Studies and survey highlight lifelong and midlife steps to support brain health

Brain health is a lifelong priority, with new research and survey data pointing to mentally, socially and physically stimulating activities as well as treatment of health conditions as key factors linked to lower dementia risk. In midlife, engaging in a diverse range of stimulating activities significantly boosted cognition even among people with a higher genetic risk for Alzheimer’s, while a separate study found that people with the highest amount of lifelong learning had onset of Alzheimer’s delayed by five years.

Engaging in physically, socially and intellectually stimulating activities in middle age can boost brain activity even among people with a higher genetic risk for Alzheimer’s, researchers reported April 21 in the Journal of Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring. For the study, researchers analyzed data from 700 people between 40 and 59 years of age with good brain health across Ireland and the U.K. who are participating in a decade-long study. A third of the participants carry genetic risk for Alzheimer’s.

Results showed that a stimulating activity can overpower even the strongest genetic risk factor for Alzheimer’s in shaping brain health in midlife. These activities included socializing with family or friends, practicing a musical instrument, creating art, exercising, reading, learning a second language and traveling. The study also found that the two most harmful risk factors for brain health were symptoms of depression and traumatic brain injury. Others included diabetes, high blood pressure, poor sleep and hearing loss.

A separate study in Neurology found that people who engage in a lifetime pursuit of learning have a lower risk of Alzheimer’s disease, as well as slower brain aging. Overall, higher scores in lifetime enrichment were linked to a 38% lower risk of Alzheimer’s and a 36% lower risk of mild cognitive impairment. People with the highest amount of lifelong learning had onset of Alzheimer’s delayed by five years, compared to those with the lowest amount, and they developed mild cognitive impairment seven years later.

For that study, researchers tracked more than 1,900 dementia-free people with an average age of 80 for about eight years. During the study, 551 people developed Alzheimer’s and 719 developed mild cognitive impairment. Among those with the highest level of enrichment throughout their lives, 21% developed Alzheimer’s, compared with 34% of those with the lowest level of enrichment. People with the highest lifetime enrichment developed Alzheimer’s at age 94 on average, compared to 88 for those with the lowest, and developed mild cognitive impairment at 85, compared to 78 for those with the lowest.

The measures of enrichment spanned life stages. Early enrichment before age 18 focused on being read to and reading books, having newspapers and atlases in the home, and studying a foreign language for more than five years. Middle-age enrichment included income level at age 40, household resources like magazine subscriptions or library cards, and frequency of visits to museums or libraries. Later-life enrichment included reading, writing, playing games and total retirement income.

Survey data from more than 3,800 U.S. adults 40 and older found that nearly 9 in 10, or 88%, consider maintaining brain health as they age very important, and 99% said it is at least as important to them as their physical health. However, only about 9% said they know a lot about how to maintain brain health and ward off dementia. Nearly all surveyed, 99%, consider lifestyle behaviors important for brain health, but fewer than half strongly linked those behaviors to a reduced risk of Alzheimer's or dementia.

When asked about specific habits that support brain health, people most often cited:

• Protecting against head injury (82%)
• Not smoking (72%)
• Managing stress (71%)
• Treating depression (71%)

People did not consistently practice the lifestyle habits known to protect brain health. Only half, or 50%, got at least seven hours of sleep on most days. Only 39% regularly eat a healthy, balanced diet, 42% engage in mentally stimulating activities like puzzle solving or learning, and 34% get physical activity daily or on most days, while 30% report doing so less a week or never.

Nearly three-quarters of adults, 73%, said they would be interested in participating in brain health programs, including cognitive exercises, health monitoring, nutrition and physical activity. Cost was the biggest factor driving their decision to participate, followed by program location, personal motivation and insurance coverage. Most respondents also said they would prefer to learn about brain health from their health care provider, and 86% welcome these conversations during routine care, but only 14% have had a conversation about brain health with their doctor and only 11% have discussed ways to reduce dementia risk.

An estimated 7.4 million people 65 and older are living with Alzheimer’s disease or dementia, and between 2000 and 2024, the number of U.S. deaths due to Alzheimer’s more than doubled. Nearly 2 in 5 respondents, or 38%, said people need to start taking steps to support their brain health during middle age, nearly half said participation in a formal brain health program should begin around that time, and about 1 in 3 said taking steps to protect brain health is a lifelong endeavor.