Leadership Message: U.S. POINTER - A successful recipe for brain health, now let’s do the cooking

Dear Colleagues,

Alzheimer’s disease and related dementias (ADRD) impact 55 million people globally, a number that is projected to increase to 139 million by 2050 and which portends an enormous public health and economic crisis.

While these numbers are dismal, it is encouraging to see evidence of how to attenuate risk in the Lancet Standing Commission’s report (our own Dr. Helen Kales is a member) on dementia prevention that illustrates 45% of the risk for dementia is actually modifiable (view the UC Davis Health news release).

Metrics like this are essential for public health dissemination of how to improve brain health. At the same time, successful behavior changes regarding a disease that is the culmination of decades of multifactorial causes is challenging to empirically demonstrate.

In July 2025 at the Alzheimer’s Association International Conference, a summary of the U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER) was announced and published in JAMA. The success of this trial is a sea change for public health, dementia prevention science, community-based research, and neuroscience – overall, it represents an opportunity for large-scale public health disseminations on behavioral changes.

Our campus was one of five sites of the U.S. POINTER trial. I’m honored to be one of the four National Study Principal Investigators as well as the UC Davis site co-principal investigator with my esteemed colleague, Professor Sarah Farias.

The impact of this lifestyle clinical trial cannot be underestimated. In a two-year period, those who participated in an intensive structured multidomain lifestyle intervention had significantly greater improved cognitive functioning compared to those who participated in the self-guided (less intensive) intervention arm. The size of the cognitive benefit between the two lifestyle groups is larger than what is seen in most pharmaceutical clinical trials for ADRD. Equally important is that 31% of those who participated in the trial are from ethnoracial groups historically underrepresented in clinical trials of ADRD, where typically 5% or less are from these groups.

This is not only a watershed moment for understanding how to improve brain health, but also a key point about how to engage all communities in clinical research. Inclusion science is a priority for ADRD research; there has never been a more pivotal moment to rigorously support it, nurture it, evaluate it and disseminate it. If we are to successfully translate evidence-based research into clinical care, then we can truly improve health on a population level.

U.S. POINTER is now in the ‘Alumni Extension’ phase, which will continue to follow all participants from an observational standpoint – this is essential because we know from clinical trials of diabetes management, such as Diabetes Control and Complications Trial (DCCT), that there can be ‘legacy’ effects – in other words, there can be far-reaching benefits on health outcomes many years into the future.

Indeed, the FINGER Trial, a multi-domain lifestyle trial for brain health in Finland that the U.S. POINTER research is based on, finished 10 years ago and, as of today, numerous long-term health benefits have continued, including reduced incident chronic disease, improved Activities of Daily Living (ADLs), as well as cost reductions.

It is a very exciting time in Alzheimer’s Disease and related dementias research, and we’re proud at UC Davis Health to have received a planning grant from the Alzheimer’s Association to develop and test scalable strategies for large-scale dissemination of the U.S. POINTER lifestyle recipe. As co-director of the UC Davis Alzheimer’s Disease Research Center (ADRC), it is an honor to lead research, discovery, and implementation of how to improve brain health for all as we take this incredibly meaningful step forward on behalf of so many people and families.

Sincerely,

Rachel Whitmer, Ph.D.
Professor and Vice Chair of Research Public Health Sciences, Professor Neurology
Division Chief, Epidemiology
Co-Director, UC Davis Health Alzheimer’s Disease Research Center