Shutterstock

Share It Tweet It Pin It

Nearly a quarter of adults 45 and older in Arkansas report cognitive and memory problems that are worsening and over 60,000 Arkansans have been diagnosed with Alzheimer’s disease. Nationally, 7 million people live with Alzheimer’s, and that number is expected to reach 13 million by 2050. 

But according to findings from a new study by the Alzheimer’s Association, certain lifestyle changes could reduce new dementia cases and subjective cognitive decline by up to 45%. The Alzheimer’s Association’s U.S. Pointer study in 2025 revealed how diet, exercise and brain health training all play critical roles in helping individuals maintain and strengthen their cognitive function.

“With prevalence here in America just skyrocketing, you’re going to have to have that risk reduction. We have to do more to get ahead of the curve,” says David Cook, director of public policy and government affairs at the Arkansas chapter of the Alzheimer’s Association, “because the health care system is just not equipped to handle that type of volume.”

Pointer Study Findings

Starting in 2019, the Alzheimer’s Association studied 2,111 U.S. adults of varying demographics and geographies, testing several evidence-backed strategies to combat cognitive decline, including special diets, exercise routines and brain health training. The study included a control group, which was asked to maintain lifestyle changes independently, and another group that was given accountability assistance to stay on track with the lifestyle changes.

The U.S. Pointer (U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk) was modeled after a similar landmark study undertaken in Europe known as the FINGER (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability). 

While the Pointer group with accountability assistance did show slightly more improvement than the control group, the study concluded that the lifestyle changes investigated helped both groups significantly improve or maintain their cognitive functioning.

“What we wanted to test here domestically is whether or not these interventions work across our U.S. population,” Cook says. “What we learned, regardless of what cohort they were in — whether it was the structured group or the non-structured group — is that when you introduce these things, you improve and strengthen your brain health.

“One of the things the Association believes is like 45% of cases could be reversed or delayed by introducing these lifestyle interventions,” he adds.

Some study participants were also able to markedly improve their physical health, even going as far as stopping medication management for conditions like high blood pressure.

“I point to the example of one lady who shared her story: She was on diabetic medication to manage diabetes; she was on blood pressure medication,” Cook says. “She was in trouble. And now, towards the end of the study, she does not have any kind of blood pressure medication, she doesn’t have diabetic medication that she has to rely on, she lost over 80 pounds. She’s just more active, involved and her mental health has improved dramatically because of that.”

Cook says the interventions’ efficacy across both physical and cognitive health can be summed up simply: “What’s good for the heart is good for the brain.”

Mind Body Connection

Dr. Mark Pippenger, a behavioral neurologist at the Baptist Health Memory Center, says cardiovascular health is closely linked to brain health. Diets that don’t rely on super-processed foods, and exercise that oxygenates the blood, both reduce stroke and heart attack risk — while also improving brain health.

“All of those things have evidence from studies that they’re beneficial to heart and brain,” Pippenger says.

Adds Cook, “Cardiovascular health is crucial, which makes sense, because if you’re not having good cardiovascular health, you’re not getting oxygen flowing to the brain. And we see vascular dementia is another form of dementia; people with diabetes usually have a higher prevalence of getting vascular dementia.”

According to the U.S. Centers for Disease Control, known risk factors for dementia, including Alzheimer’s, include lack of physical activity, uncontrolled diabetes, high blood pressure, and tobacco and alcohol use. Social isolation, even including hearing difficulties, also can increase risk for cognitive decline.

According to peer-reviewed research by the Affiliated Hospital of Weifang Medical University, from 1990 to 2019, the incidence of Alzheimer’s disease worldwide increased by roughly 148%. Cook says that’s due to a number of factors: improved diagnostics, better health care access and lifestyle changes over time.

“There’s more dependence on processed foods, there’s less social engagement. … If you look at previous generations, there was a lot more dependence on growing their own food, less dependence on processed foods,” he says. “And we get our community from cell phones now, so there’s less social engagement, which we know is a risk. Less physical activity … All of that is driving risk, not only in our space, but we’re also seeing higher prevalence of diagnosis of cancer and heart disease.”

However, with lifestyle interventions like those investigated in the Pointer study, Cook says any adult can improve their health.

“It’s never too late to start — we saw that through the study,” Cook says. “Even if you have dementia, or you are aging and you have some risk associated with that, by introducing these things, you can diminish your risk. And that’s really exciting, because risk reduction is huge.”

The MIND Diet

One intervention that Pointer study participants implemented was what’s called the MIND Diet. It stands for Mediterranean-DASH Intervention of Neurodegenerative Delay and combines heart-healthy, plant-forward whole foods with another diet known as Dietary Approaches to Stop Hypertension.

“Diets that are lower in red meat and higher in fruits, vegetables and non-red meats seem to be better, and research over the years has shown that things like olive oil, extra virgin olive oil, seem to have a mix of fat that’s beneficial,” says Pippenger. “That’s the Mediterranean diet and the DASH diet, which the (American) Heart Association published.”

The MIND Diet, he says, takes both a step farther, focusing specifically on foods that evidence shows help brain health. 

