We all misplace things and forget words now and then Minor changes in memory and thinking (known as cognitive decline) are a normal part of aging. Changes in brain function that interfere with daily life, however, are more likely caused by pathological changes in the brain, such as narrowed or clogged arteries, inflammation, or plaques or tangles of proteins. The umbrella term for these problems is dementia. Dementia can impact thinking, memory, behavior, and emotions. There is no cure for either age-related cognitive decline or dementia, but there are things we can do to slow it down. A healthy lifestyle may delay the onset of cognitive decline, and possibly even dementia.
Building and Maintenance. The two key mechanisms for keeping your brain healthy are: 1) building brain capacity (cognitive reserve), and 2) preserving that capacity by protecting the brain from detrimental changes.
It’s thought that people with larger cognitive reserves are better able to maintain their cognitive function for longer. Simply put, the more neurons and connections we have in our brains, the more losses we can sustain without noticeable effects. Anything that damages the brain or its blood vessels can take away some of that cognitive reserve.
Let’s take a look at everyday actions you can take to build and maintain cognitive reserve:
Be careful. Numerous studies have found an association between head injuries and subsequent development of dementia. Wear a helmet when biking and appropriate protective gear when playing sports. Use a seatbelt every time you’re in a car. Keep walkways clear of clutter, secure the ends of area rugs, use non-slip mats and grab bars in tubs and showers, and have good lighting in your home to minimize the risk of falling.
Rest up. Poor sleep is associated with increased risk for cognitive decline and dementia. It may also increase risk for many of the other dementia risk factors discussed here, including cardiovascular disease, high blood pressure, high blood sugar, obesity, and depression, and falls. The current recommendation is that most adults get seven to nine hours of sleep each night.
Experts recommend going to sleep and waking up around the same time every day, staying off screens and away from caffeine in the hours before bed, and adjusting the light, temperature, and any other environmental conditions so you are as comfortable as possible. If insomnia, sleep apnea, anxiety, or urinary problems are disrupting your sleep, seek help from a healthcare provider.
Avoid tobacco. Studies have found smoking and vaping increase the risk for cognitive decline and, possibly, dementia. The chemicals can also damage blood vessels, including those feeding the brain. This results in the build-up of cholesterol-laden plaque in the carotid arteries, causing narrowing. The good news is, quitting smoking lowers these risks. Air pollution may have similar effects.
If you smoke, make a plan to quit. “Quitlines” and smoking cessation programs can help. Seek help from your healthcare provider if necessary. If you don’t smoke, try to limit your exposure to second-hand smoke. If you live in an area with high air pollution, filter indoor air and limit outdoor exercise.
Increase physical activity. Regular physical activity has been associated with lower risk of cognitive decline. Getting your heartrate up increases blood flow, which may benefit brain cells by delivering more oxygen and nutrients, but some studies have shown even engaging in less vigorous activities—such as walking or strength training—is associated with brain benefits. Being active also helps prevent or control high blood pressure and type 2 diabetes, both of which increase risk for dementia, and it can lower your risk of falling.
The current recommendation is to aim for 150 minutes a week of moderate activity (like gardening or brisk walking) or 75 minutes of more vigorous activity (like jogging or pickleball) every week. Engaging in resistance training at least two days a week is also recommended. But any activity, in any amount, at any age is good.
Nourish yourself. Regularly consuming a healthy dietary pattern can reduce your risk of heart disease, stroke, diabetes, and obesity—all of which are associated with increased risk for cognitive decline and dementia. A healthy diet is also associated with lower risk for Alzheimer’s disease as well as Parkinson’s disease (which can cause dementia).
Fill your plate with whole or minimally processed fruits, vegetables, beans, lentils nuts, seeds, whole grains, seafood, poultry, lean meats, low fat or fat free dairy, and healthy plant oils in place of foods high in saturated fat (fatty meats, full fat dairy, and tropical oils) and ultraprocessed foods (UPFs). A study that looked at the dietary intake of nearly 11,000 adults in Brazil found that dietary patterns containing more UPFs (like white bread, baked goods, processed meats, desserts and sugar-sweetened and artificially sweetened drinks) were associated with a higher rate of cognitive decline in six to 10 years of follow-up. (The study did not determine if this was due to the UPFs or the fact that they replaced healthier choices.)
