{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T18:14:52Z","timestamp":1788200092251,"version":"build-2803163510"},"reference-count":51,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01AG067533"],"award-info":[{"award-number":["R01AG067533"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["U01AG032284"],"award-info":[{"award-number":["U01AG032284"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020884","name":"Agencia Nacional de Investigaci\u00f3n y Desarrollo","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020884","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020597","name":"Council on Latin American and Iberian Studies","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020597","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011493","name":"Whitney and Betty MacMillan Center for International and Area Studies","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011493","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although dementia prevention is a global priority, few interventions have been successfully translated into public health and community settings. This study evaluated the effectiveness of a nudge\u2010based communication strategy to promote Alzheimer's disease (AD) prevention on behavioral, cognitive, and provider\u2010level outcomes in a real\u2010world setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a pragmatic cluster\u2010randomized trial across seven senior centers. Eligible participants were adults aged \u2265\u200960 with cognitive impairment but no dementia. Centers were randomized to intervention (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093) or control (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094) arms. All centers offered standard activities and provider training in dementia management. The intervention arm additionally received CULTIVAMENTE, a low\u2010intensity, nudge\u2010based communication strategy involving posters, brochures, and web\u2010based content promoting AD prevention. Main outcomes included changes in a composite cognitive healthy behavior score, cognitive performance (memory and executive function), prevalence of mild\u2010to\u2010moderate cognitive impairment, and provider practices (AD prevention discussions and referrals). Analyses used intention\u2010to\u2010treat linear mixed models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 211 participants (mean age 74.8\u2009\u00b1\u20097.0\u2009years; 80.5% women), after 6\u2009months, those in the intervention group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009101) demonstrated greater improvement in cognitive healthy behaviors compared to control (SD difference\u2009=\u20090.15; 95% CI\u2009=\u20090.02\u20130.28;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021; 95.4% greater increase than control). Cognitive scores improved significantly in the intervention group (memory\u2009=\u20090.24; 95% CI\u2009=\u20090.07\u20130.41; memory\u2013executive functioning\u2009=\u20090.21; 95% CI\u2009=\u20090.08\u20130.33), and mild\u2010to\u2010moderate cognitive impairment cases declined in the intervention group (from 70 to 67) compared to the control group (from 71 to 75;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Additionally, intervention participants were more likely to report increases in knowing how to prevent AD, having discussions about ways to prevent AD with providers, and receiving referrals to manage risk factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Embedding nudge\u2010based messaging into senior centers improved dementia prevention behaviors, cognitive outcomes, and provider practices. These results support testing low\u2010cost, scalable strategies in real\u2010world settings to reduce dementia risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70251","type":"journal-article","created":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T07:22:37Z","timestamp":1766560957000},"page":"418-429","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Health Communication Strategy to Promote Dementia Risk Reduction: The\n                    <scp>CULTIVAMENTE<\/scp>\n                    Pragmatic Cluster\u2010Randomized Trial"],"prefix":"10.1111","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5844-8700","authenticated-orcid":false,"given":"Jose M.","family":"Aravena","sequence":"first","affiliation":[{"name":"Department of Social and Behavioral Sciences, School of Public Health Yale University  New Haven Connecticut USA"},{"name":"Facultad de Medicina Cl\u00ednica Alemana Universidad del Desarrollo  Santiago Chile"},{"name":"Instituto de Nutrici\u00f3n y Tecnolog\u00eda de Los Alimentos (INTA), Universidad de Chile  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Castro","sequence":"additional","affiliation":[{"name":"Cultivamente Chile  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Poblete","sequence":"additional","affiliation":[{"name":"Cultivamente Chile  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Ines","family":"Aravena","sequence":"additional","affiliation":[{"name":"Cultivamente Chile  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waldo","family":"Torres","sequence":"additional","affiliation":[{"name":"Cultivamente Chile  Santiago Chile"},{"name":"Universidad Central de Chile  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Vivar","sequence":"additional","affiliation":[{"name":"Universidad de Chile  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ester","family":"Lara","sequence":"additional","affiliation":[{"name":"Cultivamente Chile  Santiago Chile"},{"name":"Universidad Central de Chile  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maril\u00fa","family":"Budinich","sequence":"additional","affiliation":[{"name":"Cultivamente Chile  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricio","family":"Fuentes","sequence":"additional","affiliation":[{"name":"Universidad de Chile  Santiago Chile"},{"name":"Hospital Cl\u00ednico Universidad de Chile  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Albala","sequence":"additional","affiliation":[{"name":"Instituto de Nutrici\u00f3n y Tecnolog\u00eda de Los Alimentos (INTA), Universidad de Chile  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Becca R.","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Sciences, School of Public Health Yale University  New Haven Connecticut USA"},{"name":"Institution for Social and Policy Studies, Yale University  New Haven Connecticut USA"},{"name":"Department of Psychology Yale University  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(24)01296\u20100"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(15)60461\u20105"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.12923"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.13486"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40814\u2010022\u201000977\u20106"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD\u2010240229"},{"key":"e_1_2_13_8_1","unstructured":"C. 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