Key takeaways
- Two lifestyle interventions in U.S. POINTER improved cognition in older adults at risk of cognitive decline. A structured intervention with more support and accountability showed greater improvement compared to a self-guided intervention.
- In a large, representative group of older adults at high risk for cognitive decline, multidomain lifestyle interventions were delivered with high adherence and safety.
- Cognitive benefits were consistent across age, sex, ethnicity, heart health status and apolipoprotein E-e4 genotype.
(SACRAMENTO)
The Alzheimer's Association U.S. POINTER Study, a two-year, multi-site clinical trial testing two different lifestyle interventions in a representative population of older adults at risk for cognitive decline and dementia, found that both interventions improved cognition in older adults at risk of cognitive decline.
UC Davis Health is one of the U.S. academic centers and health care systems that conducted the U.S. POINTER Study in partnership with the Alzheimer's Association.
The study assessed two interventions: A structured one and a self-guided one. They both focused on physical exercise, nutrition, cognitive challenge and social engagement, and heart health monitoring. They differed in intensity, structure, accountability and support provided.
Trial participants in the structured intervention showed greater improvement on global cognition compared to the self-guided intervention, protecting cognition from normal age-related decline for up to two years.
The results were reported today at the Alzheimer's Association International Conference 2025 in Toronto. They were also published in the Journal of the American Medical Association (JAMA), "Structured vs Self-Guided Multidomain Lifestyle Interventions for Global Cognitive Function."
Rachel Whitmer, professor in the departments of Public Health Sciences and Neurology, chief of the Division of Epidemiology and co-director of the UC Davis Alzheimer's Disease Research Center, is the principal investigator of the study at UC Davis Health. She is also a co-author of the new paper in JAMA.
"U.S. POINTER is important because it was designed as a rigorous, randomized controlled clinical trial to demonstrate whether an accessible and sustainable lifestyle intervention protects cognitive function in diverse populations in communities across the United States," Whitmer said. "These positive results underscore the message that healthy behavior has a powerful impact on brain health. Positive actions can make a difference in brain health, and when combined into a program that targets multiple factors like diet, exercise, heart health and cognitive engagement, we now know it can have an even more powerful impact."
U.S. POINTER leadership acknowledges participants, their family members and study site staff for their unique and essential contributions: "You helped change what we know about brain health. Thanks to your dedication, time and support, U.S. POINTER delivered groundbreaking results. Your children, grandchildren and generations to come will benefit from the commitment you made."
Structured lifestyle intervention. Participants attended 38 facilitated peer team meetings over two years and were provided with a prescribed activity program with measurable goals for:
- aerobic, resistance and stretching exercise
- adherence to the MIND diet
- cognitive challenge through BrainHQ training and other intellectual and social activities
- regular review of health metrics and goal-setting with a study clinician
Self-guided lifestyle intervention. Participants attended six peer team meetings to encourage self-selected lifestyle changes that best fit their needs and schedules. Study staff provided general encouragement without goal-directed coaching.
"The potential to improve cognition with fewer resources and lower participant burden is compelling. It highlights that while not everyone has the same access or ability to adhere to more intensive behavior interventions, even modest changes may protect the brain," said Laura D. Baker, professor of gerontology and geriatrics, and internal medicine, at Wake Forest University School of Medicine and Advocate Health, and U.S. POINTER principal investigator.
"These are the initial results. Over the coming weeks and months, study leadership will be exploring all of the data collected in the trial to paint an even more comprehensive picture of the U.S. POINTER intervention effects on brain health," Baker said.
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