An estimated 7.2 million Americans over age 65 currently live with Alzheimer’s disease (AD), and that number is expected to nearly double to 13.8 million by 2060. While chronological age is the strongest known risk factor for cognitive decline, losing cognitive function is not an inevitable part of aging, according to researchers from Florida Atlantic University’s Charles E. Schmidt College of Medicine.

In a recent commentary, the researchers urge clinicians, public health professionals and policymakers to implement coordinated efforts to support lifestyle-based interventions that can help reduce the growing burden of cognitive decline in the United States and worldwide. It is estimated that up to 45% of dementia risk could be attributed to modifiable lifestyle and environmental factors.

Lifestyle risk factors like physical inactivity, poor diet, obesity, alcohol use, and conditions such as hypertension, diabetes, depression, and social or intellectual isolation are thought to contribute to cognitive decline. The authors point out that the same therapeutic lifestyle changes proven effective for reducing risks of cardiovascular and other major diseases may also help reduce cognitive decline – potentially with additive effects when multiple risk factors are present.

The commentary highlights recently published results from POINTER, the first large-scale US-based randomized trial to test whether intensive lifestyle changes can improve cognitive outcomes in older adults at high risk of decline. In this trial, participants who were assigned at random to a structured, team-based lifestyle intervention showed statistically significant and clinically meaningful improvements in global cognition over two years.

These gains were especially notable in executive functions such as memory, attention, planning and decision-making. The intervention emphasized regular physical activity, a combination of Mediterranean and DASH-style diets, cognitive stimulation and social engagement – reinforced through ongoing professional guidance and group support.

The POINTER findings are similar to an earlier Finnish trial, the FINGER trial, in which participants with elevated cardiovascular risk scores assigned at random to a multidomain lifestyle approach experienced cognitive benefits.

The commentary includes other relevant data as well as suggestions for policy, health system, and societal reforms to emphasize lifestyle-based strategies to protect brain health.

To download the full commentary, published in the American Journal of Medicine, click here