Just a few weeks ago at the Alzheimer’s Association International Conference 2025 (AAIC 2025), groundbreaking news emerged in the field of cognitive aging and Alzheimer’s prevention, namely:  the U.S. POINTER clinical trial results.¹  When the news broke, we shared a quick summary of it with you, and here we’ll get into more details of what U.S. POINTER is, what it did, and why it matters for everyone who wants to take better care of their brains. 

The Challenge:  Behavioral Change Isn’t Easy, Especially in Clinical Trials 

Before U.S. POINTER, most researchers agreed that lifestyle factors, like diet and exercise, could have a positive effect on brain aging and dementia prevention.  In fact, many earlier studies observed people’s behavior and tracked their cognitive decline and dementia rates, and those indicated that lifestyle factors indeed play a role.  Also, dementia rates are rising across the world, and research is showing that the best way to control its growth is through risk reduction and prevention strategies, well before people are diagnosed with diseases like Alzheimer’s. 

However, two challenges remained:  (1) most researchers suspected that many lifestyle changes working together synergistically, rather than a single change, would likely work better to protect the brain, and (2) a large, randomized clinical trial to prove such an idea had not been done and would be very challenging.  Clinical trials involving lifestyle changes inevitably mean changes in people’s behavior, and behavioral changes are hard to adopt and sustain.  Personal habits, family situations, occupations and workplace, accessibility and costs, and cultural norms tend to “lock” people into certain behaviors.  For most people, making just one behavioral change would be hard enough (think about New Year’s resolutions that never quite stuck, or a diet that didn’t last), and so how could researchers expect to do a trial where people attempt multiple behavioral changes, not just for a few weeks, but over years? 

The Inspiration:  FINGER Points the Way 

In 2015, inspiration for U.S. POINTER came from a clinical trial from Scandinavia with an interesting name:  FINGER.  In FINGER, a Finnish and Swedish research team led by Miia Kivipelto, PhD had successfully guided over 1200 people over two years through a fully randomized clinical trial where they carefully changed four lifestyle factors: 

Then, they performed comprehensive cognitive testing after the first and second years, and they found that people who were given the four lifestyle interventions improved in their overall cognitive performance compared to those who did not get the interventions.  In particular, they had marked improvements in their memory, decision-making, and processing speed. ² 

Not only were the cognitive outcomes groundbreaking, but just as important, the FINGER trial show researchers how to do a long-term lifestyle intervention trial, and it demonstrated that such a trial could be successfully completed, since only 12% of the participants dropped-out. 

This made U.S. researchers immediately ask the question:  Would this sort of lifestyle intervention work in the U.S., where the American people, their diets, their lifestyles, and their culture are very different from Finland? 

The Strategy for U.S. POINTER:  What and How 

The U.S. POINTER Study is the largest ever randomized clinical trial conducted in the U.S. of how diet and lifestyle interventions might improve cognitive health, specifically in people who are at higher risk of cognitive decline and dementia.  This study is one of the most comprehensive studies undertaken to-date on this subject, recruiting over 2000 people to participate for two years in these interventions. 

Laura Baker, PhD from Wake Forest University led a large American research team, which recruited participants across five diverse sites across the U.S. (Chicago, North Carolina, Houston, Northern California, and New England).   

Who did they choose to participate? 

In short, they chose people who are AT RISK of cognitive decline and dementia.  Many Americans fall into this category, and it’s worth it to consider whether you or a loved one falls into this as well. 

What Did They Do? 

The researchers divided the participants into 2 groups:  a “Self-Guided” low-intensity intervention and a “Structured” lifestyle intervention that intensively promoted four lifestyle changes, which were adapted from the FINGER trial for U.S. culture.  Here are the four: 

Making It Stick:  How Did People Maintain These Four Interventions? 

One of the U.S. POINTER researchers, Jeffrey Katula, PhD, remarked that doing all four of the interventions for two years is a “hard pill to swallow.”  But somehow, they were able to pull it off.    

The key was accountability. 

People in the intensive “Structured” group were divided into teams of 12-15 fellow participants – an instant accountability driver.  Each team met 38 times over two years.  Also, each participant met with study staff by telephone 26 times and made health monitoring visits 7 times over the two years. 

The result was spectacular compliance. 

So, a key insight from U.S. POINTER is that big, brain healthy changes in our lifestyles are possible, and they can be maintained for a long time – and working with accountability partners with the same goals can really help you stick to the program. 

Source:  Baker L. U.S. POINTER: Topline Results of a Large Multisite Randomized Controlled Multidomain Lifestyle Intervention Trial (AAIC 2025 Presentation). 

Cognitive abilities improved in three ways: 

The Big Takeaways:  Offsetting Brain Aging 1-2 Years, and More 

One of the biggest insights from U.S. POINTER is that the “Structured” group’s performance could be compared to offsetting cognitive decline by 1-2 years.  One to two years may not seem like much, but bear in-mind one thing:  This was only measured over two years.  Stalling cognitive decline by 1-2 years over a two year period is almost like hitting the brakes of cognitive aging.  

Imagine if a person kept up the four lifestyle changes for more than two years, say four, or six, or eight, or decades.  That could potentially compound the benefits and offset cognitive decline by MANY years.  That’s an important reason why researchers are continuing to follow the trajectory of the trial participants. 

Here are other big takeaways from U.S. POINTER: 

In the coming months, more data from this study will be available, particularly for the impact of specific nutritional components.  Given that U.S. POINTER is such a rich trial, new results regarding blood biomarkers, brain imaging, gut and microbiome, and sleep from this trial will emerge, and we’ll keep you posted on them.  

We are very delighted that U.S. POINTER used the MIND Diet as its nutritional intervention.  MIND is an acronym for “Mediterranean-DASH Intervention for Neurodegenerative Delay,” and it is one of the most widely and deeply studied brain-healthy diets, originally developed at Rush University Medical Center.  MIND is like a Mediterranean diet, but it emphasizes certain foods to eat, such as: 

You can learn more about the MIND and Mediterranean Diet, as well as other brain healthy lifestyle changes by downloading our free guide “6 Steps to Building Lasting Brain Power” below.

Not only does NeuroReserve encourage and educate on the MIND Diet and other brain-healthy diets like it, but also our goal is to support them through nutritional product, whether it be through supplementation or extra virgin olive oil.