Healthcare (Commonwealth Union) – Millions of Americans over the age of 65 are currently living with Alzheimer’s disease (AD), and that figure is projected to rapidly increase in the years ahead. This sharp rise is not simply the result of an aging population; it signals a mounting public health emergency that demands proactive solutions. Although advanced age is the most significant risk factor for cognitive decline, losing mental function should not be seen as an unavoidable outcome of growing older.
With Alzheimer’s and other dementias increasing at a troubling pace, researchers at Florida Atlantic University’s Charles E. Schmidt College of Medicine are drawing attention to a promising but underused route for prevention.
In a commentary featured in The American Journal of Medicine, the authors call on doctors, health professionals, and policymakers to take coordinated action in promoting lifestyle-centered strategies that could ease the escalating impact of dementia both in the U.S. and globally.
Charles H. Hennekens, M.D., FACPM, FACC, co-author, First Sir Richard Doll Professor of Medicine and Preventive Medicine, and senior academic advisor at the Schmidt College of Medicine indicated that since 2000, deaths from cardiovascular disease have fallen, but fatalities linked to Alzheimer’s have climbed by more than 140%. He further indicated that what was significant was that nearly 45% of dementia risk is thought to stem from lifestyle and environmental factors that can be changed.
The scientists pointed out that factors such as lack of exercise, unhealthy eating habits, excess weight, alcohol consumption, and medical conditions like high blood pressure, diabetes, depression, and reduced social or mental engagement are thought to play a role in cognitive decline. The authors note that lifestyle modifications already proven to lower the risk of heart disease and other serious illnesses may also help protect against cognitive deterioration—possibly with compounded benefits when several risk factors are addressed together.
The commentary draws attention to recent findings from POINTER, the first large-scale U.S. randomized clinical trial investigating whether intensive lifestyle changes can improve brain health in older adults at heightened risk of decline. In this study, participants randomly assigned to a structured, team-driven lifestyle program showed statistically significant and clinically relevant improvements in overall cognitive performance after two years. These improvements were most pronounced in higher-level mental processes such as memory, focus, planning, and decision-making. The program included consistent physical exercise, a blend of Mediterranean and DASH-style diets, mental stimulation, and social interaction, all supported by professional coaching and group-based encouragement.
These results align with those of the earlier Finnish FINGER trial, where older adults with elevated cardiovascular risk who followed a similar multidomain lifestyle program also experienced cognitive improvements.
Hennekens stated that findings from both of these major, large-scale randomized studies show that lifestyle modifications—already proven to lower the risk of heart disease and cancer—may also have a powerful impact on brain health.
The team further discussed possible biological explanations for these effects. Exercise, for instance, raises levels of brain-derived neurotrophic factor, which aids in hippocampal development, while also enhancing circulation and lowering inflammation. Nutritional approaches such as the Mediterranean and DASH diets can reduce oxidative stress, improve insulin sensitivity, and decrease cardiovascular risk. Giving up smoking may help maintain brain structure and protect white matter, and staying socially and mentally active encourages neuroplasticity and builds cognitive resilience.
“The implications for clinical practice, public health and government policy are potentially enormous,” explained Parvathi Perumareddi, D.O., co-author and an associate professor of family medicine in the Schmidt College of Medicine. “Clinicians now have powerful, evidence-based tools to help their patients prevent or slow cognitive decline – tools that go beyond medications, are generally low-risk, and are cost-effective. Public health agencies could adopt the framework of trials like POINTER and FINGER to develop brain health programs.”
