Just how much does lifestyle influence Alzheimer’s?

The Alzheimer’s Association is leading a $35 million study to look at whether lifestyle has an impact on brain health — and now the U.S. National Institute on Aging is contributing $47 million to extend the examination to brain imaging.

The U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER) is a two-year clinical trial. It represents the first study to test whether improvements in lifestyle like nutrition, physical activity, social and intellectual stimulation, and increased medical monitoring can protect brain function in adults aged 60 to 79 years old who are at increased risk for cognitive decline.

And this week, the U.S. NIA pledged what will likely total an additional $47 million over the next five years to incorporate advanced brain imaging into the U.S. POINTER regimen.

“A healthy diet and lifestyle are generally recognized as good for health, but U.S. POINTER is the first large randomized controlled trial to look at whether lifestyle changes actually influence Alzheimer’s disease-related brain changes,” said Susan Landau, Ph.D., in a press release. Landau is a research neuroscientist at UC Berkeley’s Helen Wills Neuroscience Institute and principal investigator of the add-on study. “Lifestyle modification is a non-drug option that is accessible to people and may reduce the likelihood of developing Alzheimer’s.”

The additional funds will allow U.S. POINTER to expand the study into the first large-scale investigation of how lifestyle affects well-known biological markers of Alzheimer’s in the structure of the brain. The study will use advanced brain imaging technology like PET and MRI scans to look at the effects of lifestyle interventions on brain health (overall and regional brain shape, size and blood flow, and on indicators of heart health risk and small vessel disease).

“U.S. POINTER is designed to determine what lifestyle interventions have a tangible impact on our brains. The addition of brain imaging is an important component that could provide the roadmap for brain health to reduce the risk of dementia before symptoms have a chance to appear,” said Maria C. Carrillo, Ph.D., Chief Science Officer of the Alzheimer’s Association.

According to the Alzheimer’s Association’s 2019 Alzheimer’s Disease Facts and Figures, Alzheimer’s is the sixth leading cause of death in America. An estimated 5.8 million Americans are living with the disease, a number that is expected to grow to nearly 14 million by 2050 without intervention.

But previous studies show that lifestyle intervention can produce cognitive improvements. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) found that in at-risk adults, lifestyle change improved cognitive function by 25% compared to adults only given health education.

And other results suggest that the benefits of lifestyle changes on brain health in older adults are potentially larger than pharmacological treatments. The U.S. POINTER study will use a geographically and ethnically diverse population to test half of the participant’s brains for two proteins that have been linked to Alzheimer’s at baseline, one, and two-year intervals.