These 4 Habits Could Help You Avoid Cognitive Decline

Alzheimer’s disease (AD) and related dementias are significant public health challenges for many reasons. More people are being affected by dementia, and the condition can bring heavy emotional, social and financial burdens. And as much as you or a loved one may want to lower your dementia risk, it can be hard to figure out where to start.

Memory decline in older adults often has multiple causes, so effective treatments ideally tackle several targets at once. While new medications that target amyloid (a group of proteins linked to Alzheimer’s) show promise in slowing the disease in its early stages, they don’t address other common problems like blood vessel damage in the brain, which can also contribute to memory loss. This highlights the need for better, more comprehensive treatments.

Non-drug approaches, like improving lifestyle factors, offer a safe, affordable, and accessible way to reduce dementia risk. A groundbreaking study in Finland (called the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability, or FINGER) showed that combining certain healthy lifestyle changes improved memory and thinking in older adults at risk for dementia.

To determine if the positive results from the FINGER study in Finland could also apply to a larger and more diverse group of people in the United States who are at risk for dementia, researchers studied this method’s impact on brain health and thinking abilities, and the results were published in JAMA. This study was called the U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk, or U.S. POINTER. 

How Was This Study Conducted?

Researchers recruited subjects for this study by using electronic health records and by working with local community organizations to reach people directly. The goal was to include older adults (ages 60 to 79) who didn’t have memory problems but were at higher risk of developing dementia. 

To qualify, participants had to meet specific criteria regarding both lifestyle factors and risk factors. Those factors included having low physical activity levels—meaning less than 60 minutes of moderate exercise per week—and not following the MIND diet, which is designed to support brain health. As for risk factors, participants needed to meet at least two of the following conditions:

• A close family member (like a parent or sibling) had memory problems.
• They had health risks like high blood pressure, high cholesterol or high blood sugar.
• They identified as part of a racial or ethnic group that is often underrepresented in research, such as Native American, Black, Middle Eastern, or Hispanic or Latino.
• They were in the older age range (70 to 79 years old) or were male, as men are often underrepresented in dementia prevention studies.

Both groups focused on improving brain health through physical activity, cognitive activity, healthy eating, social engagement and heart health monitoring. The difference between the two groups was in how the program was delivered. The first group was the structured group, and participants in this group received extra support from trained professionals and worked closely with peer teams of 10-15 people for motivation and accountability. Participants attended 38 team meetings over two years, and meetings were led by trained navigators and specialists. They also participated in the following: 

• Physical exercise: 30-35 minutes of moderate-to-intense aerobic activity four times a week, plus strength and flexibility exercises twice a week. 
• Cognitive exercise: Computer-based brain training program three times a week for 30 minutes, plus regular engagement in other intellectually challenging and social activities.
• Nutrition: Adherence to the MIND diet, which emphasizes dark leafy greens, berries, nuts, whole grains, olive oil and fish, and limits sugar and unhealthy fats.
• Health monitoring: Regular check-ins (every 6 months) on blood pressure, weight and lab results.

The second group was the self-guided group. This group was more independent but still had access to resources and support from peer teams and navigators from the Alzheimer’s Association. Participants received publicly available resources about healthy lifestyle changes, such as tips on exercise, diet and brain health. They only attended six peer team meetings over two years, and had their health checked once a year during clinic visits, following standard health guidelines.

This study measured brain health and thinking abilities using a global cognitive score, which combined results from three key areas: executive function, which includes skills like planning, problem-solving, and multitasking; episodic memory, which focuses on remembering specific events or experiences; and processing speed, which measures how quickly the brain can handle information. To calculate the global score, participants completed a series of brain tests during clinic visits at the start of the study and every six months for two years. 

What Did The Study Find?

Both groups in the U.S. POINTER study showed improvements in overall brain function over time as measured by their global cognitive scores. After adjusting for certain factors, the structured group improved slightly faster than the self-guided group, and this difference was statistically significant.

When focusing on the different cognitive areas the researchers measured, here is what they found:

• Executive Function: In planning, problem-solving and multitasking, the structured group improved more than the self-guided group, and the difference was statistically significant.
• Processing Speed: In gauging how long the brain took to process information, the structured group also showed slightly greater improvement—however, this difference was not statistically significant.
• Episodic Memory: As for remembering specific events, both groups improved at about the same rate, with no meaningful difference between them.

The structured program seemed to have the biggest impact on participants who started the study with lower cognitive function. However, the structured program worked similarly well regardless of participants’ sex, age or heart health at the start of the study. Additionally, the effects of the structured program were the same for people with or without the APOE ε4 gene, which research has linked to a higher risk of Alzheimer’s disease.

In summary, the structured program provided the most benefit for executive function and was especially helpful for participants who started with lower cognitive abilities. Other factors like age, sex and genetic risk didn’t seem to change how effective the program was.

This study has a few limitations to consider. First, the results might not apply to everyone because the study only took place at five sites, included participants specifically at higher risk for cognitive decline and required a significant two-year commitment from participants. Second, the study wasn’t designed to measure whether the interventions could prevent cognitive impairment or dementia, so those outcomes remain unknown. 

It’s also worth noting that the self-guided group wasn’t a true “no-intervention” control group, as they still received some resources and support. Plus, participants knew which group they were in, which could have influenced their behavior or results. Additionally, it’s unclear how long the benefits of the structured program will last, how easily it could be scaled up for larger populations or how meaningful the improvements are in the long term. 

How Does This Apply to Real Life?

This study highlights the power of lifestyle changes when it comes to supporting brain health and reducing the risk of memory decline. It shows that combining regular exercise, a brain-healthy diet, mental stimulation and social engagement may make a real difference, especially for people at higher risk of dementia. 

The structured program, which provided extra guidance and support, was particularly effective in improving skills like planning, problem-solving and multitasking. This observation suggests that having a clear plan and access to professional support may help people stick to healthy habits and see better results. But the self-guided group, which had more flexibility, showed improvements, proving that small, consistent changes in daily life can still benefit brain health.

This means that adopting healthier habits like staying active, following the MIND diet, engaging in mentally challenging activities, and staying socially connected can be a practical and accessible way to protect brain health. While the study focused on older adults at risk for dementia, the findings are a reminder that it’s never too early or too late to start making positive changes. 

Our Expert Take

A study recently published in JAMA provides valuable evidence that lifestyle changes can play a significant role in supporting brain health and reducing the risk of cognitive decline. In particular, these findings highlight the potential of combining regular exercise, a brain-healthy diet, mental stimulation and social engagement to improve cognitive health, especially for those at higher risk of dementia.

Both structured and self-guided programs led to improvements in overall brain function, with the structured program showing slightly greater benefits, particularly in areas like planning, problem-solving, and multitasking. Importantly, the study also demonstrated that even small, self-guided changes can make a meaningful difference, making these strategies accessible to a wide range of people.