My Take On a New Study About Lifestyle Changes and Brain Health

A new paper from the U.S. POINTER study, recently published in JAMA, a peer-reviewed medical journal published by the American Medical Association (AMA), is getting a lot of attention. Maybe you heard about it. The study investigates an important question about the impact of lifestyle choices on cognition.

More people need to understand this powerful connection. I’ve worked hard during the last few years to do just that, so I carefully reviewed the journal article and want to share my takeaways with you.

Background Information

At the end of this article, I’ll provide more details about this study for those who are interested, but here’s a quick overview.

A Related Trial: The FINGER Study

The U.S. POINTER study was modeled after the 2015 Finnish FINGER study, published in the Lancet. The POINTER study was specifically developed to assess whether the FINGER study’s results could be generalized to a larger, more diverse U.S. population.

The POINTER Study

The POINTER study aimed to answer this fundamental question:

Can a structured lifestyle intervention program improve or preserve cognitive function in older adults at risk for cognitive decline and dementia—especially in a diverse U.S. population?

Specifically, the study compared a structured, high-intensity program with regular meetings, coaching, and accountability, and a self-guided, lower intensity program with education materials and minimal support.

Both groups implemented interventions focused in four areas: physical activity, nutrition, cognitive training and social engagement, and cardiovascular health monitoring.

Results

Global Cognition

Both groups improved in overall thinking ability—likely due in part to “practice effects” (improvement simply from repeat testing). However, the structured group improved more, and the difference was statistically significant—suggesting real benefit beyond test familiarity.

Specific Cognitive Domains

• There were greater gains in executive function in the structured group. Executive function includes skills like planning, organizing, and managing tasks.

• Processing speed tended to improve more in the structured group, though it was not statistically significant.

• There was not a significant difference with long-term memory, which was consistent with the FINGER trial.

Subgroup Findings

APOE ε4 carriers (read my article on APOE to learn about its importance as an Alzheimer’s biomarker) benefited just as much as non-carriers, those with lower baseline cognitive scores showed the greatest benefit from the structured program, and there were no significant differences based on sex, age, or cardiovascular health status.

My Takeaways

I love that this study focused on non-drug interventions that are safe, accessible, and cost-effective. Most people still don’t realize that lifestyle choices can dramatically impact dementia risk. If the POINTER study helps raise awareness and gets more people talking about prevention, that’s a huge win.

Other important takeaways:

• Greater intensity, structure, and accountability clearly enhanced cognitive outcomes.

• It was smart to test whether FINGER’s findings held up in a more diverse, real-world U.S. population.

• Executive function was the biggest cognitive winner—key for maintaining independence.

• The study showed improvements consistently across key subgroups, include APOE ε4 carriers.

But there are also important limitations:

• Not powered to measure dementia incidence—just cognitive change

• Only 2 years long—we don’t know if benefits endure

• Single-blind—participants knew which group they were assigned to, and this can affect behavior

• Adherence measurement was indirect—adherence was measured by attendance at meetings and not by to what extent participants made lifestyle adjustments

• There was no control group—this makes it harder to isolate the structured intervention’s impact

• Limited generalizability—the highly specific eligibility criteria and intensive commitment may not reflect the broader aging population

• Practice effects likely influenced results, though the study tried to account for this

One other limitation: every participant received the same four intervention types (physical activity, diet, cognitive/social challenge, and cardiovascular monitoring). What I’d love to see is a study that personalizes the interventions based on an individual’s specific risk profile.

For example, my own lab tests revealed low vitamin D and B12, high uric acid, and low magnesium—but great omega-3 levels and an APOE ε3/ε3 genotype. These can all impact brain health, so I implemented interventions to address my areas of risk. Someone else may uncover different opportunities—maybe around hormone levels, sleep, or stress, for example.

