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Individuals in early dementia prevention trials may differ in how much they benefit from interventions depending on their initial risk level. Additionally, modifiable dementia risk scores might be used as surrogate/intermediate outcomes.    Methods  In the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), we investigated in post hoc analyses (N = 1207) whether the cognitive benefits of the 2‐year multi‐domain lifestyle intervention differed by baseline dementia risk measured with the “LIfestyle for BRAin Health” (LIBRA) score. We also investigated intervention effects on change in LIBRA score over time.    Results  Overall, higher baseline LIBRA was related to less cognitive improvement over time. This association did not differ between the intervention and control groups. The intervention was effective in decreasing LIBRA scores over time, regardless of baseline demographics or cognition.    Discussion  The cognitive benefit of the FINGER intervention was similar across individuals with different LIBRA scores at baseline. Furthermore, LIBRA may be useful as a surrogate/intermediate endpoint and surveillance tool to monitor intervention success during trial execution.

Quantifying dementia prevention potential in the FINGER randomized controlled trial using the LIBRA prevention index