What the US POINTER study means for you and why it’s more than a diet change

In 2015, the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) proved that lifestyle changes can protect brain health and reduce the risk of cognitive decline in older adults. The FINGER study was the first of its kind and later led to the US POINTER study, which was designed to test whether the results of the Finnish study could be applied to the US. population.

The US POINTER study, formally known as the US Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk, was funded by the Alzheimer’s Association and published in 2025. At the end of the two-year study, all participants had at least some improvement in memory and thinking skills.

“We launched the POINTER study because one of the most common questions we get at the Alzheimer’s Association is: ‘Is there anything I can do to lower my risk of cognitive impairment?’” said Heather M. Snyder, PhD, senior vice president of Medical & Scientific Relations at the Alzheimer’s Association and a leader of the POINTER study.

About the US POINTER study

The study included just over 2,000 people between ages 60 and 79 who were at risk of cognitive decline because of family history, high blood pressure, diabetes, low levels of physical activity, or poor diet. They were divided into two groups: self-guided and structured.

The self-guided group received publicly available information about brain health and were encouraged to design a lifestyle program that best suited their needs. They attended six team meetings over two years that offered general encouragement without goal-directed coaching.

The structured group followed a program that included coaching, goal setting, regular appointments to check weight and blood pressure, and 38 group sessions over two years. Dr. Snyder explains that part of the coaching included “navigators”—Alzheimer's Association staff who supported the participants throughout the study. The navigators partnered with a person from the clinical team to teach the curriculum at the group sessions.

Participants in both groups were encouraged to follow the MIND diet, which shows that some of the best foods for brain health are green leafy vegetables, berries, nuts, whole grains, olive oil, and fish.

The structured group did 30 to 35 minutes of moderate-to-intense aerobic activity four times a week, plus strength and flexibility exercises twice a week. Additionally, the structured group used a computer-based brain training program three times a week for 30 minutes and regularly engaged in other intellectually challenging and social activities.

By the end of the study, both groups had improved their cognitive scores, but the participants in the structured group showed more improvement than those in the self-guided group.

How lifestyle changes can improve brain health outcomes

The POINTER study shows that future prevention for Alzheimer’s disease and dementia could be a combination of medications and lifestyle changes. Dr. Snyder explains, “Complex diseases like heart disease and cancer use combination treatment strategies tailored to individual characteristics. The next generation of treatments for diseases like Alzheimer’s will likely integrate drug and non-drug strategies [and the] US POINTER study provides a strong foundation for such combination approaches.”

Darren Gitelman, MD, FAAN, professor of neurology at Wake Forest University School of Medicine and a site leader of the POINTER study at Advocate Health, says that the “US POINTER and related studies demonstrate that nearly everyone, regardless of their background, can make changes in their lifestyle that can benefit their brain health long-term.”

“And the study matters because dementias are debilitating,” says Glen Finney, MD, FAAN, vice-chair of neurology at the Geisinger Health System. “Dementia robs you, piece by piece, of the person you have been, and puts incredible strain on the people with the disease and their families.” Prevention is probably our best opportunity, says Dr. Finney, “and the POINTER study showed improvement in preservation of cognitive function.”

How does exercise improve brain health?

“Exercise actively builds, repairs, and protects brain cells,” says Dr. Finney. “While food provides the raw materials and fuel, physical activity triggers blood flow, reduces brain shrinking, and releases growth factors that nutrition alone can’t activate.”

Exercise can lead to:

• Better blood flow. Pumping your heart sends more oxygen and glucose to brain tissue.
• A stronger memory center. Regular workouts can increase the size of the hippocampus, which protects against memory loss.
• A cleaner brain. Good blood circulation may help clear out harmful proteins that can be linked to Alzheimer's disease.
• Less inflammation. Physical activity cools down brain stress and swelling.

Improving cognition later in life

You can improve your brain function at any age. Dr. Gitelman says that improving your brain function later in life has the added benefits of remaining independent for longer and even saving money on a nursing home or in-home care.

The Alzheimer’s Association has created two resources to help you make positive lifestyle changes and have conversations with your doctor:

• The US POINTER Brain Health Recipe offers guidance about exercise, diet, brain challenges, social activities, and health monitoring.
• The Brain Health Habit Builder is a free online tool for adults of all ages. Even if you have a family history of dementia, there are things you can do to support your brain health. Check your current habits—like physical activity, diet, and sleep—and make a plan to protect your brain health.

Expect more results to be published from the POINTER study. Most of the original participants joined a four-year follow-up period so that the study researchers can look at the long-term effects of the various lifestyle habits.