More intensive lifestyle program did not change brain markers
In a two-year randomized trial involving 983 older adults at risk of cognitive decline, structured and self-guided programs did not differ in brain-marker changes.
Our read
Interventions- Studied:
- Randomized trial in 983 older adults at risk for cognitive decline, 2-year (Blinded, multicenter, registered NCT03688126)
- What changed:
- Changes in brain imaging markers did not differ between the structured and self-guided lifestyle programs
- The catch:
- Higher baseline tau among amyloid-positive participants in the structured group could mask intervention effects
- Stake:
- An author works for Perceptive.
- In the record:
- The 98th paper on multidomain lifestyle intervention with results in people; 211 on record in all.
Editor of record: Boris Djordjevic · AgingResearch.News
Adults aged 60 to 79 with sedentary lifestyles, suboptimal diets and at least two additional risk factors for cognitive decline participated in a two-year randomized trial. The imaging analysis included 605 women and 378 men. Both programs emphasized physical and cognitive activity, healthy eating, social engagement and cardiovascular health monitoring. The structured program provided greater intensity and accountability.
The groups did not differ in changes in brain imaging measures or overall cognitive scores. A smaller hippocampus, a brain region involved in memory, at the start was associated with greater cognitive benefit from the structured program compared with the self-guided program. Increasing tau protein buildup was linked to declining cognitive scores in the self-guided group, but this association was weaker in the structured group. Scanning involved four procedure-related adverse events; no severe scanning events were reported.
Why it matters
Brain markers may help identify which older adults at risk of cognitive decline are most likely to benefit from lifestyle programs.
Caveats
The analyses involved multiple comparisons without statistical correction, making subgroup findings more vulnerable to chance. Both groups received lifestyle programs, and the imaging analysis did not cover people outside ages 60–79 or those unable to undergo brain imaging.
From the paper
- Limitation
First, the parent trial topline finding of a global cognitive benefit of the STR intervention did not replicate in the POINTER Imaging ancillary study subsample (n=983) making the STR-related cognitive benefits we identified more difficult to interpret.
Quoted word for word from the full text on PubMed Central.
The paper
University of California, Berkeley
JAMA Neurology, Apr 21, 2026, Open access, accepted manuscript
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