A major new study in the United States has found that a combination of regular exercise, social activities, a nutritious diet, and brain-training games can improve cognitive performance for those at heightened risk of dementia. The findings, which drew on more than 2,000 adults aged 60 to 79 over a two-year period, offer hope and insight into practical strategies that people—including Thais—can adopt to help protect their brain health as they age. While the study reveals both opportunities and limitations, its lessons are highly relevant as dementia becomes an escalating challenge for Thailand’s ageing society.
Dementia is a growing public health concern globally, including in Thailand, where recent figures from the Thailand Ministry of Public Health estimate that nearly 1 million citizens currently live with dementia—a number projected to sharply increase as the population ages. With rising life expectancy, many Thai families are increasingly worried about cognitive decline in older relatives, making prevention efforts a top priority. The US POINTER study, as reported by The Irish Times, is the largest of its kind to investigate whether a structured programme of healthy behaviours can help maintain cognitive function in people most at risk for dementia.
The research, conducted across five sites in the US, involved 2,111 participants from diverse racial and ethnic backgrounds, all with sedentary lifestyles, suboptimal diets, and at least two other dementia risk factors such as family history or hypertension. None had cognitive impairment at the start. Participants were split into two groups: one received an intensive, facilitator-led programme including prescribed exercise, a healthy diet, frequent social and group activities, and computer-based cognitive training. This group attended 38 supervised meetings over two years. The second group, however, received educational materials and encouragement to pursue healthy behaviours independently and only attended six meetings.
Both groups demonstrated marked improvement in cognitive abilities, particularly in planning and organisation—known as executive function. The high-intensity intervention group showed slightly greater improvement, which, according to a principal investigator from a US medical school, “slowed the cognitive ageing clock by one to two years” compared to the self-guided group. These gains, while moderate, are encouraging, especially for those with lower baseline cognitive scores, who benefited most.
However, the difference between the two groups was small, raising questions among experts about the necessity and practicality of high-intensity interventions. An Alzheimer’s specialist at the University of Southern California noted that it’s not clear whether individual lifestyle changes or their combination accounted for improvements, and cautioned that “we cannot conclude this directly slows or prevents Alzheimer’s disease itself.” Other scientists, including a dementia prevention authority from Australia, warned that only affordable and scalable lifestyle interventions can realistically address dementia on a population level, as most Thais—like people everywhere—may face barriers to costly, high-intensity programmes.
Critically, the study did not have a control group receiving no intervention whatsoever, due to ethical concerns from the Alzheimer’s Association, which led and funded the research. This means improvements could partly stem from the so-called “practice effect,” where people score better on repeated cognitive tests simply because they are familiar with them. Still, the researchers are encouraged that all subgroups, including ethnic minorities and those with a strong hereditary risk, benefited consistently.
Personal accounts from the study highlight the transformative power of social support and structure. One participant, whose family had suffered dementia, said exercising and engaging in regular group meetings “woke me up” after a period of poor health. Another, encouraged by her peers, adopted a much healthier diet and found tangible everyday improvements in her memory and concentration. These stories echo traditional Thai values of community, family bonds, and collective activity—a reminder that fostering social engagement and intergenerational interaction can be a powerful tool in dementia prevention.
Looking specifically to Thailand, these findings offer actionable recommendations. Regular physical activity, such as daily walks, swimming, or community aerobics—already popular with many older Thais—should be further promoted. So too should traditional Thai diets, rich in fresh vegetables, fish, and moderate portions, while discouraging overly processed and high-sugar foods. Social activities like temple fairs, communal gardening, or cultural clubs not only align with the findings but are most effective when regularly scheduled and well-facilitated. Authorities, primary care centres, and community leaders can play a crucial role by organising and supporting these programmes.
However, experts emphasise that some elements, such as online brain games, may be less accessible or appealing to older Thais unused to digital platforms. Instead, stimulating the mind with reading, music, or crafts—all common pastimes in Thai culture—can offer cognitive benefits. An expert in cognitive ageing from the University of California, San Francisco, not involved in the research, noted that “any intellectual stimulation is helpful,” not just computerised games.
One important caveat: memory performance, a hallmark of Alzheimer’s disease, did not improve over the two years; both groups’ memory scores declined, albeit without significant differences between them. This indicates that lifestyle interventions may be most effective for vascular-related cognitive decline rather than Alzheimer’s. The researchers plan to continue tracking participants with brain scans and blood tests to see whether changes in activity levels lead to measurable reductions in the biological markers of dementia.
Thailand’s situation in dementia care presents unique challenges. While urban centres offer increasing access to health and social services, rural areas may lack resources for sustained, structured programmes. Most Thai families act as primary caregivers for elders with dementia, often at great emotional and financial cost. Policy initiatives like the Department of Older Persons’ “Community Care for the Elderly” have begun to promote active ageing, but there is a pressing need for localised, affordable interventions that combine physical, social, and cognitive elements.
The US POINTER study builds on similar research from Finland, where structured, multi-domain interventions resulted in 25% greater cognitive improvement than minimal intervention groups. Applying such approaches in Thailand will require adaptation to the local context—using village health volunteers, religious networks, and intergenerational family life to foster regular group activities and healthy habits.
Looking ahead, as the number of Thais over 65 is projected to reach 20 million by 2040, dementia prevention must become a central part of provincial and national health strategy. The Alzheimer’s Association and other funders are investing further in research to determine whether community-wide, tailored “brain health” programmes can slow cognitive decline at scale. Thai researchers and policymakers have an opportunity, and responsibility, to continue developing and studying interventions that work within Thailand’s unique cultural and economic context.
For Thai readers concerned about dementia risk, the message is clear: staying physically active, maintaining a healthy diet, participating in social and community activities, and finding activities that stimulate the mind—all contribute to brain health, particularly for those with a family history or other risk factors. These steps need not require expensive programmes. Simple, enjoyable habits, embedded in daily routines and community life, can offer meaningful protection against cognitive decline.
As recommendations, Thai families and communities should build in daily movement (such as walking to the market or practicing traditional dance), join group activities at local temples or community centres, adopt the principles of the Thai food pyramid, and encourage lifelong learning—whether through reading, storytelling, or music. Policymakers should ensure these opportunities are accessible in all provinces, especially for vulnerable and rural elders, and continue investing in research that adapts global best practices to local Thai needs.
The latest research underscores that while there is no single solution to preventing dementia, each step towards a more active, engaged, and healthy daily routine can make a difference—both for Thai individuals and for the society as a whole.
Sources: The Irish Times, JAMA Network, Alzheimer’s Association, Thailand Ministry of Public Health