Brain Imaging Biomarkers and Cognitive Outcomes in a Multidomain Lifestyle Intervention: The POINTER Imaging Ancillary Study

Overview

Brain imaging can offer a window into how lifestyle interventions may affect the aging brain. In the POINTER Imaging ancillary study, researchers examined whether a structured multidomain lifestyle program could change brain biomarker trajectories and whether baseline brain characteristics could help identify older adults most likely to benefit cognitively. The study was nested within the larger U.S. POINTER clinical trial, a 2-year randomized study designed to test whether a higher-intensity lifestyle intervention improves cognition in adults at increased risk for cognitive decline.

The main takeaway was nuanced: the structured intervention did not measurably alter the major imaging biomarkers overall, and it was not linked to Alzheimer’s disease amyloid burden. However, some participants with lower hippocampal volume at baseline appeared to gain greater cognitive benefit from the structured program. In addition, changes in tau in the entorhinal cortex tracked differently with cognition depending on intervention intensity, suggesting that the relationship between brain biology and lifestyle change is complex.