Observed Improvement in Cognition During a Personalized Lifestyle Intervention in People with Cognitive Decline

J Alzheimers Dis. 2023;94(3):993-1004. doi: 10.3233/JAD-230004.


Background: Alzheimer's disease (AD) is a chronic condition marked by progressive objective cognitive impairment (OCI). No monotherapy has substantially altered disease progression, suggesting the disease is multifactorial and may require a multimodal therapeutic approach.

Objective: We sought to determine if cognitive function in a sample with OCI would change in response to a multimodal, individualized care plan based on potential contributors to cognitive decline (e.g., nutritional status, infection, etc.).

Methods: Participants (n = 34) were recruited from the San Diego, CA area. The multimodal intervention included lifestyle changes (i.e., movement, diet, and stress management), nutraceutical support, and medications. It was delivered pragmatically over four clinical visits, and outcome measures were gathered at four study visits, occurring at baseline, one, three, and six months (primary endpoint). Study participants received weekly phone calls for nutrition support throughout study participation. Outcome measures included the Cambridge Brain Sciences (CBS) battery, and the Montreal Cognitive Assessment (MoCA).

Results: At 6 months, mean MoCA scores improved from 19.6±3.1 to 21.7±6.2 (p = 0.013). Significant improvement was observed in mean scores of the CBS memory domain [25.2 (SD 23.3) to 35.8 (SD 26.9); p < 0.01] and CBS overall composite cognition score [24.5 (SD 16.1) to 29.7 (SD 20.5); p = 0.02]. All CBS domains improved.

Conclusion: Multiple measures of cognitive function improved after six months of intervention. Our results support the feasibility and impact of a multimodal, individualized treatment approach to OCI, warranting further research.

Keywords: Alzheimer’s disease; Cambridge Brain Sciences; Montreal Cognitive Assessment; clinical trial; dementia; mild cognitive impairment.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / etiology
  • Alzheimer Disease / psychology
  • Alzheimer Disease / therapy
  • California
  • Cognition* / physiology
  • Cognitive Dysfunction* / drug therapy
  • Cognitive Dysfunction* / etiology
  • Cognitive Dysfunction* / psychology
  • Cognitive Dysfunction* / therapy
  • Diet, Healthy*
  • Dietary Supplements
  • Disease Progression
  • Exercise
  • Feasibility Studies
  • Female
  • Healthy Lifestyle*
  • Humans
  • Infections / complications
  • Male
  • Memory
  • Middle Aged
  • Nutritional Status
  • Pragmatic Clinical Trials as Topic
  • Reproducibility of Results
  • Stress, Psychological / prevention & control
  • Time Factors
  • Treatment Outcome
  • Verbal Behavior