Is dementia inevitable for some people—or can a healthy lifestyle prevent it?

And if so, which lifestyle changes actually keep your mind from declining?

These are big questions—and we’re finally getting some answers. Until now, most studies have focused on changing a single lifestyle factor such as physical exercise, “brain-training” games or puzzles, diet or medical risk factors such as high blood pressure…and the results have been merely promising. Example: The National Academies of Sciences, Engineering, and Medicine recently reported that specific interventions to prevent cognitive decline are “encouraging although inconclusive.”

But what if the sum is greater than its parts? What would happen if you tried several lifestyle changes at once? Would you stay sharper as you age…and cut your chance of getting dementia?

The answer is a resounding…yes!

Background: Several lifestyle and medical factors increase the risk of developing age-related cognitive decline, yet single-factor prevention trials have had disappointing results. But a multifactor approach hadn’t been tried.

Study: Finnish and Swedish researchers recruited more than 2,600 elderly men and women (average age about 70) at risk for cognitive decline to participate in a two-year study. To be included, they needed to be free of clinically diagnosed dementia but with a cognitive score that was in the bottom 50% for people their age.

Half of the participants, the control group, got good medical care and good, standard lifestyle advice—they were encouraged to eat right, get exercise, do stimulating activities, socialize and manage medical risk factors.

The other half entered a more intensive program. Each participant…

  • Met with a nutritionist individually three times and in a group session seven to nine times. The goal was to follow nutrition guidelines closely, including high consumption of fruits and vegetables, whole-grain cereals, low-fat milk and lean meats, no more than 50 grams of sugar a day, and two servings a fish a week.
  • Exercised under the direction of physical therapists to improve strength, balance and endurance. They did strength training one to three times a week and aerobic training two to five times a week.
  • Engaged in cognitive training. Each participant met in groups with psychologists who helped them understand age-related cognitive decline and the known ways to prevent it. Participants also used computer-based cognitive-training programs—loosely called “brain games”—three times a week for 10 to 15 minutes at a time.
  • Met frequently with a study nurse and physician to address any health issues, including weight issues and high blood pressure. Each participant was encouraged to also visit his/her own primary care doctor to actively address medical risk factors.

All of the study participants, both the control and the intervention group, had periodic medical evaluations. Complete cognitive evaluations were conducted at the beginning, halfway through and at the end of the study.

Results: After two years, both groups showed improvements in cognitive function. That makes sense since, even the control group got regular medical care and was encouraged to reduce lifestyle risk factors—to lose weight if needed, for example—that can help improve cardiovascular health…which affects cognition.

But the intervention group did much better. On an overall measure of cognitive health, they scored 25% higher than the control group. They did even better than that on certain specific measures…

  • Executive functioning (skills such as planning, prioritizing, organizing) was 83% higher in the intervention group.
  • Processing speed (the ability to think and respond quickly) was 150% higher in the intervention group.

Crucially, previous research has shown that such cognitive scores can predict the risk for cognitive decline in the future. Upshot: At the end of the study, participants in the control (nonintervention) group were calculated to be 31% more likely to develop cognitive decline than those in the intervention group.

Bottom line: There’s no quick fix, and no one fix, to staying mentally sharp as you age—but a multifactor approach really works. If you want to keep yourself sharp and reduce the chance that you’ll get dementia, keep your weight, blood pressure, cholesterol and blood sugar within healthy ranges…eat a brainy diet…play brain games…and try this ultimate exercise workout to enhance brainpower.

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