A recent study has shown that structured lifestyle interventions can improve cognitive function in older adults who are at risk for cognitive decline. The U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER) is a two-year, multi-site clinical trial involving several centers, including Baylor College of Medicine’s Alzheimer’s Disease and Movement Disorder Center.
The study compared two groups: one received a structured (STR) intervention with higher intensity, structure, accountability, and support; the other group followed a self-guided (SG) approach. Results indicated that participants in the structured program experienced greater improvement in global cognition over two years than those in the self-guided group.
The findings were announced at the Alzheimer’s Association International Conference 2025 in Toronto and published simultaneously in The Journal of the American Medical Association (JAMA). U.S. POINTER is recognized as the first large-scale randomized controlled trial to show that accessible and sustainable healthy lifestyle changes can help protect cognitive function among diverse populations across the United States.
“This study demonstrates that there are actions we can all take to improve our cognition as we age and provides a model for implementation of future, larger scale interventions. I want to thank our POINTER participants as well as the Baylor, Kelsey and Alzheimer’s Association teams for their great work on this important study,” said Dr. Melissa Yu, professor of neurology at and director of the Alzheimer’s disease and Memory Disorders Center at Baylor.
“As the burden of dementia grows world-wide, U.S. POINTER affirms a vital public health message: healthy behavior has a powerful impact on brain health,” said Dr. Joanne Pike, Alzheimer’s Association president and CEO.
“This is a critical public health opportunity. The intervention was effective across a broad, representative group — regardless of sex, ethnicity, APOE genetic risk, or heart health status — demonstrating its applicability and scalability for communities across the country,” said Pike. “The positive results of U.S. POINTER encourage us to look at the potential for a combination of a lifestyle program and drug treatment as the next frontier in our fight against cognitive decline and possibly dementia.”
U.S. POINTER leadership acknowledged all participants and staff: “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.”
Both groups in the study engaged in activities focused on physical exercise, nutrition, mental challenges, social engagement, and heart health monitoring; however, they differed in how these elements were delivered.
“This was a landmark study showing that changes in diet, physical activity and mental and social engagement can result in significant, measurable cognitive benefits in a very short period of time. We hope the results will encourage health care providers to recommend the lifestyle changes tested in the POINTER trial,” said Dr. Valory Pavlik, professor of neurology at Baylor.
“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 Dr. Laura D. Baker from Wake Forest University School of Medicine and Advocate Health.
“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 added.
Experts point out that people with cognitive decline often have multiple harmful changes occurring in their brains simultaneously; thus effective treatments may require combining several strategies rather than relying solely on one approach.
“Complex diseases like heart disease and cancer use combination treatment strategies tailored to individual characteristics. The next generation of treatments for diseases like Alzheimer’s will likely integrate drug and non-drug strategies. U.S. POINTER provides a strong foundation for such combination approaches,” said Dr. Heather M. Snyder from the Alzheimer’s Association.
“While these results are fascinating and extremely hopeful, how they are rolled out to the public — especially those at risk for Alzheimer’s and other diseases that cause dementia — needs to be handled with care and individual attention to tailor to the local environment,” Snyder continued.
The Alzheimer’s Association led this research effort with close to $50 million invested so far; additional funding came from agencies such as National Institute on Aging at NIH for related studies focusing on imaging or sleep patterns among others. Plans include investing another $40 million over four years both for ongoing participant follow-up as well as expanding access across American communities.
“It was an honor for the research team in the Alzheimer’s Disease and Memory Disorders Center in Department of Neurology to have opportunity serve one sites," Pavlik noted."We want thank partners Kelsey Research Foundation essential contributions implementing intervention."
U.S POINTER enrolled over 2,100 adults aged 60-79 years who had sedentary lifestyles or suboptimal diets along with other risk factors such as family history or cardiometabolic concerns; roughly 31% identified as part ethnoracial minority groups while nearly 70% were female participants—retention rate stood high at 89% after two years completion assessment period.
Statistical analysis showed significantly better global cognitive scores among STR participants compared SG counterparts—executive function also improved more within STR group while processing speed differences were not statistically significant; memory outcomes did not differ between groups.
Looking forward,"the Association will build momentum launching several programs initiatives including bringing interventions wider range US communities".
