5 Science-Backed Lifestyle Changes to Supercharge Your Brain Health and Slow Cognitive Decline

In a recent clinical trial led by Ornish et al., published in Alzheimer’s Research & Therapy in 2024, researchers explored how intensive lifestyle changes affect the progression of mild cognitive impairment (MCI) or early dementia related to Alzheimer’s disease (AD).

What does the science say on ways to slow cognitive decline

Let’s dive into this clinical trial and see what the researchers were investigating, their methodology, and their findings. Clinical trials are critical in advancing medical knowledge and improving patient care, as they rigorously evaluate the effectiveness and safety of new treatments or interventions. This will also allow us to see if there are any key takeaways that can be implemented based on the current findings.

Clinical Trial Description:

Objective: This randomized, controlled trial aimed to determine if intensive lifestyle changes could benefit individuals with MCI or early AD. The hypothesis was that such interventions, previously shown to reverse coronary heart disease, might slow, stop, or reverse AD progression and cognitive decline.

Study Design: A 1:1 multicenter randomized controlled Phase 2 trial.

Participants: 51 participants, aged 45-90 (mean age 73.5), enrolled between September 2018 and June 2022, all with MCI or early dementia due to AD (MoCA score ≥ 18) and plasma Aβ42/40 ratios (<0.0672). Exclusions: moderate/severe dementia, physical disabilities preventing exercise, other neurodegeneration causes, significant psychiatric/substance abuse issues. Two withdrew, leaving 49 for analysis.

Intervention:

• Intervention Group (26 participants): Underwent a 20-week intensive lifestyle program including:

  • Diet: Whole foods, plant-based diet, low in harmful fats and refined carbs, with provided meals and supplements.

  • Exercise: Daily aerobic exercise and mild strength training thrice weekly, personalized and supervised.

  • Stress Management: Daily hour of meditation, yoga, relaxation, and breathing exercises, with sleep encouragement.

  • Group Support: Thrice-weekly sessions with emotional support and memory exercises.

  • Supplements: Omega-3s with Curcumin, multivitamins, Coenzyme Q10, Vitamin C, B12, Magnesium L-Threonate, Lion's Mane mushroom, and probiotics.

• Control Group (25 participants): Maintained usual habits for 20 weeks, with an option for intervention post-study, continuing standard medical care.

  
  

Outcome Measures:

• Primary (Cognition and Function): Changes in CGIC, ADAS-Cog, CDR-SB, and CDR-G, assessed by blinded psychometrists.

• Secondary (Biomarkers and Microbiome): Plasma Aβ42/40 ratio, other blood biomarkers (e.g., phosphorylated Tau181, insulin, LDL cholesterol, GlycA), microbiome composition, and correlation with "lifestyle index."

  
  

Summary of Findings:

The trial showed significant benefits of the intensive lifestyle intervention:

• Cognition and Function: After 20 weeks, the intervention group improved significantly in CGIC (p=0.001), CDR-SB (p=0.032), and CDR Global (p=0.037), with borderline significance in ADAS-Cog (p=0.053), compared to the control group. The intervention group generally improved or had less progression, while the control group worsened in all measures. Excluding one outlier, all cognitive measures were statistically significant.

• Biomarkers:

  • Plasma Aβ42/40 Ratio: Increased in the intervention group and decreased in the control group (p=0.003), indicating a beneficial shift in amyloid processing.

  • Other Biomarkers: Significant improvements were seen in insulin (p=0.048), beta-Hydroxybutyrate (p=0.021), LDL cholesterol (p<0.001), and GlycA (p=0.005). Other markers showed beneficial trends, though not always statistically significant.

• Dose-Response Correlation: A significant correlation was found between adherence to lifestyle changes and improvements in cognition, function, and biomarkers. Greater adherence led to better outcomes, with substantial adherence halting or improving cognitive decline.

• Microbiome: The intervention group had beneficial changes in gut microbiome composition, with increases in taxa linked to lower AD risk and decreases in those linked to higher AD risk.

• Depression: No significant differences in depression scores were found, suggesting cognitive improvements were not due to reduced depression.

Conclusion: Intensive lifestyle changes can significantly improve cognition, function, and biological markers in patients with MCI or early AD within 20 weeks. These findings support the need for larger, long-term trials and highlight lifestyle medicine as a potential therapeutic strategy for AD.

5 Exciting Lifestyle Changes for Better Brain Health

(Backed by Science):

Inspired by the intervention components that delivered remarkable benefits, older adults can embrace these five lifestyle changes into their daily routines, ideally with guidance from a healthcare provider:

1. Embrace a Whole-Foods, Plant-Based Diet: Transform your eating habits by focusing on vibrant, unprocessed plant foods like fruits, vegetables, whole grains, legumes, nuts, and seeds. Make it a mission to reduce or eliminate harmful fats (like saturated and trans fats), refined carbohydrates (white bread, pasta), and added sugars. This comprehensive dietary change was a standout in the trial, promoting enhanced brain health.

2. Commit to Regular Moderate Physical Activity: Make movement a joyful priority every day! Aim for at least 30 minutes of moderate-intensity aerobic exercise most days of the week, such as brisk walking, swimming, or cycling. Plus, add mild strength training exercises at least three times a week to keep your muscles strong and your physical function sharp, all linked to better cognitive health.

3. Incorporate Daily Stress Management Techniques: Dedicate a special hour each day to stress-busting activities. Whether it's meditation, gentle yoga, stretching, deep breathing, or guided imagery, these practices are designed to create a sense of relaxation, sharpen your focus, and boost overall awareness, counteracting the negative cognitive effects of chronic stress.

4. Build Strong Social Connections and Support: Dive into social groups, connect with friends and family, or join community activities. The trial underscored the power of a supportive environment and social interaction, which can significantly uplift your emotional well-being and contribute to cognitive resilience, fighting off the social isolation often linked with cognitive decline.

5. Focus on Quality Sleep and Explore Targeted Supplements: Ensure you enjoy restful, rejuvenating sleep each night, as it's vital for brain health. Additionally, discuss with your doctor the potential benefits of targeted nutritional supplements. The trial's intervention included Omega-3 fatty acids, B vitamins (especially B12), Magnesium L-Threonate, and Hericium erinaceus (Lion's Mane) mushroom, among others, all believed to support brain function and address AD pathophysiology.