She’s also hoping these changes could help prevent her from rapid cognitive decline or developing Alzheimer’s, a progressive brain disorder that gradually impairs thinking, behavior, and memory. The study she participated in found that targeted lifestyle interventions could help protect brain health.
“Just be physically active, eat well, and have a good, meaningful life in terms of social engagement and brain stimulation,” said Dr. Stephen Salloway, the founding director of the Memory and Aging Program at Butler Hospital in Providence, and the principal for the New England site of the study. “Really, all of these things just make so much common sense.”
The Protect Brain Health Through Lifestyle Intervention to Reduce Risk, or US POINTER study, was conducted in five locations across the US over two years, and is the largest randomized trial to investigate whether healthy behaviors protect brain health.
Jessica Rinaldi/Globe Staff
The results were published in the journal JAMA and presented Monday in Toronto at the Alzheimer’s Association International Conference.
More than 2,000 adults between the ages of 60 and 79 who were at risk for cognitive decline and dementia in five hospitals participated in the study, which tested two different lifestyle interventions. The results found that both interventions improved cognition in older adults at risk of cognitive decline.
Both interventions focused on physical exercise, nutrition, cognitive challenge and social engagement, and heart health monitoring, but differed in intensity, structure, accountability, and support provided.
Half of the participants followed a structured program where they attended more than three dozen facilitated peer team meetings over two years, and were provided with a prescribed activity program with measurable goals for aerobic, resistance and stretching exercise; adherence to a specific diet similar to the Mediterranean diet; brain training and other intellectual and social activities; and regular review of health metrics and goal-setting with a study clinician.
The other half went through a “self-guided lifestyle intervention,” where participants would attend six peer team meetings to encourage self-selected lifestyle changes that best fit their needs and schedules. Study staff also provided general encouragement without goal-directed coaching.
Cognitive function significantly improved in both groups, but participants in the structured group performed at a level comparable to adults one to two years younger in age, according to Dr. Laura D. Baker, a professor of gerontology and geriatrics and internal medicine at Wake Forest University School of Medicine, and a POINTER investigator.
“It looks like it slows the cognitive aging clock,” said Baker.
The results cannot be compared to the general population, since it did not include a group that did not receive any sort of intervention.
Alzheimer’s disease is the most common type of dementia, and an estimated 6.7 million older adults have Alzheimer’s in the US. That number is expected to double by 2060, according to the CDC. Many factors can play a role in causing Alzheimer’s, including genetics and habits, and symptoms include problems with short-term memory.
“As the burden of dementia grows world-wide, US POINTER affirms a vital public health message: healthy behavior has a powerful impact on brain health,” said Dr. Joanne Pike, Alzheimer’s Association president and CEO.
The Alzheimer’s Association spent $50 million as the lead funder of the study, according to Dr. Maria C. Carrillo, the organization’s chief science officer and medical affairs lead.
Participants came from diverse racial and ethnic backgrounds, and they all had sedentary lifestyles, poor diets, and other dementia risk factors, like a family history of cognitive decline.
“The next generation of treatments for diseases like Alzheimer’s will likely integrate drug and non-drug strategies. US POINTER provides a strong foundation for such combination approaches,” said Dr. Heather M. Snyder, Alzheimer’s Association study primary investigator and senior vice president of medical and scientific relations.
Peter Gijsbers van Wijk, 72, of Pearland, Texas, was a participant in the self-guided group. A retired chemical-tanker company employee, Gijsbers van Wijk said he purchased a smart watch to keep track of his steps and began walking more. He lost his wife to cancer in the middle of the study, but said he remained committed, and started volunteering for community programs.
“I only have one child, and I thought it was important to have as much information as possible for both of us to reduce the risk,” said Gijsbers van Wijk, whose family has a history of dementia, and who had high blood pressure, high cholesterol, and had undergone a quadruple bypass when he started the study.
Gijsbers van Wijk acknowledged that some participants of low-income backgrounds might have found it challenging to follow the study’s guidelines.
“My teammates had difficulty finding a local gym that was affordable, or hours that met their needs,” he said. “Being in Texas during the summer months, it’s too hot and humid to work out outside.”
The trial ended last year, but researchers will continue to analyze blood samples, brain scans, and the tests participants completed to see if these interventions reduced Alzheimer’s-related proteins or other biological factors.
“Alzheimer’s disease has such a stigma, still, today, and naturally brings a lot of fear and anxiety,” said Susan Antkowiak, vice president of programs and services for the Alzheimer’s Association’s chapter in Massachusetts and New Hampshire. “When we talk about what science is proving to us for lifestyle interventions, that enables us to have hope.”
The Alzheimer’s Association will spend another $40 million to follow participants and help communities adopt local programs.
“Some people try to understandably ignore their brain health and symptoms they may be experiencing because they’re afraid of the outcome,” added Antkowiak. “By providing a more proactive, preventative approach, it allows us to introduce hope based on science. There are things we can do.”
Alexa Gagosz can be reached at alexa.gagosz@globe.com. Follow her @alexagagosz and on Instagram @AlexaGagosz.
