Eat, Move, Learn, Collaborate: The Lifestyle Formula That Turned Back the Brain Clock

At AAIC 2025, researchers shared that older adults who combined healthy habits with structured support were able to achieve higher scores on cognitive tests and effectively slow brain aging by two years.

Remember nagging your kids to eat their veggies, go outside and play, and pick up a book? Well, it turns out that advice is good for older folks too.

At the 2025 Alzheimer’s Association International Conference, researchers presented data from the new U.S. POINTER study, which indicates that a healthy diet combined with regular vigorous exercise, brain training, and maintaining heart health — when supported by teamwork and coaching — can turn the brain aging clock back by up to two years.

“Our best estimate is that participants performed cognitively at a level comparable to adults one to two years younger,” lead investigator Laura Baker, PhD, said at AAIC. “We believe that this improvement will increase resilience against age-related cognitive decline.”

But the study also showed that teamwork and coaching were key to success. Participants who were encouraged to make these changes on their own did experience some benefit. But those who got a structured program, with lots of team meetings, phone calls, and clinic visits reaped the biggest reward: significantly improved scores on cognitive testing after two years of work, said Baker of Wake Forest University, Winston-Salem, NC.

Inside the U.S. POINTER study

U.S. POINTER is the American spin-off of the highly regarded Finnish FINGER study, published in 2015. The ground-breaking study relied on a brain-health-friendly diet that the researchers dubbed the “healthy Nordic diet” featuring lots of fish, fruits and vegetables and oils, combined with structured exercise, brain training, and social interaction. FINGER has since spawned a global network of similar studies in 71 countries, including the U.S. version.

POINTER, which was simultaneously published in JAMA, enrolled more than 2,000 older Americans (average age 68) who had a suboptimal diet and a sedentary lifestyle. Everyone also had at least two other risk factors for cognitive decline: older than 70 years, a family history of cognitive impairment, cardiovascular risk factors, or native American, Black, or Hispanic ethnicity.

Participants were split into two groups, both of which focused on lifestyle factors:

eating better,

exercising more,

learning new things, and

keeping track of blood pressure and cholesterol.

The big difference was in the way people made these changes.

One group was completely self-directed. They received all the information needed to make these changes, but other than six meetings and four phone calls with an advisor over the 2 years, they were on their own to figure out how to implement the changes.

The other group, however, got a lot of support. Their program was highly structured:

Everyone received a Fitbit and had to meet solid daily, weekly, and monthly goals for aerobic, strength, and stretching exercise.

This group was asked to adhere to the MIND diet , with a weekly adherence score.

They underwent brain training with the Brain HQ app .

They received regular cardiovascular health checkups.

Another big difference? Personal support, with 38 coached team meetings, 26 phone calls, and seven in-person health checkups, for a total of 71 meetings over the course of just two years.

The primary outcome was change on what the investigators called “global cognitive function.” This total score was a combination of scores on 13 individual tests of episodic memory, processing speed, and executive function.

U.S. POINTER results

At the end of the study, both groups had significantly improved global cognitive scores relative to their starting points, but the structured intervention group improved significantly more than the self-guided group.

The between-group difference was small, but important, Baker said. When she and her colleagues compared the scores to historical data on age-related cognitive decline, people in the structured intervention group were scoring as if they were a year or two younger.

This finding is especially important when considering that, while everyone was cognitively normal at enrollment, they were also at risk for age-related cognitive decline, Baker said. “We believe this indicates an increased resilience against cognitive decline in the future,” she said.

Interestingly, of the three cognitive areas tested, the only significant improvement was in executive functioning – the skills needed to manage everyday life, like planning and problem-solving. There were no significant changes in memory or processing speed in either group.

That’s not a complete surprise, said Heather Snyder, PhD, senior vice president of medical and scientific relations at the Alzheimer’s Association.

“When we look at age-related cognitive decline, executive functioning is often what we see impacted first,” she told Being Patient. This change is also similar to the original FINGER results, she said, adding that investigators hope memory and processing speed will also improve if people stick with the program.

In fact, more than 80 percent of the structured intervention group has agreed to continue, Snyder said. Investigators will keep following these folks for four more years in the POINTER alumnae cohort.

What’s next for clinical research into lifestyle factors and brain health?

Four more POINTER-spawned studies are in the works, with results to be released in December. Some participants gave blood and cerebrospinal fluid as well as samples for gut microbiome analysis. Others underwent brain and vascular imaging, and recorded sleep information. This information will give some insight into just how exercise, diet, and brain training might impact the biologic processes that contribute to cognitive decline and Alzheimer’s.

“This study is a treasure trove of data and information and it’s going to change the conversation around brain health in the United States and around the world,” Snyder said. “It’s going to help us rethink individual approaches to risk reduction and treatment.”