“Among the vegetables, it’s leafy green vegetables, and among berries, it’s dark berries like blueberries, raspberries and blackberries,” Pippenger says. “It’s a combination of the mix of the types of fats that are consumed, with more unsaturated fats and omega-3 fatty acids, the things you would find in fish, nuts.”

Pippenger says the Mediterranean and DASH diets are both considered superior to the “standard American diet, which tends to be much higher in saturated fats, high in red meats, that have been shown repeatedly to be less beneficial.” If one can’t abide by the MIND Diet, incorporating principles from the Mediterranean or DASH diets can still improve heart and brain health, he says.

“It’s a matter of finding something that you actually will follow,” he says.

Aerobic Exercise

The Pointer study also explored the impact exercise has on the brain, specifically investigating  aerobic, resistance and stretching training. Pippenger says increasing blood flow helps oxygenate the brain and body, resulting in better heart and brain health.

“There’s more solid evidence for the benefit of physical exercise on brain health than there is even for diet. We have increasing evidence of that in numerous trials, trials both of people who do and don’t have cognitive impairment,” he says. “It’s been shown that physical exercise can reduce the rate of decline and reduce the likelihood of progression into dementia.”

Aerobic exercise, also called cardio, is any rhythmic activity where large muscle group movements can be maintained continuously, according to the American College of Sports Medicine. Common aerobic exercises include brisk walking or running, dancing, gardening, tennis, biking, swimming and jumping rope. The American Heart Association recommends at least 150 minutes per week of moderate-intensity aerobic activity for all adults. 

“In the Pointer trial, they used 30 minutes of physical activity or aerobic exercise, 15 to 20 minutes of resistance training and 10 to 15 minutes of flexibility training as their intervention,” Pippenger says. “It doesn’t require all day sitting in the gym, and it doesn’t require trying to look like Arnold Schwarzenegger or anything like that. It just requires doing some activity.”

Strength training, or resistance exercises, help older adults maintain lean muscle mass, increase bone density, and manage weight and other chronic conditions, according to the Mayo Clinic. Flexibility training, or stretching exercises, likewise has been proven to reduce one’s likelihood of developing dementia and related conditions, Pippenger says.

“It’s not like it absolutely prevents it from occurring, but it delays the age at which it occurs, which for many people, would prevent it,” he says.

As with diet, Pippenger recommends finding an exercise routine that resonates with your lifestyle and preferences — something you can count on yourself to maintain.

“Tai Chi has been shown to be something that’s very well-received, something people enjoy, that they actually tend to do, Pippenger says, “and it tends to be lower-impact, especially on the front end. So for people who are not physically fit, it’s something that you can do a little more easily. Simply walking can be a good one.

“The best exercise is something you will do,” he adds. “The lesson for the whole thing is to get out there and get moving.”

Brain Training

The Pointer study utilized a specific brain training platform called Brain HQ. The web program is subscription-based and, according to its website, offers exercises that “work out” attention, brain speed, memory, people skills, navigation and intelligence. However, Pippenger says any kind of games or activities that challenge ones’ thinking can improve brain health.

“The U.S. Neuropsychological Association issued a statement several years ago saying we don’t really have a lot of evidence that specific computerized training programs are superior to what you might be able to do on your own,” he says. “You can get something for free that will work, potentially, just as well.”

Pippenger says puzzles, like sudoku and crosswords, can be utilized, as well as more challenging or complex activities, like spatial reasoning games or chess. 

“Things like that are fun and make you think – you have to use your reasoning power a little bit — and games that utilize memory, where you have to remember where something is,” he says.

Performing a variety of “brain training” activities will strengthen different areas of the brain. 

“If you do a recall of numbers task, then you tend to be better at recalling numbers. It seems to be a little more task-specific, so that would argue for doing a broad range of puzzles to stretch your mind,” Pippenger says. ”Just avoid those games where it’s just plain chance, games where you’re basically rolling dice or whatever. You have no control over the direction of the game.”

Implementing Study Findings

The Alzheimer’s Association plans to invest $40 million over the next four years to implement the findings from the Pointer study across the U.S.

“We’ve been really good at translating science into programming,” says Cook, pointing to recent updates to national and local programs to integrate risk-reduction strategies. “But we also have to bring that into the clinical space.”

Cook says the Alzheimer’s Association will be working with health systems nationwide to educate providers on the study findings, particularly risk reduction techniques. The group utilizes Project Extension for Community Healthcare Outcomes (ECHO),  a telementoring process for rural health care providers, which Cook says will be valuable in spreading the word throughout Arkansas. The University of Arkansas for Medical Sciences is a Project ECHO partner.

“Disseminating it through our partners and being able to normalize the conversation around brain health, that’s really where we’re trying to push our state agencies,” he says. “Federally, we’re working on expanding Project ECHO so we can get to those rural providers.  

“One of the most trusted health care professionals in every county is a pharmacist, so how do we disseminate this information using the pharmacy infrastructure? Those are some conversations we’ve kicked around in the Arkansas chapter,” he adds.

Cook encourages adults to start implementing brain health strategies into their daily lives now, no matter their age.

“Get out and walk 30 minutes a day, try to reduce your dependency on processed foods. It’s never too late to start,” he says. “The more we get to younger populations, the better it is, not only to attack stigma. But if you can introduce these lifestyle habits early, you can improve your brain health and age healthy, like we all want to do.”