In the Society of Behavioral Medicine

Coles Hoffmann, MC; Arizona State University

Many of us know someone who has been affected by a decline in cognitive function (e.g. memory, thinking), dementia, or Alzheimer’s Disease (the most common form of dementia). Cognitive decline and dementia can take a toll on an individual’s ability to perform activities of daily living, or every day activities such as eating and getting dressed, as well as on the individual’s quality of life.

The biggest risk factor associated with cognitive decline and dementia is aging. As the older adult population continues to grow, with one-fifth of the world population projected to consist of older adults (60+) by 2050, the rates of dementia will rise, affecting an estimated 65.7 million people worldwide by 2030, and 115.4 million by 2050.1 With little advancement in the ability for drugs to treat dementia, many people are left asking:

• What can I do to help prevent or delay the onset of cognitive decline and dementia?
• What can I do to maintain healthy living as I grow older?

Fortunately, there is a lot of evidence to suggest that adopting certain lifestyle behaviors, such as exercising, consuming a healthy diet, and participating in social activity, as well as maintaining heart health and monitoring cardiovascular risk factors (e.g. high blood pressure, diabetes, and obesity), can reduce the risk of cognitive impairment and dementia.2 In the past, many studies have focused on one lifestyle behavior at a time, but more recently, researchers have found that participating in multiple healthy lifestyle behaviors associated with cognitive decline and dementia may be more beneficial than participating in just one.3

Tip #1: Participate in weekly physical activity

Studies have shown that a combination of aerobic physical activity and muscle strengthening can be beneficial to cognitive function. It is recommended that adults participate in 150-300 minutes of moderate aerobic physical activity a week, or 75-150 minutes of vigorous aerobic physical activity a week, or a combination of the two.4

Aerobic physical activity improves cardiovascular fitness and can consist of brisk walking, running, or bicycling. Examples of moderate physical activities include walking briskly, raking the yard, or playing volleyball.

Vigorous physical activities can include running or jogging or taking part in a high intensity work-out class. Several activities can be performed at either moderate or vigorous intensities (e.g. cycling or swimming).

Adults should also participate in muscle-strengthening exercises at least 2 days per week. Muscle strengthening exercises increase the strength, power, and endurance of muscles and can include resistance training and weight lifting.

Older adults (65+) should participate in physical activity that combines balance training, aerobic exercise, and muscle-strengthening exercises. Balance training is an important component for older adults to prevent falls and improve quality of life.

Tip #2: Maintain a healthy diet

Diet guidelines that closely follow a “Mediterranean diet” have long been associated with many health benefits on top of showing evidence to support cognitive health.5,6 A typical meal is centered around plant-based foods (vegetables, fruits, nuts, whole grains, and beans), with moderate amounts of seafood, poultry, eggs, and dairy, and only occasional consumption of red meat. The following guidelines should be closely adhered to:

• Eat a variety of fruit and vegetables
• Eat whole grains
• Eat fish and poultry in place of red meat (eat lean cuts of red meat when it is consumed)
• Limit sweets and sugar-sweetened beverages
• Eat nuts and legumes
• Use olive oil or similar monosaturated fat sources in food
• Limit the amount of trans fat, sodium, and saturated fat in your diet

Tip #3: Engage in social activity

Engagement in social activity may also reduce the risk of cognitive decline and assist in preventing dementia. Adults can participate in a variety of social activities, including ones that combine other lifestyle behaviors (e.g. community exercise classes). There are many ways that adults and older adults can become socially active including joining a club or group, becoming a volunteer, and/or joining a community fitness center.

Tip #4: Monitor cardiovascular risk factors (high blood pressure, diabetes, and obesity) and maintain heart health

Participating in a healthy lifestyle in aging, especially by being physical active and consuming a good diet, can also reduce the risk of cardiovascular risk factors that are associated with cognitive decline and dementia. It is also important to consistently get screening tests to monitor for risk factors associated with heart health (and cognitive function). The following screenings can be helpful to know when and if you need to take more action to reduce your risk:

• Blood pressure: High blood pressure can show no symptoms, but can increase your risk of stroke, heart disease, and cognitive decline (especially high blood pressure in mid-life).
• Blood sugar: High blood sugar increases your risk of developing prediabetes and type II diabetes, which can also lead to stroke, heart disease, and is associated with cognitive decline.
• Body weight: Measuring waist circumference and body weight can allow you or your provider to identify if you are at a higher risk for developing disorders associated with cognitive decline and dementia.

By following these tips and consistently participating in multiple healthy lifestyle behaviors adults can reap a multitude of benefits, including the potential to reduce cognitive decline associated with aging.