7 Tips to Help Prevent Alzheimer’s Disease

Neurologist Dr. Richard Isaacson shares the most important lifestyle habits to help reduce the risk of the common brain disease.

MRI images of a human brain

Left: MRI image shows how a brain with Alzheimer’s shrinks over time. Middle: A glucose PET scan shows how brain metabolism decreases in Alzheimer’s. Right: Amyloid PET scan shows how Amyloid, an abnormal protein, has built up in the brain, marking the key pathologic hallmarks of the disease. Source: "Phenotypical variation in Alzheimer's disease: insights from posterior cortical atrophy" by Slattery CF, Crutch SJ, and Schott JM, used under CC BY/Modified from original.

Alzheimer’s affects more than 5 million Americans, and by 2050, that number is projected to increase to nearly 14 million, according to the Alzheimer’s Association. However, recent advances in the field are giving doctors newfound hope in the area of prevention.

Experts are learning that the disease actually begins 20 to 30 years before the first symptoms appear. During this time, the disease begins to develop silently in the brain, and recent estimates suggest that more than 46 million Americans are now affected by this initial, or “preclinical,” stage of the disease.

“Back in medical school, students like me were taught that dementia starts when the person starts having memory loss,” says Dr. Richard Isaacson, a neurologist and the founder and director of the Alzheimer’s Prevention Clinic at Weill Cornell Medicine and NewYork-Presbyterian. “But we have learned a ton since and now know Alzheimer’s starts decades earlier.”

A new study led by Dr. Isaacson shows that people are not powerless in the fight against Alzheimer’s. In this trial, 176 patients from the Alzheimer’s Prevention Clinic aged 25-86 were given specific, personalized instructions about how to manage their own unique risk factors associated with Alzheimer’s so they could potentially slow the progression of cognitive decline. After 18 months, this individualized clinical management approach improved cognitive function and reduced the risk of developing Alzheimer’s and cardiovascular disease across a broad range of ages and diagnostic groups.

This study builds upon past research showing that lifestyle changes can maintain or improve cognition and reduce a person’s risk of developing the Alzheimer’s. One out of three cases of Alzheimer’s disease may be preventable based on lifestyle changes and managing certain medical conditions, according to this study. On average, the Alzheimer’s Prevention Clinic recommends 21 separate interventions for patients, such as medication management, diet, exercise, stress reduction, and sleep hygiene.

“I have four family members that have been affected, and there are few words to describe how difficult Alzheimer’s is on the person and the entire family,” Dr. Isaacson says. “So, I’ve tried to get a jump-start on the disease by seeing patients (like me) with a family history who are not yet experiencing memory loss.”

Read on for Dr. Isaacson’s top lifestyle habits to help prevent Alzheimer’s and other types of dementia, and click below to hear Dr. Isaacson discuss Alzheimer’s disease on the podcast “This is Your Brain with Dr. Phil Stieg,” Chairman of the Weill Cornell Medicine Brain and Spine Center and Neurosurgeon-in-Chief at NewYork-Presbyterian/Weill Cornell Medical Center.

Dr. Isaacson and Dr. Stieg talk about Alzheimer's prevention

Listen to Dr. Richard Isaacson (left) describe the difference between Alzheimer’s and age-related memory problems on “This Is Your Brain With Dr. Phil Stieg,” a Life Sciences podcast about the human brain featuring conversations with leading medical experts and patients. Click here to listen to the full podcast.

1. Eat clean.
The best diet for your brain is the Mediterranean diet. Think lots of leafy greens, whole fruits and vegetables, whole grains in moderation, lean protein, fatty fish (like salmon), and healthy fats such as nuts, seeds, and olive oil. A 2017 study in Neurology found that people in their 70s who consumed a Mediterranean diet lost less brain mass than people who ate a diet more typical of their native Scotland. “The brain shrinks as you age, and the nutrients in certain foods can help nourish and replenish brain cells,” says Dr. Isaacson. “Many people don’t realize that you are what you eat when it comes to brain health, too.”

2. Exercise regularly.
According to one study, a bigger waistline can increase your risk of Alzheimer’s nearly threefold.

