Prevention

Alzheimer’s disease affects people across economic, educational, social, racial, and gender lines. Age is the greatest risk factor for Alzheimer’s disease, but who and when it strikes is unpredictable. Currently, there is no cure for Alzheimer’s disease, placing a lot of importance on Alzheimer's disease prevention. Scientists have found evidence that some lifestyle changes can delay the onset or lower risk for the disease.

Watch "6 Ways to Reduce Your Risk for Alzheimer's Disease," presented by Nathaniel Chin, MD, and available on PBS Wisconsin.

To help keep your mind healthy, follow these six evidence-based lifestyle recommendations we call the 6 Brain Health Pillars to Build a Brain Buffer.

Physical activity

photo shows legs of someone running with blue tennis shoes and red University of Wisconsin socks

Physical activity and exercise offer a host of benefits throughout the body, including in the brain. At the University of Wisconsin-Madison, Dr. Ozioma Okonkwo has conducted several studies showing exercise improves brain health and thinking skills. Any movement is beneficial, and each person should speak with their doctor about the type of exercise that is healthy for them. In general, healthy seniors should try to get 30 minutes of moderate intensity exercise five days a week. If you can’t fit in 30-minute bouts each day, attempt two 15-minute bouts instead. How do you know the intensity of the exercise you are doing? Try the talk test: During light physical activity, you can easily talk and sing. When you are engaged in moderate physical activity, you can talk, but you cannot sing. During vigorous levels of physical activity, you cannot say more than a few words without having to pause to catch your breath.

Diet

In 2015, Dr. Martha Clare Morris, Rush University, published the MIND diet for healthy brain aging, based on years of research into nutrition, aging, and Alzheimer’s disease. The MIND diet emphasizes eating vegetables, nuts, fish, poultry, beans, whole grains, and berries, especially strawberries and blueberries. The diet also recommends limiting red meat, butter and margarine, cheese, pastries and sweets, and fried foods. A study of nearly 1,000 people who followed the MIND diet found those who closely followed the diet reduced their risk of developing Alzheimer’s disease by 53 percent. People who loosely followed the diet still saw results, reducing their risk of developing Alzheimer’s disease by 35 percent.

Sleep

Sleep is essential to healthy living. Dr. Barbara Bendlin, University of Wisconsin-Madison, published a study in 2017 that found people who reported more sleepiness during the day and not feeling rested after a night of sleep showed more brain changes related to Alzheimer’s disease. Scientists are still trying to figure out if poor sleep causes Alzheimer’s disease-related brain changes, or if the brain changes of Alzheimer's disease cause the sleep disturbances commonly seen in the disease. But it is clear there is a connection. Aim for 7 to 9 hours of restorative sleep each night, prioritize sleep, and start a relaxing evening routine that includes dim lights (but not smartphones, TVs, or other screens) and peaceful thoughts.

Social engagement

two elderly people looking at a tablet computer

Social engagement is an important factor in the prevention of Alzheimer’s disease and dementia itself. Studies have shown people with regular social contact are less likely to get dementia and that social interaction may even help delay the progression of dementia. What does social engagement look like, particularly in a time of COVID-19 and social distancing? The COVID-19 pandemic makes social engagement much harder, but also even more important for our brain health. Making regular social contact with friends, neighbors, family and acquaintances requires us to converse, to engage in activities together, and to think about topics we may not think of independently — all factors that help our brains stay active. Connecting with others helps us feel less isolated. Some ideas to practice social engagement from home include emailing friends and family, scheduling a daily phone call with a friend, playing a card game with others over an online platform, finding ways to volunteer in our communities from home such as knitting or quilting donations for people in need. As many churches and community groups have transitioned to virtual services, there are now more ways to attend religious services or classes from home, and new ways to join in online social clubs. Senior centers, libraries, churches and civic groups can be places to find new, virtual social opportunities. And of course as pandemic restrictions are lifted, there will likely be many more opportunities to engage socially outside the home. 

Cognitive Enrichment

Cognitive enrichment is keeping your mind active. Another way to think of it is exercise for your brain. How can we exercise our brain? We can try to learn new things! Learning a new activity could include practicing a new language, playing an instrument, trying a new craft, learning a new topic and teaching it to others — these are examples of learning that are mentally stimulating and engaging and can have real impact on our brain health. While there is not one, best way to practice brain exercise, there is clear evidence that pursuing new interests and learning new skills are a great way to enrich our cognitive ability. The expression "you can’t teach an old dog new tricks" is especially harmful to people interested in brain health because not only is it false, but as we age, it is actually important to practice new skills and explore new interests. Studies have shown participation in a range of mentally and socially engaging activities in midlife reduces the risk for Alzheimer’s disease and dementia, in addition to having great benefits for our moods and emotional health.

Some ideas of cognitive activities include visiting museums (during COVID, many museums and aquariums also have online tours available), taking a course at a college or community center, mastering a new cooking or baking technique, quilting and sewing or knitting, learning a language, playing musical instruments, arts and crafts, woodworking, sports, card groups, dancing, gardening, cultural activities and conversation, playing board games, and practicing crosswords, sudoku and puzzles. While all of these activities are potentially beneficial, it’s especially good to look for cognitive activities also involving socialization and physical activity. Research suggests combining cognitive, social and physical components in leisure activities offers the greatest benefit in terms of reducing dementia. A dance class, for example, would be a way to practice all three brain health benefits because it is physical, it is social, and it requires thinking and remembering dance steps. Martial arts classes or tai chi classes are another example of an activity that captures that trilogy of brain health: a social activity that includes physical and cognitive exercise.

Stress and coping

Chronic stress can have long-term effects on the brain, so managing stress is an important factor in overall brain health. When experiencing stress, the brain releases cortisol, a hormone that increases sugars in the blood and increases metabolism, partly through stimulating insulin release in the blood. If stress levels remain high for an extended period, the brain is exposed to too much cortisol, resulting in increased anxiety, weight gain, depression, and sleep disruptions. Dr. Megan Zuelsdorff of the Wisconsin Alzheimer’s Disease Research Center and principal investigator of the Stress and Resilience in Dementia (STRIDE) study, found in 2013 that the more stressful events that occurred in an individual, the worse they performed on cognitive testing. Dr. Zuelsdorff's research also found that stressful life events disproportionately affect African Americans and pose as a risk factor for Alzheimer's disease. While the link between stressful life experiences and cognition is still being explored, it is worth noting that stress is a controllable risk factor; unlike our genes that cannot be changed, there are ways to reduce stress in life and ultimately improve your mental health and possibly alter trajectories for Alzheimer’s disease. 

One of the best ways of managing stress is by practicing mindfulness. Some effective ways to practice mindfulness is with meditation, performing breathing exercises throughout the day, and reserving time for yourself to relax on a daily basis. These can be just a few minutes of your day and will help improve your overall mood and boost focus levels.

Learn more

UW Health offers additional information about strategies people can follow to reduce their risk or delay symptoms of dementia.

Read "Can Alzheimer's Disease Be Prevented?" by the Alzheimer's Association.

"12 Things You Can Do to Help Prevent or Delay Dementia" from BeingPatient.com reviews the recommendations from the Lancet Commission on dementia prevention.

The National Institute on Aging offers helpful information on its page "Preventing Alzheimer's Disease: What Do We Know?"