Recommendations from the European interdisciplinary council on ageing on physical activity and diet for mental health conditions in older adults.

The global rise in life expectancy is accompanied by an increase in the prevalence of mental health conditions among older adults, including mild cognitive impairment (MCI), dementia, delirium, depression, anxiety, and other severe mental illness. These conditions significantly impact independence, increase healthcare costs, and increase mortality risk. Mounting evidence underscores the central role of modifiable lifestyle factors-particularly physical activity and diet-in the prevention and management of these conditions. This consensus, developed under the auspices of the European Interdisciplinary Council on Ageing (EICA), synthesizes current evidence and expert perspectives. Regular exercise, ranging from aerobic and resistance training to mind-body practices, improves cognition, mood, and physical resilience, while also mitigating cardiometabolic and functional risks. Similarly, adherence to dietary patterns such as the Mediterranean or MIND diets has been consistently associated with reduced incidence of cognitive decline, Alzheimer's disease, and comorbid chronic illnesses, although much of the evidence is observational. Landmark multidomain trials, including the Finnish FINGER and U.S. POINTER studies, have shown that combined interventions targeting diet, physical activity, cognitive stimulation, and social activity can slow cognitive decline in at-risk populations. Lifestyle strategies that promote brain health may enhance functional outcomes in dementia and, in turn, mitigate the risk of delirium. However, widespread implementation of such strategies faces numerous barriers, including physical frailty, socioeconomic constraints, health system fragmentation, and stigma. To overcome these barriers, caregivers, healthcare and public health professionals, policymakers, and community organizations must collaborate in designing accessible, culturally sensitive, and sustainable interventions at a policy level. Emerging digital tools, group-based programs, and co-designed approaches offer novel opportunities to enhance adherence and impact. Integrating lifestyle interventions into standard healthcare pathways represents an urgent, cost-effective strategy to promote mental health and resilience in ageing populations worldwide. This document provides actionable recommendations to guide policy, research, and clinical implementation across diverse health systems.