It’s never too late to adopt a healthy diet. Studies show making these changes even in later life can benefit brain health.
Hear well. Hearing loss has been associated in some research with higher risk of developing dementia. One reason is hearing loss can cause social isolation, which means less time interacting with others and learning new things.
In a study of over 430,000 adults aged 40 to 69 years, uncorrected hearing loss was associated with a higher risk of developing dementia compared to not having hearing loss or wearing hearing aids. A randomized controlled trial involving nearly 500 participants found a connection between hearing loss and cognitive decline only in participants already at higher risk for cognitive decline.
If you suspect you or someone close to you suspects you have trouble hearing, it is important to be tested. If it is determined a hearing aid will help, get one!
Evaluate health conditions. Several common health conditions can increase dementia risk. Mid-life high blood pressure, for example, is associated with dementia later in life. Studies have also shown an association between type 2 diabetes and increased risk of cognitive decline and possibly dementia. High blood levels of LDL cholesterol can lead to hardening of the arteries, which contributes to vascular dementia by restricting blood flow to the brain and causing ischemic stroke. There is some evidence of a link between depression and cognitive decline as well, but not all research agrees.
Get regular check-ups, consume a healthy dietary pattern, be physically active, and take medications as prescribed if you have these conditions.
Avoid excessive alcohol use. Heavy drinking is associated with cognitive impairment and dementia. (Research has found this association with weekly intake of the amount of alcohol in around two 750 milliliter bottles of wine, nine typical beers, or two cups of liquor or more.) While the impact of moderate drinking is unclear and some studies have found light drinking to have a possible protective effect, it is best to stick to the recommendation of no more than one alcoholic drink a day for women and two for men (and, if you don’t drink, don’t start.)
Lose weight (if you have obesity). A mid-life body mass index (BMI) of 30 or above (defined as obesity) has been associated with increased dementia risk. Having an “overweight” BMI in midlife (25 to 30) has not. In fact, a 2023 study of older adults found that reduced BMI and waist circumference was associated with an increased risk of dementia in participants who did not have obesity.
If you have obesity, make healthy dietary choices, be as active as you can, work to address stress and emotional issues, try to get at least seven hours of quality sleep a night, and talk to your healthcare provider or a weight loss specialist to get help and support.
Brain your brain. Education builds cognitive reserve. Less education in early life (age 20 and under) is strongly associated with risk of developing dementia. While it has not been proven that continuing education later in life reduces risk for cognitive decline or dementia, taking an adult class in your community (or online), studying a new language, or learning a new skill is highly recommended.
Based on research to date, experts recommend regularly challenging your brain. This increases blood flow to the brain and builds new connections. Choose activities for which you need to make an intellectual effort and focus. Learn a new language or skill, be creative, take up an instrument or hobby, travel, or regularly play strategy games or do puzzles. Be aware that, while some so-called “brain-training” games may be beneficial, many make unsubstantiated claims. There is no “app” that has been proven to prevent Alzheimer’s disease or any other form of dementia.
➧ Protect your head.
➧ Get at least 7 hours of sleep.
➧ Don’t smoke or vape (and avoid secondhand smoke).
➧ Move as much as you can.
➧ Consume a healthy dietary pattern.
➧ Address hearing loss.
➧ Manage Risk factors like high blood pressure, high LDL-cholesterol, and high blood glucose.
➧ Avoid excessive alcohol use.
➧ Work to lose excess body fat.
➧ Stimulate your brain with education and challenging tasks.
➧ Socialize with others.
Have fun! Social isolation has been associated with higher risk of developing dementia. It can be hard to disentangle this from dementia increasing social isolation, but experts agree socializing is important. So, call a friend or, better yet, get out, get moving, register for an adult course, join a walking group, volunteer, and stimulate your brain with others!