In 2025, the JAMA Network identified one of the most viewed articles in the Journal of American Medical Association (JAMA) as one that explores a question central to many older adults: can lifestyle changes help maintain brain health and slow cognitive decline as we age?
A large-scale study, known as the US POINTER randomized clinical trial, included 2,111 adults aged 60 to 79 years who were considered at elevated risk for cognitive decline due to sedentary behavior, poor diet, and other health and lifestyle factors. The study was a single-blind, multicenter randomized clinical trial to help assess the effect of structured lifestyle changes in participants’ brain function over a two-year period.1
Participants were randomly assigned to one of two lifestyle interventions. One group took part in an intensive, structured lifestyle intervention program that included regular physical activity, dietary guidelines, cognitive and mental stimulation, social engagement, and regular coaching to guide cardiovascular and overall health. A second group took part in a self-guided, less intensive program that offered the same general recommendations, but with less coaching, support, and supervision.
At the end of the two-year period, both groups showed improvements in overall cognitive performance. However, participants in the structured lifestyle program experienced a slightly greater improvement in global cognitive function compared with those in the self-guided group. While the difference was modest, it was statistically significant (p value=0.008) and suggests that having structured support may make lifestyle changes more effective for brain health.
This study adds to growing evidence that healthy lifestyle habits, such as regular physical activity, nutritious eating, mental stimulation, and social engagement can support cognitive health, even later in life, especially when those changes are structured and supported rather than self-directed. Although the trial does not yet show whether these interventions can prevent dementia long-term, the findings are encouraging and suggest that improving everyday habits may help older adults maintain cognitive sharpness and brain resilience, reinforcing that it is never too late to support brain health.
References
1Baker LD, Espeland MA, Whitmer RA, et al. Structured vs Self-Guided Multidomain Lifestyle Interventions for Global Cognitive Function: The US POINTER Randomized Clinical Trial. JAMA. 2025;334(8):681-691. doi:10.1001/jama.2025.12923
