A $50 million study funded by the Alzheimer’s Association has found that lifestyle interventions can protect at-risk older adults from normal cognitive decline for up to two years. The more structured and supportive the intervention, the greater the apparent benefits, the researchers report. Clinicians can use the pioneering results to counsel patients in staying cognitively healthy, they say.
The results of the US POINTER study were unveiled Monday at the Alzheimer’s Association International Conference (AAIC) 2025 in Toronto. About 94% of 2,111 volunteers completed the study, which looked at global cognitive function. This included changes in executive function, memory and processing speed. The researchers enrolled older participants, with an average age of 68. While cognitively healthy at the study’s outset, all were at risk of cognitive decline and dementia based on health status and family history. In fact, 78% had a family history of dementia.
To ensure that the study was representative of the United STates population, the researchers also included more than 30% of participants from populations and communities not typically included in clinical trials.
Participants were split into two lifestyle intervention groups. One was provided with ongoing encouragement to make self-selected lifestyle changes, and another was given a highly structured intervention with ongoing, prescribed supports. The interventions focused on:
- exercise with resistance training, balance and stretching;
- adherence to the brain-healthy MIND diet;
- ongoing encouragement to be more socially adventurous; and
- goal setting and health metrics reviews with a medical adviser
Healthy lifestyle behaviors matter
Cognitive function improved across both groups, with consistent benefits across age, sex, ethnicity, heart health status and dementia risk based on genotype measures. But results for the participants in the structured study stood out. At two years, the data showed that these participants functioned at the cognitive level of adults one to two years younger.
“What we’ve learned is that … healthy behaviors matter for brain health,” said principal investigator Laura Baker, PhD, of Wake Forest University School of Medicine, Winston-Salem, NC, at the AAIC presentation.
The investigators believe that this structured approach especially helped to build cognitive resilience against cognitive decline, and that this likely contributed to slowing the aging clock.
Use this knowledge now
People can immediately start using the knowledge gained in the US POINTER study to protect their brain health, and it should be spread amongst the US health community as well, Baker said.
“This test of the POINTER lifestyle prescription provides a new recipe for Americans to improve cognitive function and increased resilience to cognitive decline,” she said. “The structured lifestyle intervention … is scalable to roll out into the community. Not later, but now.”
Baker’s prescription for brain health is, “move more, sit less; add color to your plate; learn something new and stay connected — challenge yourself to do this on a regular basis — and know your health numbers. Awareness changes behavior,” she said.
In addition to the researchers, two study participants who represented the structured and unstructured groups spoke about their experiences with the study during the AAIC presentation. Phyllis Jones of the structured groups said her cognitive health transformation was so apparent that she now views her life in terms of “Before POINTER” and “After POINTER.” For example, early in the study, it was hard for her to follow and participate in group discussions, she said. By the end, she said she had no trouble engaging and participating.
Partnering with healthcare systems
The Alzheimer’s Association will fund the study for another four years, following the same participants in order to see if they continue to reap cognitive benefits. The organization is also planning to partner with US health systems and clinics to ensure that the study results are disseminated as widely as possible, said Chief Science Officer Maria Carrillo, PhD.
“Participants in the structured group performed at a level comparable to adults one to two years younger in age, an effect that likely increases their resilience against cognitive decline, and who does not want that?” she said at the AAIC presentation. “It is now time to transition the POINTER brain health recipe to the rest of America.”