The Pointer Study: What is it and why is it important for our brain health?

The U.S. POINTER study, formally called the ‘Protect Brain Health Through Lifestyle Intervention to Reduce Risk’ trial, was first launched by the Alzheimer’s Association in 2018 with participant recruitment beginning in 2019.

The study is a large, ongoing clinical trial investigating whether lifestyle changes can help protect cognitive function in older adults who are at higher risk of cognitive decline. It is the first study of its kind in the United States and it builds on earlier, promising research in Europe, notably the FINGER Study which took place in Finland.

The FINGER study demonstrated that a combination of lifestyle changes significantly slowed cognitive decline in older adults. It showed that up to 40% of dementia cases may be preventable through changes in the way we live. For example, what we eat (nutrition), how much we move (exercise), how well we sleep (sleep), and whether we challenge our brains (active mind) and stay socially engaged (healthy life) – the 6 core pillars that form the foundation of Brain Health Network and collectively shape our long-term brain health. The Pointer Study aims to see if similar results can be achieved in a diverse American population in which lifestyle changes have the greatest impact.

The study involves 2,111 adults between the ages of 60-79. According to the Alzheimer’s Association, “more than 30% of participants were from groups typically under-represented in dementia research”. This cohort was made up of those who do not exercise regularly, who may have a family history of memory loss, slightly high blood pressure, cholesterol or blood sugar levels. Participants were randomly split into two intervention groups and followed over a two year period.

Throughout this time, both groups received advice and support in terms of lifestyle habits, but one group received a more intensive programme. These programmes were referred to as self-guided vs. self-structured intervention programmes.

They included:

• Physical activity: a structured exercise programme was created with both aerobic and strength training sessions adjusted to ability.
• Healthy diet: emphasis was on the Mediterranean diet which included plant-based foods, lean protein, whole grains and healthy fats.
• Cognitive training: regular brain training exercises designed to stimulate problem-solving, memory and processing speed.
• Social engagement: focus was on group activities and regular contact with others to support strong social networks.
• Monitoring vascular risk: regular health checks were carried out to manage blood pressure, cholesterol and blood sugar levels.

Participants in the more intensive self-structured programme received personalised coaching, group sessions and support to help them stick with these new habits. The self-guided group received general health education.

Recently, the U.S Pointer study has been highlighted in the news as the study’s initial results were revealed on 28 July 2025 during the Alzheimer’s Association International Conference (AAIC) 2025 in Toronto. The findings were then published in JAMA (the Journal of American Medical Association).

Both programmes showed improved cognitive function in older adults at risk of dementia, but the structured programme delivered significantly better results. The structured intervention, which featured greater intensity, structure, accountability and support, produced greater cognitive benefits. It “showed greater improvement on global cognition compared to the self-guided intervention, protecting cognition from normal age-related decline for up to two years.”

These findings show new insights and actionable steps that can be taken for public health and clinical practice in helping to reduce the risk of dementia in later life. As Professor James Goodwin explains, ‘The US POINTER study confirms earlier studies that favourable lifestyle factors can reduce the risk of cognitive decline. The Finnish FINGER study was the first to show this, and Brain Health Network bases its approach on this proven principle’.

According to Professor Goodwin, one of the overlooked findings from POINTER was the consistency in keeping to a healthy lifestyle – a major factor in the effectiveness of any lifestyle change. In particular, our Healthy Life pillar reflects what these studies (POINTER and FINGER) have shown: one third of dementia cases can be explained by ‘healthy life’ factors – diabetes, blood pressure, being overweight, physical inactivity, depression and smoking.

Visit our ‘Healthy Life’ pillar on our website to find out more.