Science offers hope we can act to improve brain health
Emerging research on lifestyle changes and the development of preventive approaches are revealing an opportunity to measure and boost cognitive health.
Dan Jones liked his job as a quality-control inspector and loved his hobby even more: playing in a local bagpipe band.
Then he started making mistakes in the pieces he played. He found himself having to write tasks down if he wanted to remember them. In 2021, at age 56, he was diagnosed with dementia. The future he had plotted with his wife, Darla, suddenly seemed to evaporate.
“We had lots of plans, and they all ended,” he says. Jones packed up his bagpipes for good and moved to a work role that offered a more predictable schedule.
Then his wife learned about a study testing whether lifestyle changes could reverse early-stage Alzheimer’s disease. Enrolling meant Jones had to give up his favourite foods, like roast beef, homemade spaghetti and ice cream, for a plant-based diet with minimally processed foods that are low in refined carbs and sugars. He had to do more exercise, meditate daily and meet regularly with a support group.
Several months into the study, Jones picked up his bagpipes again, and by July 2022 he was performing in a parade in his hometown of Cedar City, Utah. He stopped waking up confused about where he was while travelling. Cognitive assessments showed that aspects of his memory had stabilised or improved.
“You could not pay me to quit eating the way I eat now, or to quit doing the exercise,” he says. “It made that big a difference.”
Jones wasn’t alone. The full study, published in 2024 and led by the non-profit Preventive Medicine Research Institute, found that brain function and cognition significantly improved in patients who made lifestyle changes.
As tools and tests that gauge brain health become more accessible, a growing body of research suggests we can actually do something about it.
The research comes as the gap widens between lifespan and healthspan — the number of years spent in good health. Americans are living longer on average, leaving more time to develop age-related diseases including dementia. New cases of dementia in the US will double by 2060 to roughly one million annually, according to a recent study.
Dr Dean Ornish, founder of the Preventive Medicine Research Institute, spent decades testing whether and how lifestyle changes could affect other diseases such as prostate cancer, heart disease and aspects of ageing itself.
For the Alzheimer’s study that included Jones, Ornish and a team of researchers randomly assigned 51 participants to one of two groups: a control group with no lifestyle changes, or an intensive program. Patients were tested at baseline and retested after 4½ months.
In a test measuring changes in brain function over time, 71 per cent of patients who made lifestyle changes showed improvement or no deterioration in their condition. In the control group, none improved, and 68 per cent got worse. The study’s small sample size makes the findings difficult to generalise, according to Ornish, but the results show a big difference.
“The earlier you intervene, the less intensive the lifestyle changes likely need to be to prevent it,” Ornish says. “It’s really giving new hope and new choices to people who didn’t have that before.”
A separate study published in 2024 looked at healthy people. It found that even modest levels of physical activity, as low as 25 minutes of moderate to vigorous activity a week, are linked to bigger brain sizes — a marker for better brain health.
“Lifestyle matters,” says Rudolph Tanzi, a professor of neurology at Harvard Medical School and director of the McCance Centre for Brain Health at Massachusetts General Hospital, who studies Alzheimer’s disease genes and who worked on the study including Jones.
Advances in diagnostic and prognostic tools are helping doctors and scientists gain new understanding of how to measure and modify cognitive function.
Andrei Irimia, an associate professor at USC Leonard Davis School of Gerontology who has studied brain ageing for more than a decade, co-developed an artificial-intelligence model that uses MRI scans to calculate how fast a patient’s brain is ageing relative to chronological age.
The model takes into account variables linked to brain ageing, such as the size of the hippocampus, which is involved in memory, and the thickness of the cortex, the brain’s outermost layer. Irimia says the model can monitor in real time how the brain reacts to problems or improvements in lifestyle.
Faster brain ageing is linked to a higher risk of cognitive impairment, he says.
In May, the Food and Drug Administration approved the first blood test to help diagnose Alzheimer’s disease. It is designed for people who are already having memory problems, not healthy people without symptoms.
Various companies are developing blood tests that would let anyone determine “brain age.”
NeuroAge Therapeutics, a longevity biotech company, makes a $700 blood test that tracks dozens of RNA molecules. A more expensive package includes the blood test, a brain MRI, genetic testing, memory games and an analysis that offers a comprehensive brain-age score.
NeuroAge was founded by Dr Christin Glorioso, a neuroscientist. Glorioso carries one copy of the APOE4 gene, which carries an elevated risk of developing Alzheimer’s, and she says she started putting a priority on sleep after seeing her results. There is a link between insufficient sleep and dementia risk.
Many doctors and researchers say biological-age testing requires rigorous research and validation before it should be widely adopted. It is also expensive — many of the blood tests cost hundreds of dollars out of pocket, and elective MRIs can cost hundreds to thousands.
“I would be extremely cautious as a consumer, and I would want to see scientific evidence that whatever they measure is relevant,” says Tony Wyss-Coray, a professor of neurology at Stanford University. His lab has developed a protein-based blood test to measure the ages of the brain and other organ systems.
With refinement, these tools could one day make a big difference for patients like Dan Jones.
“The people who can know those things sooner have an advantage,” says Jones, who adds that he didn’t take any genetic or brain health-specific tests before his diagnosis. “I would have made the changes a lot earlier.”
Study participants made these changes to improve brain function
In the study led by the Preventive Medicine Research Institute, some participants adopted these practices.
Diet. A wholefoods, minimally processed vegan diet, low in harmful fats, refined carbs and sweeteners. Meals, along with certain nutritional supplements, were provided to the participants.
Exercise. At least 30 minutes daily of moderate aerobic exercise and mild strength training at least three times a week, with personalised recommendations for participants.
Stress management. One hour a day of techniques, including meditation, stretching and breathing exercises, overseen by a certified stress-management specialist. Adequate sleep was encouraged.
Support. Participants and their partners or spouses attended one-hour support-group sessions three times a week, focusing on emotional support. There were lectures on lifestyle as well as memory classes.
The Wall Street Journal
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