A randomized clinical trial (The U.S. POINTER trial) found that lifestyle changes benefited cognitive health in older adults at risk for cognitive decline and dementia. The study included 2,111 men and women ages 60 to 79 years at five clinical sites in the U.S. Participants had a sedentary lifestyle, suboptimal diet, and at least two other risk factors for cognitive decline and dementia (such as family history of memory impairment and cardiometabolic risk factors). They were randomly assigned to either a structured or self-guided lifestyle intervention program.
In the two-year study period, the structured intervention had 38 meetings with “navigators” who helped them through behavior changes to increase physical and cognitive activity, shift to a healthier dietary pattern, be more socially engaged, and monitor their cardiovascular risk factors like high blood pressure and high LDL cholesterol. The self-guided group had six meetings and were directed to publicly available education materials and encouragement. Researchers measured executive function, episodic function, and processing speed every six months.
All participants showed improvement in cognitive function, although the structured intervention group had a significantly greater improvement than the self-guided group. The structured intervention benefited carriers of a gene that increases risk for Alzheimer’s disease (APOE4) as much as it benefited noncarriers.
While extended follow-up is needed to determine whether these cognitive benefits are sustainable, this study shows that a healthy dietary pattern, regular physical activity, cognitive and social stimulation, and regular monitoring of and attention to cardiovascular risk factors improved cognitive health and may lower risk for or delay onset of cognitive decline and dementia.