Time restricted eating through self-regulatory behaviors for metabolic and cognitive health in mild cognitive impairment: Feasibility and acceptability findings from the TEMPO trial

Background Mild cognitive impairment (MCI) and Alzheimer's disease and related dementias (ADRD) occur at 1.5–2-fold higher rates among adults with obesity or metabolic syndrome. Time restricted eating (TRE) represents a portable and potentially effective strategy to enhance metabolic function and reduce ADRD risk. Objective To assess the feasibility and acceptability of TRE among older adults with MCI and metabolic risk. Methods We assessed a 16–18-h TRE protocol, implemented 2–3 days per week, among older adults (65–85 years of age) with MCI (proposed n = 40) and metabolic risk over 12-weeks. Feasibility was assessed by recruitment and completion of trial activities, while Acceptability was assessed using psychometric self-report. Cognitive function was assessed using a standard neuropsychological test battery, including tests of Executive Function/Processing Speed (Trail Making, Stroop, Controlled Oral Word Association Test, Animal Naming, Digit Span, and Digit Symbol Substitution Tests), Learning/Memory (Hopkins Verbal Learning Test–Revised and Benton Visual Memory Test–Revised. We also examined treatment- and state-dependent changes in metabolic and inflammatory biomarkers, including multiple ketone metabolites and pro-inflammatory cytokines, among others. Results From 9/28/23 until 3/25/25, thirty-three individuals (83% of target goal [n = 40]) were recruited. Enrolled participants completed all treatment sessions and assessments (100%) and self-reported Acceptability was high. Modification of study recruitment practices and inclusion criteria allowed for an increased screening-to-recruitment ratios over the course of the trial, rising from 1.3% to 11.1%, while still resulting in appropriate recruitment of individuals with MCI. Conclusions TRE is a feasible and acceptable intervention among older adults with metabolic risk factors.