Age, Multidomain Lifestyle Intervention, and White Matter Integrity: Secondary Analysis of the POINTER
By
Pauline Maillard
Prashanthi Vemuri
Danielle J. Harvey
Theresa M. Harrison
Ashritha L. Reddy
Hwamee Oh
Stephen Salloway
Simin Mahinrad
Thomas M. Holland
Rachel Whitmer
Mark A. Espeland
Laura D. Baker
Susan M. Landau
Charles DeCarli
July 13, 2026
Clinical Scorecard: Influence of Age and Multidomain Lifestyle Interventions on White Matter Integrity: A Secondary Analysis from the POINTER Study
At a Glance
Category Detail
Condition Cognitive decline in older adults Key Mechanisms Cerebrovascular pathologies, white matter integrity, and lifestyle interventions Target Population Older adults aged 60-79 years at risk for cognitive decline Care Setting Multicenter randomized clinical trial
Key Highlights
Multidomain lifestyle interventions may influence cognitive trajectories. Cerebrovascular pathologies are prevalent in late life and contribute to cognitive impairment. The POINTER Imaging study assessed microstructural vulnerability in older adults. Diffusion MRI measures were used to evaluate white matter integrity. Participants were randomized to a structured intervention or a self-guided program. Guideline-Based Recommendations
Diagnosis
Participants were cognitively unimpaired but at risk for decline and dementia. Management
Structured multidomain lifestyle interventions targeting physical activity, diet, and cognitive engagement. Monitoring & Follow-up
MRI scanning sessions at baseline, 12 months, and 24 months. Risks
Exclusion of individuals with clinically significant cognitive impairment. Patient & Prescribing Data
Community-dwelling older adults with at least 2 risk factors for cognitive decline.
Interventions aimed at improving lifestyle factors may affect white matter integrity.
Clinical Best Practices
Utilize diffusion MRI as a biomarker for assessing white matter injury. Implement structured lifestyle interventions in older adults at risk for cognitive decline. Related Resources & Content
