Lifestyle Program Boosts Brain Health in Older Adults

Multi-pronged approach shows significant cognitive gains without medication

A groundbreaking two-year lifestyle intervention has demonstrated significant improvements in cognitive function among older adults at risk of dementia. The program, focusing on exercise, diet, mental engagement, and social connection, offers a promising non-pharmaceutical path to preserving brain health.

Structured Intervention Yields Superior Results

The U.S. POINTER trial, involving 2,111 participants, compared a structured lifestyle program with a self-guided version. Those in the structured group, which included regular team meetings, education, and goal-setting, saw greater improvements in composite cognitive scores than their counterparts who followed a less intensive, self-directed plan.

Bridget Stratton of the Alzheimer’s Association highlighted the trial’s significance, noting it was designed to rigorously test an accessible and sustainable lifestyle intervention. She emphasized that over 30% of participants belonged to groups historically underrepresented in dementia research, making the findings broadly applicable.

Team-Based Approach Crucial for Adherence

Experts believe the enhanced results in the structured program stem from its emphasis on support and accountability. Ryan Arnold, MD, founder of Clava Health, pointed out that the self-directed group lacked the essential dedicated coaching and physician follow-up. He stated, “This vital distinction underscores how absolutely necessary a team-based approach is for the comprehensive care of patients at risk of, or in the early stages of, cognitive impairment.”

“POINTER’s results affirm that structure and coaching are not just nice to have, they are necessary.”

—John Enwere, Founder, Caringene

John Enwere, founder of Caringene, a home care company, observed that clients thrive with engaged caregivers implementing personal care plans. He added, “The magic occurs when the environment meets the clients where they are, physically and cognitively.”

Holistic Health Strategies Address Complex Needs

The trial’s success reinforces the principle of addressing multiple health factors simultaneously. For adherence to complex components, particularly those related to vascular and metabolic health, a team-based approach is likely most beneficial. This team, ideally physician-led, would include a health coach and a trainer aware of individual cognitive goals and physical limitations.

The findings align with growing evidence that lifestyle modifications can combat cognitive decline. A recent report in The Lancet identified 14 modifiable risk factors for Alzheimer’s disease and related dementias (ADRD). This supports the assertion that interventions targeting multiple risk pathways are critical.

Dr. Arnold expressed strong support for non-pharmaceutical approaches to Alzheimer’s treatment. He stated, “My professional stance on treating Alzheimer’s from a non-pharmaceutical angle is one of strong support and profound optimism.”

“There is certainly a time and place for medications, but only in certain stages. Medications do not address the underlying behavioral or vascular aspects of decline, a decline that can be made worse by medications.”

—John Enwere

The U.S. POINTER trial’s results are published in JAMA.