Sandison · Journal of Alzheimer's disease : JAD 2023 · single-arm before-and-after trial · n=34

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

Cited 20 times in the scientific literature.

Level 4 - case-series / case-control

Single-arm prospective before-and-after trial without a control group.

PubMed 37355891 · doi:10.3233/JAD-230004 · record verified 2026-08-28

What was done

Researchers evaluated a 6-month pragmatic, multimodal, and personalized intervention in 34 adults with objective cognitive impairment recruited from San Diego, California. The individualized protocol incorporated lifestyle modifications (exercise, diet, stress management), nutraceuticals, and medications, delivered across four clinical visits alongside weekly nutritional support phone calls. Cognitive outcomes were measured at baseline, 1, 3, and 6 months using the Montreal Cognitive Assessment (MoCA) and the Cambridge Brain Sciences (CBS) battery.

What was found

At 6 months, mean MoCA scores increased from 19.6 ± 3.1 to 21.7 ± 6.2 (p = 0.013). The CBS memory domain score improved from a mean of 25.2 (SD 23.3) to 35.8 (SD 26.9) (p < 0.01), and the overall CBS composite score improved from 24.5 (SD 16.1) to 29.7 (SD 20.5) (p = 0.02). Improvements were reported across all CBS subdomains.

Why it matters

This study provides preliminary feasibility data suggesting that individualized, multi-domain interventions targeting lifestyle and metabolic factors could support cognitive stability or modest improvement in early cognitive decline.

Limits

The study lacked a randomized control group, making it impossible to separate intervention effects from practice effects on cognitive tests, placebo response, or regression to the mean. The sample size was very small (n = 34) from a single geographic region, the follow-up duration was short (6 months), and the multi-component design prevents isolating which elements contributed to the observed changes.

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