Lifestyle Interventions Improve Cognition for At-Risk Older Adults

Significantly greater benefit on global cognition seen for structured versus self-guided intervention over two years

By Elana Gotkine HealthDay Reporter

WEDNESDAY, July 30, 2025 (HealthDay News) — Lifestyle interventions improve cognition for older adults at risk for cognitive decline and dementia, with significant benefit seen for a structured intervention, according to a study published online July 28 in the Journal of the American Medical Association to coincide with the Alzheimer’s Association International Conference, held from July 27 to 31 in Toronto.

Laura D. Baker, Ph.D., from the Wake Forest University School of Medicine in Winston-Salem, North Carolina, and colleagues compared the effects of two two-year lifestyle interventions on the cognitive trajectory in older adults (aged 60 to 79 years) at risk for cognitive decline and dementia. A total of 2,111 participants were randomly assigned to structured or self-guided interventions (1,056 and 1,055 individuals, respectively). The structured arm included frequent peer team meetings, regular exercise, the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, BrainHQ cognitive training, social/cognitive challenge, and monthly blood pressure monitoring, while the self-guided arm included fewer peer team meetings and general health education.

The researchers found that in both groups, the mean global cognitive composite z score increased from baseline over time, with a mean rate of increase per year of 0.243 and 0.213 standard deviations (SDs) for the structured and self-guided interventions, respectively. The mean rate of increase per year was significantly greater for the structured group by 0.029 SD. The structured intervention benefit was consistent for APOE ε4 carriers and noncarriers but seemed greater for adults with lower versus higher baseline cognition. The structured group had fewer ascertained adverse events compared with the self-guided group.

“The potential to improve cognition with fewer resources and lower participant burden is compelling,” Baker said in a statement. “It highlights that while not everyone has the same access or ability to adhere to more intensive behavior interventions, even modest changes may protect the brain.”

Several authors disclosed ties to the biopharmaceutical and nutrition industries.