Park S-Y, Park S-R, et al. Clinical and empirical applications of the Rey–Osterrieth Complex Figure Test. Nat Protoc. 2006;1(2):892–899. PubMed CrossRef
  69. Bechtoldt HP, Benton AL, Fogel ML. An application of factor analysis in neuropsychology. Psychol Rec. 1962;12:147. CrossRef
  70. Kaplan E, Goodglass H, Weintraub S. Boston naming test. Pro-ed; 2001.
  71. Zhao Q, Guo Q, Li F, et al. The Shape Trail Test: application of a new variant of the Trail making test. PLoS One. 2013;8(2):e57333. PubMed CrossRef
  72. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179–186. PubMed CrossRef
  73. Dongmei J, Tiebin Y, Haihui Z. Validity and reliability of Berg balance scale on assessing balance function. Chin J Rehabil Med. 2003;18:25–27.
  74. Zhang C, Zhang H, Zhao M, et al. Assessment of geriatric depression scale’s applicability in longevous persons based on classical Test and item response theory. J Affect Disord. 2020;274:610–616. PubMed CrossRef
  75. Yu HM, He RL, Ai YM, et al. Reliability and validity of the quality of life-Alzheimer disease Chinese version. J Geriatr Psychiatry Neurol. 2013;26(4):230–236. PubMed CrossRef
  76. Cao W, Ying G, Weiwei P, et al. Development and psychometric testing of the Chinese version of the Health-Promoting Lifestyle Profile II (HPLP-II). Chin J Dis Control Prev. 2016;20:286–289.
  77. Hu Y, Zhou L. Reliability and validity of the Chinese version of Health Behavior Ability Self-assessment Scale. Chin Nurs Mag. 2012;47:261–262.
  78. Gazzaniga M, Ivry R, Mangun G, et al, eds. Cognitive Neuroscience: The Biology of the Mind. China Light Industry Press; 2011.
  79. Jonker C, Geerlings MI, Schmand B. Are memory complaints predictive for dementia? A review of clinical and population-based studies. Int J Geriatr Psychiatry. 2000;15(11):983–991. PubMed CrossRef
  80. Li F, Harmer P, Eckstrom E, et al. Clinical effectiveness of cognitively enhanced Tai Ji quan training on global cognition and dual-task performance during walking in older adults with mild cognitive impairment or self-reported memory concerns : a randomized controlled trial. Ann Intern Med. 2023;176(11):1498–1507. PubMed CrossRef
  81. Gu L, Wang M. Research progress on loneliness in the elderly. Today Nurse. 2024;31:26–30.
  82. Malhotra R, Tareque MI, Saito Y, et al. Loneliness and health expectancy among older adults: a longitudinal population-based study. J Am Geriatr Soc. 2021;69(11):3092–3102. PubMed CrossRef
  83. Meng X, Su J, Gao T, et al. Multidomain interventions based on a life-course model to prevent dementia in at-risk Chinese older adults: a randomized controlled trial. Int J Nurs Stud. 2024;152:104701. PubMed CrossRef
  84. VivianiOrdonez CBRMATN, Pereira AR, Pereira AR, et al. Subjective impacts of computerized cognitive training for healthy older adults in the context of the COVID-19 pandemic. Arq Neuropsiquiatr. 2023;81(3):240–247. PubMed CrossRef
  85. Hausman HK, Alexander GE, Cohen R, et al. tDCS reduces depression and state anxiety symptoms in older adults from the augmenting cognitive training in older adults study (ACT). Brain Stimul. 2024;17(2):283–311. PubMed CrossRef
  86. Srisuwan P, Nakawiro D, Kuha O, et al. Efficacy of a group-based 8-week multicomponent cognitive training on cognition, mood and activities of daily living among healthy older adults: a two-year follow-up of a randomized controlled trial. J Prev Alzheimers Dis. 2025;12(2):100033. PubMed CrossRef
  87. Lee J, Kim J, Park A, et al. Efficacy of a mobile-based multidomain intervention to improve cognitive function and health-related outcomes among older Korean adults with subjective cognitive decline. J Alzheimers Dis. 2023;93(4):1551–1562. PubMed CrossRef
  88. Clouston SAP, Smith DM, Mukherjee S, et al. Education and cognitive decline: an integrative analysis of global longitudinal studies of cognitive aging. J Gerontol B Psychol Sci Soc Sci. 2020;75(7):e151–e160. PubMed CrossRef
  89. Perry BL, McConnell WR, Coleman ME, et al. Why the cognitive “fountain of youth” may be upstream: pathways to dementia risk and resilience through social connectedness. Alzheimers Dement. 2022;18(5):934–941. PubMed CrossRef
  90. Penninkilampi R, Casey AN, Singh MF, et al. The Association between social engagement, loneliness, and risk of dementia: a systematic review and meta analysis. JAD. 2018;66(4):1619–1633. PubMed CrossRef
  91. Sommerlad A, Sabia S, Singh-Manoux A, et al. Association of social contact with dementia and cognition: 28-year follow-up of the Whitehall II cohort study. PLoS Med. 2019;16(8):e1002862. PubMed CrossRef
  92. Deal JA, Power MC, Palta P, et al. Relationship of cigarette smoking and time of quitting with incident dementia and cognitive decline. J Am Geriatr Soc. 2020;68(2):337–345. PubMed CrossRef
  93. Anstey KJ, Von Sanden C, Salim A, et al. Smoking as a risk factor for dementia and cognitive decline: a meta-analysis of prospective studies. Am J Epidemiol. 2007;166(4):367–378. PubMed CrossRef
  94. Koch M, Fitzpatrick AL, Rapp SR, et al. Alcohol consumption and risk of dementia and cognitive decline among older adults with or without mild cognitive impairment. JAMA Netw Open. 2019;2(9):e1910319. PubMed CrossRef
  95. Xue H, Sun Q, Liu L, et al. Risk factors of transition from mild cognitive impairment to Alzheimer’s disease and death: a cohort study. Compr Psychiatry. 2017;78:91–97. PubMed CrossRef
  96. Cheng ST. Cognitive reserve and the prevention of dementia: the role of physical and cognitive activities. Curr Psychiatry Rep. 2016;18(9):85. PubMed CrossRef
  97. Hamer M, Chida Y. Physical activity and risk of neurodegenerative disease: a systematic review of prospective evidence. Psychol Med. 2009;39(1):3–11. PubMed CrossRef
  98. Pecher H, Storch M, Beyer F, et al. Hypothalamic atrophy and structural covariance in amnestic mild cognitive impairment and Alzheimer’s dementia. Neuroimage Clin. 2024;44:103687. PubMed CrossRef
  99. He Y, Yang L, Zhu X, et al. Mental health chatbot for young adults with depressive symptoms during the COVID-19 pandemic: Single-Blind, three-arm randomized controlled trial. J Med Internet Res. 2022;24(11):e40719. PubMed CrossRef
  100. Yang P, Zhu X, Chen Z. Research advances in hypertension management based on mobile healthcare. Chin J Hypertens. 2020;28(5):415–419.
  101. Röhr S, Kivipelto M, Mangialasche F, et al. Multidomain interventions for risk reduction and prevention of cognitive decline and dementia: current developments. Curr Opin Psychiatry. 2022;35(4):285–292. PubMed