“As the belly size gets larger, the memory center in the brain gets smaller,” says Dr. Isaacson. “Exercise can help to reduce body fat and also be the brain’s first defense against that amyloid plaque, the bad sticky stuff that builds up in the brain of a person with the disease.”

Aim to exercise at least three or four times a week for a minimum total of 150 minutes, with a mix of aerobic workouts and resistance/weight training. The cardio from the aerobic exercise (especially high-intensity interval training) helps you burn fat, while the weight training builds muscle, which boosts your metabolism.

Another recent study showed that exercise can specifically reduce shrinkage of the memory center in the brain in people with the earliest symptomatic stage of Alzheimer’s disease. “Most physicians now believe in the power of exercise to support overall brain health, but fewer believe that exercise can specifically impact people with early Alzheimer’s,” says Dr. Isaacson. Based on recent evidence, he believes that personally tailored exercise programs — based on a person’s percent body fat, percent lean muscle mass, vascular/metabolic risk factors, and cognitive function — may be the most powerful driver of change.

3. Get at least 7.5 hours of sleep every night. (And put your computer and smartphone to bed an hour earlier.)
When you get quality sleep, your brain can clean out those damaging amyloid plaques that build up throughout the day. Dr. Isaacson recommends having a plan to improve your sleep. This means turning off electronics at least an hour before going to bed.

“No texting, no emails, no late-night Netflix,” he says. “The bright blue light from screens can disrupt your circadian rhythm and keep you from producing melatonin, a vital sleep hormone. Have a quiet, dark room. It helps to clear your mind and prepare you for sleep.”

Infographic depicting the difference between a healthy brain and one with Alzheimer's disease

4. Drink alcohol in moderation.
A 2018 study showed that people who abstained from alcohol during midlife were at an increased risk of developing dementia, and people who had more than 14 units of alcohol per week (equivalent to seven medium glasses of wine or six pints of average-strength beer) were also at an increased risk.

“The science behind alcohol and Alzheimer’s is still evolving, but in my clinical practice I advise that women drink no more than 4-7 servings, and men drink no more than 7-10 servings, per week. Moderation is essential, and when in doubt, less is more,” says Dr. Isaacson.

5. Connect with people regularly.
For decades, studies, including this one in The Lancet, have repeatedly shown that maintaining relationships and social connections helps to stimulate the brain and may slow cognitive decline.

“While we aren’t entirely sure why this is, it likely has something to do with the increasing neural connections that happen within the brain when we are engaged in mental and social stimulation,” Dr. Isaacson says.

6. Listen to music, or — better yet — play music.
There is a growing body of research on music’s many benefits to the brain, whether starting early in life or in midlife. (Dr. Isaacson plays the bass guitar and joined a band called the Regenerates with several of his neuroscience colleagues.) Listening to music may also have some benefits, but playing it or singing is even better.

7. Challenge your brain.
Use your mind — often. But that doesn’t mean just doing jigsaw or crossword puzzles, although studies have shown that those activities certainly don’t hurt. Dr. Isaacson stresses the importance of continuously working different parts of your brain — whether that’s learning a new skill or taking up a new hobby.

“Learning something new, like a new language, helps to build vital backup pathways in the brain,” he says. “Learning new things helps to stimulate and challenge your mind, creating new connections within the brain’s neural pathways.”

Dr. Isaacson is an avid Pokémon GO player (currently at level 39), which he says was a great way for him “to learn something new, explore new places, get some exercise, and meet new Poké friends.” He also tries to stay socially active by attending frequent Yankees games, and playing music with his band, the Regenerates.

For more information on Alzheimer’s prevention, visit alzu.org.

Richard Isaacson, M.D., specializes in Alzheimer’s prevention at NewYork-Presbyterian/Weill Cornell Medical Center. He is the founder of the Alzheimer’s Prevention Clinic and the Weill Cornell Memory Disorders Program and is a Trustee of the McKnight Brain Research Foundation. He is also the author of two best-selling books, The Alzheimer’s Prevention & Treatment Diet (with Christopher Ochner, Ph.D.) and Alzheimer’s Treatment, Alzheimer’s Prevention: A Patient & Family Guide.