Impact of Lifestyle, Obesity, and Psychosocial Factors on the Risk of Atherosclerotic Cardiovascular Disease and Cognitive Dysfunction

With great pleasure, we present to you the 4th issue (October–December 2025) of the Journal of Atherosclerosis Prevention and Treatment, which is consisted of a Systematic Review, a Comprehensive Narrative Review and two Review Articles. The objective of the systematic review is to evaluate the effectiveness of digital interventions compared with conventional in-person approaches for weight loss in overweighted or obese adults, ensuring comparable intensity and frequency. Since obesity is expected to rise markedly in the coming years, technology-based interventions have been developed as an alternative to face-to-face interventions. In the present systematic review, authors included 12 eligible studies (1.932 participants), among which 7 were randomized controlled trials. Authors suggest that technology-based interventions may achieve weight loss outcomes in adults, which are comparable to those observed in traditional face-to-face interventions. However, the existing evidence is of low quality since it is supported by a small number of studies with notable limitations concerning study design, participant numbers, and follow-up duration. Authors conclude that in order, (i) to validate the generalizability of these findings, (ii) to determine which digital modalities are most effective, and (iii) to establish the optimal duration and implementation strategies for digital weight loss interventions, further well-designed, adequately powered trials should be conducted. The Narrative Review of this issue aims to synthesize current evidence on the complex and bidirectional relationship between frailty and stroke in older adults. Indeed, frailty represents a critical geriatric syndrome characterized by decreased physiological reserve and increased vulnerability to adverse health outcomes. Frailty is more common in stroke patients than in the general older population and consistently predicts greater stroke risk, more severe acute presentations, poorer functional and cognitive outcomes, institutionalization, and higher mortality. Authors examine how preexisting frailty influences stroke risk, acute clinical presentation, and poststroke outcomes and further explore the mechanisms through which stroke may accelerate or exacerbate frailty progression. They also evaluate the role of frailty assessment in contemporary stroke care. The present review suggests that prioritizing standardized frailty measures, clarifying underlying mechanisms, and testing frailty-informed treatment strategies in prospective studies will be crucial for improving outcomes in an aging, multimorbid population. In the next review article, the authors discuss the role of Atherosclerosis as a significant and modifiable risk factor for cognitive impairment and dementia. Indeed, epidemiological studies consistently demonstrate a positive association between atherosclerosis (particularly in the carotid arteries) and the development of cognitive dysfunction, including vascular dementia and Alzheimer’s disease. This paper explores the mechanistic link between atherosclerosis and dementia, emphasizing the role of cerebral hypoperfusion, inflammation, and amyloid-beta accumulation. Indeed, understanding the underlying mechanisms linking atherosclerosis to cognitive decline is crucial for developing effective prevention strategies. A proactive, multifaceted approach focusing on prevention, early detection, and personalized interventions holds immense promise for reducing the burden of dementia and promoting cognitive health throughout the aging process. The authors suggest that further research is needed to refine prevention strategies and identify novel therapeutic targets. The last review article of this issue reflects the views of the current board of the Hellenic Atherosclerosis Society working group on lifestyle, psychosocial factors, and atherosclerosis. Authors highlight the importance of behavioral factors (namely dietary habits, physical activity, sleep patterns, smoking behavior, and mental health conditions, including depression, anxiety, posttraumatic stress-related disorders), as modifiable cardiovascular disease (CVD) risk factors. Therefore, they represent key targets for CVD prevention and health promotion. They also emphasize the positive well-being in the preventive CVD interventions and propose strategies for effectively addressing all the above factors within the context of Greece. Authors suggest that lifestyle and well-being, should be a high priority for healthcare policy-makers in Greece. This is the last issue of Journal of Atherosclerosis Prevention and Treatment (JAPT) in 2025. Our peer-reviewed journal is dedicated to advancing the science, clinical practice, and innovation surrounding the prevention, early detection, and management of atherosclerosis and related cardiovascular disorders. In 2026, JAPT aims not only to continue its very successful path but also to further increase its scientific quality and impact by warmly welcoming clinicians, researchers, and innovators to submit high-quality manuscripts in the multi-disciplinary scientific field of Atherosclerosis. Through collaboration and open scientific dialogue, our journal will continue to bridge discoveries from molecular science to global health impact.