Multidomain approaches and specific supplements show promise for Alzheimer's disease prevention and management in at-risk elderly populations.

Alzheimer’s disease (AD) is a progressive and currently incurable neurodegenerative disorder, which is driving a paradigm shift in research focus toward preventive and disease-modifying strategies. This mini-review synthesizes current evidence on dietary and lifestyle interventions for AD prevention and management from randomized controlled trials (RCTs) and observational studies. Current findings indicate that multidomain approaches, such as the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and the Finnish Geriatric Intervention Study (FINGER) model, which integrate nutrition, physical activity, and cognitive training, consistently demonstrate efficacy in slowing cognitive decline and reducing brain atrophy in at-risk elderly populations. The evidence for specific nutritional supplements is mixed; however, certain combinations like omega-3 fatty acids paired with carotenoids, B vitamins (folate/B12), and probiotics show promise, particularly for improving memory and reducing inflammation. Intervention outcomes are significantly influenced by genetic factors, especially the APOE4 carrier status, which modulates nutrient metabolism and amyloid response, thereby underscoring the critical need for personalized approaches. Key targeted biological pathways include oxidative stress, phospholipid metabolism, and neuro-inflammation. Despite promising data, several limitations persist, such as inconsistent results, short trial durations, and a lack of standardized protocols. Future research must prioritize long-term, genetically stratified trials alongside mechanistic studies to validate efficacy, optimize personalization, and translate findings into clinically actionable, scalable guidelines for diverse populations.