If you ask someone how to lower their risk of a heart attack, most people can name a few steps. But if you ask how to reduce dementia risk, many would assume it is out of their control.
But that assumption is not only wrong, it has real consequences: it keeps people from discussing brain health with their doctors, from seeking or accepting early diagnosis, and from engaging in everyday behaviors that can meaningfully support long-term brain health.
In the U.S. alone, over 7 million people are living with Alzheimer’s, a number projected to nearly double by 2050. Globally, nearly 60 million people are living with dementia. U.S. healthcare costs for people living with dementia are estimated to reach $384 billion this year and nearly $1 trillion by 2050.
Google searches for “brain health” have nearly doubled in the last five years, and people are increasingly hungry for solutions. “If this decade is about obesity drugs,” said Dave Ricks, CEO of Eli Lilly recently, “I’m hopeful the 2030s are about brain drugs. And if you look at human suffering, that’s the largest area.”
There are currently 138 novel drugs and 182 active trials in the Alzheimer’s disease pipeline. But one of the most groundbreaking studies of the year so far about brain health was about the power of our daily behaviors. Published in July in JAMA and presented at the Alzheimer’s Association International Conference in Toronto, the study found that a combination of behavior changes, including exercise, a healthier diet, brain games, and more social connection significantly improved cognitive function for those at risk for dementia.
The study, called U.S. POINTER, is the largest lifestyle intervention trial for Alzheimer’s in the U.S. and is modeled on the landmark FINGER study of 2015 in Finland. The idea was to see if the results of the earlier study could be applied to the U.S population, which is larger and less healthy than Finland’s.
The answer is a resounding “yes.” The study’s lesson is to “move more, sit less, add color to your plate, learn something new, and stay connected,” said Laura Baker, study co-author, and professor at Wake Forest University School of Medicine.
But as comprehensive as the study was, there was a major omission in the list of interventions studied: sleep. Along with food, movement, stress management and connection, sleep is one of the foundational daily behaviors that govern our health—including our brain health.
And it’s not the only time sleep has been omitted. In 2024, the Lancet Commission added vision loss and high LDL cholesterol to its list of 12 modifiable risk factors that can prevent up to 45% of dementia cases. The full list includes things like obesity, physical inactivity, and social isolation—but not sleep.
What makes this omission striking is that the science has shown sleep isn’t just important for brain health—it’s fundamental. In 2013, Dr. Maiken Nedergaard, a professor at the University of Rochester, co-authored a seminal 2013 study showing that during sleep the brain clears out harmful waste proteins like amyloid-beta that are linked to Alzheimer’s. Dr. Nedergaard and her fellow researchers called it the glymphatic system, echoing the body’s lymphatic system, which filters waste and helps fight disease and infection.
Last year, three new studies were published in Nature that revealed more about how the glymphatic system works. During sleep, electrical waves deep in the brain push fluid around cells to the surface, where waste goes into the bloodstream and then on to the liver and kidneys for removal. As Jonathan Kipnis, professor at Washington University in St. Louis and an author of two of the papers, put it, “You have the water pipes and the sewage pipes. So the water comes in clean, and then you wash your hands, and the dirty water goes out.”
Matthew Walker, professor at the University of California, Berkeley, led a study showing that deep sleep may mitigate Alzheimer’s memory loss. He uses a different metaphor: “Think of deep sleep almost like a life raft that keeps memory afloat, rather than memory getting dragged down by the weight of Alzheimer’s disease pathology.” And of course, sleep is not only powerful but modifiable. “This is especially exciting because we can do something about it,” says Walker. “There are ways we can improve sleep, even in older adults.”
In fact, sleep helps protect nearly every facet of brain health: sleep disorders are connected to cognitive aging, and chronically short sleep is linked to lower memory performance, faster cognitive decline, and a higher incidence of dementia.
The science on how the other four key daily behaviors protect the brain is just as solid. For example, with food, a 2025 study in Nature Medicine found that following a Mediterranean-style diet can help offset a person’s genetic risk for Alzheimer’s. Because “Mediterranean diet” can mean different things to different people, the researchers defined it precisely. Participants who ate more vegetables, fruits, fish, nuts, legumes, whole grains, and monounsaturated fats (like those in olive oil), and who consumed less red and processed meat as well as saturated fat (such as butter), showed greater resilience to the disease despite their genetic predisposition. The authors concluded that long-term adherence to the Mediterranean diet was “strongly associated” with a lower risk of Alzheimer’s and Alzheimer’s-related dementias.
Another 2025 study by researchers from the University of Hawaiʻi at Mānoa, found that adopting the MIND diet, even later in life, may reduce the risk of Alzheimer’s and other forms of dementia. The MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet combines the Mediterranean diet with the DASH (Dietary Approaches to Stop Hypertension) diet, which emphasizes vegetables, fruits, whole grains, low sodium foods, low-fat dairy products, fish, poultry, beans and nuts. “The take-home message is encouraging,” said study co-author Song-Yi Park. “It’s never too late to make changes. Eating more plant-based, nutrient-rich foods—even later in life—can protect your brain.”
With movement and exercise, a landmark study in April, published in Alzheimer’s and Dementia, found that even light exercise can slow cognitive decline in those at risk for Alzheimer’s. The study was the largest clinical trial of exercise ever for adults with mild cognitive impairment. “This is a critical time to intervene, because they don’t have dementia yet, but are at a very high risk,” said Aladdin Shadyab, lead author and professor at UC San Diego. “These findings show us that even low-intensity exercise may slow cognitive decline in at-risk older adults.”
As for stress, a recent study in JAMA Network Open found that those who reported higher levels of stress were significantly more likely to develop cognitive impairment. Stress impacts the brain in a variety of ways, from memory and attention to mental health and specifically anxiety.
Of the many ways to reduce stress, mindfulness has been found to have particular benefits for brain health. A 2025 study in the journal eNeuro found that just 30 days of guided mindfulness meditation led to measurable cognitive improvements in adults of all ages. “This study shows that mindfulness isn’t just about feeling more relaxed—it can literally change the way your brain handles attention,” said study author Andy Jeesu Kim of USC. “And that’s incredibly important for maintaining cognitive health as we age.” Studies have also shown that breathing techniques, like conscious deep breathing, can both lower stress and increase cognitive function in older adults.
And finally, with connection, a U.K. study of over 460,000 people found that being socially isolated is associated with a 26% higher risk of dementia, separate from risk factors like depression and loneliness. Those with less social connection were also found to have smaller gray matter volume in regions of the brain associated with thinking and learning. As Dr. Frederick Chen, Chief Health and Science Officer of the American Medical Association, put it, “Having strong relationships with others, receiving support and actively participating in social activities can help our brains stay healthy as we get older. This is because these factors contribute to something called cognitive reserve, which acts as a protective buffer against cognitive decline or worsening brain function.”
Brain health is moving to the center of the healthcare conversation. As Dr. Charles Hennekens wrote in The American Journal of Medicine, “While deaths from cardiovascular disease have declined since 2000, deaths from Alzheimer’s disease have surged by more than 140%.”
It’s never too late to protect your brain health. And nearly four in five Americans say they’d want to know if they had Alzheimer’s before they experienced symptoms. As Anne White, President of Lilly Neuroscience told me, “Brain health starts with awareness—of risk factors, of potential actions, and of possibilities.”
The stakes are high. But we know we have a powerful tool that can help protect our brain health: our daily behaviors. Yes, the coming decade will bring life-saving drugs to protect and improve our brain health. But the science is clear that the miracle drug of our daily behaviors is already available to us. Much more of our brain health is in our hands than we once believed—and the sooner we act on that truth, the better.
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