MARC

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022 |a 1552-5260 
022 |a 1552-5279 
024 7 |a 10.1002/alz70855_098286  |2 doi 
035 |a 3285996977 
045 0 |b d20251201 
100 1 |a Katula, Jeff  |u Wake Forest School of Medicine, Winston Salem, NC, USA, 
245 1 |a U.S. POINTER: Design of the Multidomain Lifestyle Interventions 
260 |b John Wiley & Sons, Inc.  |c Dec 1, 2025 
513 |a Journal Article 
520 3 |a Background U.S. POINTER was a multisite randomized controlled trial testing the impact of multidomain lifestyle intervention on cognitive function in cognitively unimpaired older adults at risk for cognitive decline and dementia. Inspired by the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), the study aimed to assess the generalizability of FINGER's positive cognitive findings in a diverse and representative U.S. cohort. Method The U.S. POINTER interventions were modeled on FINGER, targeting physical activity, nutrition, cognitive/social challenge, and cardiometabolic risk management. Additional goals included (1) delivering the intervention within the community, (2) collaborating with community partners (Alzheimer's Association, community exercise facilities) to ensure/test intervention sustainability, (3) incorporating objective adherence metrics to permit responder analyses, (4) adapting the MIND diet, and (5) introducing a cognitive training program with greater potential for participant adoption. The interventions were designed and implemented using a cognitive‐behavioral framework and theory driven self‐motivation tools. Intervention fidelity was centrally monitored through data‐driven reports and annual site visits. Results U.S. POINTER interventions included two arms, both targeting multidomain lifestyle modification but differing in intensity and accountability. Following the baseline assessment, participants were randomized to the Structured (STR) or Self‐Guided (SG) arm. The STR intervention included 38 group sessions, a structured exercise prescription using community facilities, a nutrition program modeled on the MIND diet, BrainHQ computerized cognitive training, regular cognitive/social challenge, and frequent cardiometabolic health monitoring. The SG intervention included six facilitated group sessions, general health education across all intervention domains, and gift cards to support participants’ chosen health behaviors. Adherence was tracked using objective and self‐report metrics, with central monitoring to ensure consistent implementation across sites. Conclusion U.S. POINTER expands upon FINGER with modifications aimed at improving intervention uptake and accountability in a U.S. cohort. The study design will permit extensive analyses of adherence as it relates to cognitive response. Findings could have significant implications for future trials and for public health programs aimed at reducing Alzheimer's disease and dementia risk in older U.S. adults. 
651 4 |a United States--US 
653 |a Physical fitness 
653 |a Cognitive functioning 
653 |a Exercise 
653 |a Intervention 
653 |a Alzheimer's disease 
653 |a Public health 
653 |a Dementia 
653 |a Nutrition research 
653 |a Cognitive responses 
653 |a Politics 
653 |a Older people 
653 |a Self evaluation 
653 |a Cognition 
653 |a Lifestyles 
653 |a Cognitive impairment 
653 |a Community 
653 |a Nutrition programs 
653 |a Central monitoring 
653 |a Motivation 
653 |a Diet 
653 |a Health behavior 
653 |a Health education 
653 |a Generalizability 
653 |a Adherence 
653 |a Risk management 
653 |a Training 
653 |a Mental health services 
653 |a Fidelity 
653 |a Clinical trials 
653 |a Accountability 
653 |a Cognitive skills training 
653 |a At risk populations 
653 |a Adults 
653 |a Cognitive-behavioral factors 
653 |a Computerization 
653 |a Gift giving 
653 |a Nutrition 
700 1 |a Ventrelle, Jennifer  |u Rush University Medical Center, Chicago, IL, USA, 
700 1 |a Graef, Sarah  |u Rush University, Chicago, IL, USA, 
700 1 |a Heinrich, Allison  |u Wake Forest University, Winston‐Salem, NC, USA, 
700 1 |a Wilmoth, Sharon  |u Wake Forest University School of Medicine, Winston Salem, NC, USA, 
700 1 |a Rushing, Scott  |u Wake Forest University School of Medicine, Winston‐Salem, NC, USA, 
700 1 |a Krueger, Kristin R  |u Rush Institute for Healthy Aging, Chicago, IL, USA, 
700 1 |a Morris, Martha Clare  |u Rush University Medical Center, Chicago, IL, USA, 
700 1 |a Kivipelto, Miia  |u Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden, 
700 1 |a Snyder, Heather M  |u Alzheimer's Association, Chicago, IL, USA, 
700 1 |a Carrillo, Maria C.  |u Alzheimer's Association, Chicago, IL, USA, 
700 1 |a Baker, Laura D  |u Wake Forest University School of Medicine, Winston‐Salem, NC, USA, 
773 0 |t Alzheimer's & Dementia  |g vol. 21 (Dec 1, 2025) 
786 0 |d ProQuest  |t Consumer Health Database 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/3285996977/abstract/embedded/6A8EOT78XXH2IG52?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3285996977/fulltextPDF/embedded/6A8EOT78XXH2IG52?source=fedsrch