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Structured vs Self-Guided Multidomain Lifestyle Interventions for Global Cognitive Function: The US POINTER Randomized Clinical Trial
Baker LD, Espeland MA, Whitmer RA, Snyder HM, Leng X, Lovato L, Papp KV, Yu M et al.. JAMA, 2025-08-01
Topic: Risk, prevention and care in population studies
Importance Identifying new interventions to slow and prevent cognitive decline associated with dementia is critical. Results Among the 2111 individuals enrolled (mean age, 68.2 [SD, 5.2] years; 1455 [68.9%] female), 89% completed the year 2 assessment. The mean rate of increase per year was statistically significantly greater for the structured group than the self-guided group by 0.029 SD (95% CI, 0.008-0.050; P = .008). Fewer ascertained adverse events were reported in the structured group (serious: 151; nonserious: 1091) vs the self-guided group (serious: 190; nonserious: 1225), with a positive COVID-19 test result being the most common adverse event overall and more frequent in the structured group. Conclusions and relevance Among older adults at risk of cognitive decline and dementia, a structured, higher-intensity intervention had a statistically significant greater benefit on global cognition compared with an unstructured, self-guided intervention.
Key findings
- Importance Identifying new interventions to slow and prevent cognitive decline associated with dementia is critical.
- Results Among the 2111 individuals enrolled (mean age, 68.2 [SD, 5.2] years; 1455 [68.9%] female), 89% completed the year 2 assessment.
- The mean rate of increase per year was statistically significantly greater for the structured group than the self-guided group by 0.029 SD (95% CI, 0.008-0.050; P = .008).
- Fewer ascertained adverse events were reported in the structured group (serious: 151; nonserious: 1091) vs the self-guided group (serious: 190; nonserious: 1225), with a positive COVID-19 test result being the most common adverse event overall and more frequent in the structured group.
- Conclusions and relevance Among older adults at risk of cognitive decline and dementia, a structured, higher-intensity intervention had a statistically significant greater benefit on global cognition compared with an unstructured, self-guided intervention.
Why it matters
In this randomized trial of 2,111 older adults, a structured lifestyle program improved global cognition significantly more than a self-guided version of the same components over two years. The year-over-year difference between groups was modest in absolute terms, though the benefit was consistent across age, sex, ethnicity, heart-health status, and APOE ε4 carrier status.
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Study details
- Participants1,056
- Effect size68.9%
- Evidence strengthHigh
How this study scored 75/100
Published in a top-tier journal. Scored zero for study design because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (JAMA) |
| Journal's citation record | 4 / 4 | JAMA: journal h-index 1,011 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 3 / 4 | 1,056 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 5 / 7 | Cited 251 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 83.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 6 / 6 | Cited 158.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 28 other studies in this library |
| Still being cited | 4 / 4 | Cited 251 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Marı́a C. Carrillo: h-index 24 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | Harvard University: institution h-index 3,235 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 18 institution(s) in 4 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40720610) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 75 / 100 | — |
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Read the original
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Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Baker, L. D., Espeland, M. A., Whitmer, R. A., Snyder, H. M., Leng, X., Lovato, L., et al. (2025). Structured vs Self-Guided Multidomain Lifestyle Interventions for Global Cognitive Function: The US POINTER Randomized Clinical Trial. JAMA. https://doi.org/10.1001/jama.2025.12923
Vancouver
Baker LD, Espeland MA, Whitmer RA, Snyder HM, Leng X, Lovato L, et al. Structured vs Self-Guided Multidomain Lifestyle Interventions for Global Cognitive Function: The US POINTER Randomized Clinical Trial. JAMA. 2025. doi:10.1001/jama.2025.12923. PMID: 40720610.
BibTeX
@article{baker2025-40720610,
author = {Baker, L. D. and Espeland, M. A. and Whitmer, R. A. and Snyder, H. M. and Leng, X. and Lovato, L. and Papp, K. V. and Yu, M. and others},
title = {{Structured vs Self-Guided Multidomain Lifestyle Interventions for Global Cognitive Function: The US POINTER Randomized Clinical Trial}},
journal = {JAMA},
year = {2025},
doi = {10.1001/jama.2025.12923},
pmid = {40720610},
url = {https://doi.org/10.1001/jama.2025.12923}
}
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