A two-year program of exercise, Mediterranean-style diet, brain training and social activity improved cognition in 2,100+ older adults, with scores akin to people 1–2 years younger.
At the Alzheimer’s Association International Conference in Toronto, researchers unveiled results from the POINTER study, published in JAMA, showing that a two-year mix of exercise, Mediterranean-style eating, brain training and social engagement sharpened cognition in more than 2,100 sedentary adults aged 60 to 79 across the United States. The intensive program beat a self-guided plan and appeared to slow typical age-related decline.
Why and how it worked
Who was studied: Adults 60 to 79 with normal memory and thinking but at elevated risk for cognitive decline and Alzheimer’s. Participants were sedentary and eating a suboptimal diet at baseline.
The design: Half were asked to improve diet and exercise on their own. The other half followed an intensive plan that included aerobic exercise four times a week, a heart-healthy Mediterranean diet, online cognitive training, mandatory social activities, and monitoring of blood pressure and blood sugar.
The outcome: Both groups improved on memory and thinking tests, but the intensive group did markedly better. “These people are obtaining cognitive function scores that are similar to people [like them who are] one to two years younger than they are,” said Laura Baker, principal investigator and professor at Wake Forest University School of Medicine.
What researchers and experts said
“This is really showing that we can change people’s trajectories over time,” said Jessica Langbaum of the Banner Alzheimer’s Institute, who was not involved in the study.
The regimen required effort. “There is no way to form a new habit or change behavior without intentional work on a regular basis. It’s impossible,” Baker said, noting many participants called the program life-changing.
The Alzheimer’s Association plans to take the model into communities. “The translation from the POINTER prescription to how we then deliver that into the community is absolutely the next step,” said co-author Heather Snyder, a senior vice president at the Association.
For clinical practice, Langbaum added, “Doctors should be treating lifestyle interventions as they would a drug,” urging coverage and structured prescriptions for patients.
For individuals: A practical path to preserve everyday thinking and memory, with gains that resemble turning back the clock by one to two years for people at similar risk.
For providers and payers: A push to prescribe and reimburse structured lifestyle programs, not just advise generic exercise or diet.
For public health: Evidence to support community programs that combine physical activity, nutrition, cognitive training and social engagement in older adults.
The findings align with decades of data that single interventions like exercise help the aging brain. They also mirror the earlier Finnish FINGER trial, which used a similar multi-domain approach in a less diverse population.
POINTER’s budget underscores the stakes. The Alzheimer’s Association invested nearly 50 million dollars, while the National Institutes of Health funded brain scans, blood tests and sleep studies that will report biological changes tied to cognitive outcomes.
Researchers stress the results address normal brain aging, not treatment of Alzheimer’s disease. Still, delaying decline could push back dementia onset.
The POINTER plan at a glance
| Component | What the trial did | How to try it safely |
|---|---|---|
| Aerobic exercise | 4 sessions per week | Build to 150–210 minutes weekly of brisk walking, cycling or swimming; add strength twice weekly |
| Mediterranean-style diet | Heart-healthy meals | Emphasize vegetables, fruits, whole grains, legumes, fish, olive oil; limit red meat and ultra-processed foods |
| Cognitive training | Regular online exercises | Do 20–30 minutes, 3–5 days weekly of novel, challenging tasks; rotate activities to keep it fresh |
| Social engagement | Mandatory group activities | Join group classes, clubs, volunteer work or walking groups; combine movement with social time |
| Risk factor control | Track BP and blood sugar | Monitor at home if advised, take medications as prescribed, follow up with your clinician |
Build a brain-healthy routine
- Talk to your doctor
- Review medications and any heart or joint issues before starting new exercise.
- Set a realistic exercise plan
- Start with 10–15 minutes of walking most days and add time each week until you reach 150–210 minutes.
- Shift one meal at a time
- Swap butter for olive oil, add a salad or lentil dish daily, and fish twice per week.
- Train your brain with novelty
- Pick activities that are new and a bit hard, not just easy puzzles. Increase difficulty as you improve.
- Add social time to your week
- Schedule two group activities, like a class, a club or a walking meet-up.
- Track key numbers
- Check blood pressure as advised, keep a simple log, and follow up on blood sugar if you are at risk.
- Make it stick
- Use reminders, set specific days and times, and pair habits, like a short workout before breakfast.
The POINTER results suggest that a structured mix of movement, healthy eating, mental challenge and social connection can keep aging brains sharper over two years. The Alzheimer’s Association plans to invest another 40 million dollars over four years to roll the approach out in communities. Biomarker analyses from POINTER, expected later this year, could show whether cognitive gains line up with measurable brain changes. Even healthy adults may want to level up their routine. As Langbaum puts it, “If you already do the Sunday crossword puzzle and it’s not challenging, pick up something new, find that exercise regimen that you’ll adhere to, and if you can do it around people, that’s even better.”
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