Additional Details About POINTER

Key Similarities Between FINGER and POINTER

• Overall Objective: How interventions might slow and prevent cognitive decline in older adults at risk of dementia

• Intervention Strategy: Multi-domain lifestyle interventions, including diet, exercise, cognitive training, and vascular risk management

• Intervention Duration: Two years

• Main Cognitive Outcomes: Improvements in executive function and processing speed were the most consistent benefits; changes in episodic memory were not significant in either study

Key Differences

• Study Population: FINGER was conducted in Finland with a mostly homogenous population and POINTER was conducted at five U.S. clinical sites with a more diverse participant group

• Intervention Comparison: FINGER compared a multidomain intervention to a control group; POINTER compared a structured, high-intensity lifestyle program to a less structured, self-guided program

• Intensity and Structure: The structured POINTER interventions involved more coaching, accountability, and goal-setting

Study Design

The U.S. POINTER study was a single-blind, multicenter randomized clinical trial:

• Randomization ensured participants were assigned to interventions groups by chance and not because of any bias.

• The researchers didn’t know who was in which intervention group, thereby eliminating bias in how results are measured and interpreted. The participants, however, did know which group they were in. This is why it’s called a single-blind study and not a double-blind study.

• Conducting the study at multiple research sites improved generalizability to diverse populations and settings.

The Two Intervention Groups

Structured Group

This was a higher-intensity intervention with greater accountability.

• Meetings: 38 facilitated team meetings over 2 years, focused on education, goal setting, and support/accountability

• Physical Activity goals:

  • Cardio Training: 4 days per week, 30-35 minutes per session

  • Resistance Training: 2 days per week, 15-20 minutes per session

  • Flexibility Training: 2 days per week, 10-15 minutes per session

  • Exercise was conducted at a community facility, like a YMCA

• Dietary Guidance: Encouraged to follow the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and reinforced with meeting, calls, and small incentives (e.g., $10 blueberry rebates)

• Cognitive and Social Engagement: Cognitive training using BrainHQ, 3 times per week for 15-20 minutes per session, and encouragement to engage in regular intellectually and socially engaging activities (read my BrainHQ article)

• Cardiovascular Health Monitoring: Biannual reviews of abnormal laboratory results (blood pressure, cholesterol, hemoglobin A1c) and medical consultations every 6 months

• Support: Group meetings and coaching by certified interventionists

Self-Guided Group

This was an unstructured, self-guided, lower-intensity intervention.

• Meetings: 6 meetings over 2 years that offered general encouragement without goal-directed coaching

• Education Materials: Publicly available health information and lifestyle suggestions

• Support: Minimal—general encouragement, but not structured coaching

• Health Monitoring: Annual clinic visits for basic health data

• Incentives: Gift cards ($75) provided at team meetings to support behavior change

Note: This was not a true control group—participants still received low-intensity intervention

Participant Profile

• Total participants: 2,111

• Completion rate: 89% completed the 2-year follow-up

• Demographics:

  • ~70% female

  • ~30% racial/ethnic minorities

  • ~30% had no college degree

• Cognitive status: Mostly cognitively healthy; <5% had mild cognitive impairment

• Health indicators:

  • Median BMI: 30.0 (overweight/obese)

  • ~30% were APOE ε4 carriers

  • ~79% had a family history of memory loss

Eligibility Requirements included:

• Age 60–79

• Sedentary (<60 minutes moderate activity per week)

• Suboptimal MIND diet screener score of ≤9 out of 14

• Plus two or more risk factors (e.g., family history, cardiometabolic markers, age 70+, minority status, etc.)

Exclusion Criteria included:

• Cognitive impairment, major psychiatric illness, active depression, or use of cognition-altering drugs

• Being too physically active or already adhering to the MIND diet

• Medical conditions or logistical barriers to participation

Final Thought

The POINTER study is a major milestone in understanding how lifestyle choices affect brain health. It provides additional evidence that structured interventions across multiple domains can help cognitive function—even in those at elevated risk for dementia. And unlike drugs, these tools are in your hands.

While no study is perfect and I’d love to see future research explore personalized, targeted interventions based on individual risk profiles, each step forward—like this one—brings us closer to meaningful prevention.

---

I am not a doctor or healthcare provider. This content is for general informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. I do not claim to have expertise in health, medicine, or wellness, and the content shared here should not be used to make decisions about your health or well-being. This information may provide ideas about topics to discuss with your medical team.

Always consult with a qualified healthcare provider for any questions or concerns regarding your health. Do not disregard professional medical advice or delay seeking it based on the information you have read here. Reliance on any information provided here or linked to from here is solely at your own risk.

I make no warranties about the completeness, reliability, or accuracy of the information presented.