Healthy Lifestyle Can Limit Dementia, Even After Brain Changes Occur: Evidence from the Rush Study
Research shows that healthy diet, exercise, and lifestyle habits can build cognitive reserve in older adults, protecting brain function even when dementia pathology is present. A large study of 586 adults found that healthy lifestyle scores were associated with better cognitive function before death.
Healthy Lifestyle Can Limit Dementia, Even After Brain Changes Occur
Research has found that diet, exercise, and other lifestyle habits can increase the 'cognitive reserve' of older adults.
A healthy lifestyle is associated with better cognitive function in older adults—even those whose brains show signs of dementia, according to research published in JAMA Neurology last month. The study demonstrated that a healthy lifestyle can protect older adults from cognitive decline and increase their 'cognitive reserve.'
Researchers used data from the Rush Memory and Aging Project, a long-term study that observes patients' lifestyles and health and analyzes autopsy data from 1997 to 2022.
The scientists examined demographic information, lifestyle data, and postmortem findings on 586 patients, including details about their diet, cognitive function before death, and lifestyle factors such as alcohol consumption and physical activity.
The patients, 70.8 percent of whom were female, lived to an average age of 90.9 years. Their brain autopsies were examined for physical signs associated with dementia, including amyloid plaque buildup, which disrupts brain cell function and is linked to Alzheimer's disease.
Among all patients, higher healthy lifestyle scores in five domains—diet, cognitive activity in older age, physical activity, smoking cessation, and low alcohol consumption—were associated with better cognitive function before their death. This relationship persisted even when autopsy showed signs of brain changes consistent with dementia. Overall, each one-point increase in lifestyle score was associated with better cognition.
The analysis suggests that a healthy lifestyle can increase a person's 'cognitive reserve,' allowing patients to remain sharp despite changes in their brains, the researchers wrote.
Lifestyle factors such as diet and nutrition may protect the brain from inflammation and oxidative stress, the researchers wrote. Most patients in the research sample were white, and researchers noted that lifestyle information was self-reported.
This analysis "is an important first step" in answering questions about the relationship between lifestyle, brain changes, and cognition, wrote two researchers in an accompanying editorial in JAMA Neurology. They suggested that lifestyle factors be prescribed alongside other pharmacological solutions and emphasized the need for more research observing reductions in dementia risk among diverse groups.
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References
- Rush Memory and Aging Project (1997–2022). Longitudinal study of aging and dementia prevention.
- JAMA Neurology (2026). Lifestyle factors and cognitive reserve in older adults with dementia pathology.
Cognitive reserve is the brain's ability to adapt to changes caused by aging or disease. A healthy lifestyle—including diet, exercise, cognitive activity, and social engagement—builds cognitive reserve and allows the brain to maintain function even when dementia pathology is present.
Yes. The Rush Memory and Aging Project found that participants with higher healthy lifestyle scores had better cognitive function before death, even when autopsies showed signs of dementia pathology such as amyloid plaque buildup.
According to the research, the five domains are: (1) healthy diet, (2) cognitive activity in older age, (3) physical activity, (4) smoking cessation, and (5) low alcohol consumption.