Healthy Lifestyle May Offset Cognitive Decline Even in People With Dementia

Older man biking in blue jersey outside.
A study looks at how a healthy and active lifestyle can impact cognitive decline. Justin Paget/Getty Images
  • A new study finds being active can help offset signs of cognitive decline.
  • A new study found being physically active, eating well, and avoiding smoking and alcohol can all help slow mental decline.
  • Even people diagnosed with dementia had less decline by taking on these healthy habits.

It’s well known that a healthy lifestyle can have a tremendous impact on our physical and mental health, and new research shows it may keep our brains sharper as we age, too. 

The study, published in JAMA Neurology February 5, found that healthy lifestyle choices — being physically active, eating well, avoiding smoking and limiting alcohol consumption — may slow cognitive decline, even in people with neuropathologies like dementia. 

More research is needed to understand why lifestyle factors have this impact, but scientists suspect healthy behaviors promote brain cell growth and plasticity, fight inflammation in the brain, and boost vascular function. 

“Even for individuals with cognitive decline and dementia, adhering to and improving upon multiple lifestyle factors may be able to slow cognitive decline, or improve behavioral outcomes such as mood or certain aspects of cognition,” Ryan Glatt, CPT, NBC-HWC, a senior brain health coach and director of the FitBrain Program at Pacific Neuroscience Institute in Santa Monica, CA, told Healthline. 

Better brain function detected in people with healthier lifestyles

The researchers evaluated the health data of 586 individuals who participated in the Rush Memory and Aging Project, a longitudinal study that ran from 1997 to 2022. 

The participants were deceased and had undergone an autopsy. 

The study included information about the individual’s cognition, lifestyle factors, and results from neuropathologic evaluations. 

A lifestyle score, ranging from 0 to 5, was assigned to each individual, depending on how much regular physical activity they get, whether they smoked or drank alcohol, what their diet was like, and if they were involved in cognitive activities.

The researchers found that a healthier lifestyle was linked to better cognitive function, regardless of whether the participants had brain pathologies like Alzheimer’s disease.

Higher lifestyle scores were also associated with lower levels of the beta-amyloid plaque, a protein that accumulates in the brain in people with Alzheimer’s disease.

This suggests lifestyle factors may have a protective effect on brain function in older adults, even in people who are actively experiencing cognitive decline.

“Using a large autopsy study sample, the authors showed that this relationship between lifestyle and cognition is largely independent of the burden of dementia-related changes,” said Dr. Irina Skylar-Scott, a board-certified, fellowship-trained cognitive and behavioral neurologist at Stanford Medicine.

How you can protect your cognitive function

Evidence consistently shows that a healthy lifestyle provides numerous cognitive benefits, and may reduce the risk of dementia even in people who are genetically predisposed to the condition. 

A recent report estimated that modifying 12 risk factors, many of which relate to a healthy lifestyle, could delay or prevent up to 40% of dementia diagnoses.

“This study provides more evidence that leading a healthy lifestyle is important in virtually all aspects of our lives,” said Dr. Jonathan Rasouli, Director of Complex and Adult Spinal Deformity Surgery at Staten Island University Hospital.

Rasouli was not involved in the study.

More research is needed to better understand how and why lifestyle factors affect cognition, but scientists have a few theories. 

“When engaging in healthy lifestyle factors for brain health, lifestyle behaviors such as physical activity and cognitive stimulation can help to increase brain blood flow, improve heart health, increase brain activity, and increase brain volumes,” says Glatt. 

For example, evidence has shown that a healthy lifestyle boosts vascular function in the body, reducing the risk of diabetes and hypertension, and ultimately, dementia. 

In addition, lifestyle factors may promote neurogenesis, or brain cell growth, along with neuroplasticity, which is the brain’s ability to form new connections between brain cells, according to Skylar-Scotts.

A healthy lifestyle may prevent neuroinflammation and oxidative stress in the brain, too, she added.

Investing in health now can payoff in later years

Skylar-Scott recommends doing 150 minutes of physical activity a week, spending time with friends and family, doing cognitively stimulating tasks, and eating a well-rounded diet.

The effects of lifestyle on cognitive function are strongest in older adults without dementia.

“It’s like investing in retirement,” says Skylar-Scott.

But even those with existing brain pathologies may benefit from participating in social, cognitive, and physical activities.

“In elderly patients with dementia, being healthy can be immensely beneficial and help improve outcomes, so it is imperative that we focus on holistic as well as medicative approaches to patients with dementia,” says Rasouli.

The bottom line:

A new study found that healthy lifestyle choices — including being physically active, eating well, avoiding smoking and limiting alcohol consumption — may slow cognitive decline, even in people with neuropathologies like dementia. It’s believed that healthy behaviors promote brain cell growth and plasticity, fight inflammation in the brain, and boost vascular function. 

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