Improving Brain Health Through Lifestyle Changes in Older Adults at Risk for Dementia: Rebecca M. Edelmayer, PhD

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"It’s exciting to see that, for the first time here in the United States, we have very rigorous data demonstrating that there is a protective effect if we are able to incorporate some of these lifestyle changes into our everyday activities. There’s more to come from the U.S. POINTER study—we know that we’ll be reporting out more data from some of the ancillary studies that are focused on the gut microbiome, imaging, the sleep study, and even a neurovascular study."

U.S. POINTER trial (NCT03688126) is a phase 3, 5-site, 2-year, single-blind randomized study testing 2 lifestyle interventions and their ability to impact cognitive function among older adults at risk for dementia. The trial, which aimed to evaluate whether the results from the FINGER study (NCT01041989) could be generalized to a larger and more diverse population at risk for cognitive decline and dementia in the United States, used over 2000 patients. Secondary objectives explored the effects of the interventions on individual cognitive domains and examined whether outcomes varied according to baseline cognition, sex, age, APOE ε4 genotype, and cardiovascular risk.¹

The study was conducted at 5 U.S. academic centers and health care systems across multiple regions in collaboration with the Alzheimer’s Association. Participants were selected to increase the likelihood of cognitive decline and met criteria including aged 60 to 79 years, sedentary behavior, suboptimal diet and cardiometabolic health, and a family history of memory impairment. A total of 2111 individuals were randomized to either the structured intervention (n = 1,056) or self-guided intervention (n = 1,055). The mean age was 68.2 years, 68.9% were women, and 30.8% were from ethnoracial minority groups. In the study, 78% of participants reported a first-degree relative with memory loss, and 30% were APOE ε4 carriers. Notably, retention was high, with 89% completing the 2-year study period.

Findings from the study, presented at the 2025 Alzheimer’s Association International Conference (AAIC), held July 27-30, in Toronto, Canada, revealed a statistically significant intervention group difference on the primary outcome at 2 years. In a recent interview with NeurologyLive^®, Rebecca M. Edelmayer, PhD, vice president of scientific engagement at the Alzheimer's Association, discussed how the comprehensive lifestyle interventions were associated with measurable improvements in brain health over time. She talked about how structured approaches offering guidance, accountability, and support were more effective in enhancing cognitive performance than self-directed methods. Additionally, she noted that adherence to healthy eating patterns and regular health evaluations was associated with positive cognitive outcomes. Edelmayer also spoke about ongoing analyses that will further examine factors influencing brain health, with additional findings expected later this year.

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REFERENCES
1. U.S. Pointer Study Shows Structured Lifestyle Program Targeting Multiple Risk Factors Improves Cognition in Older Adults at Risk of Cognitive Decline. News Release. Alzheimer’s Association. Published July 28, 2025. Accessed September 10, 2025. https://aaic.alz.org/releases-2025/us-pointer-study-results-announced.asp