Revamping lifestyle can boost brain health and prevent neurocognitive decline

In a recent article published in the journal cureresearchers from Loma Linda University Medical Center and the University of California Irvine reviewed the impact of applying the six pillars of lifestyle medicine (stress management, plant-based nutrition, avoiding hazardous substances, physical activity, social connections and restful sleep) in Neurocognitive Impairment and Dementia.

Review: The impact of the six pillars of lifestyle medicine on brain health.  Image Credit: Black Salmon / ShutterstockReview: The impact of the six pillars of lifestyle medicine on brain health. Image Credit: Black Salmon / Shutterstock


Alzheimer’s disease and other neurocognitive disorders have become very common among older adults worldwide and are a growing financial burden on health care systems. Furthermore, available treatment methods only slow the progression of the disease in some cases and cannot reverse cognitive decline or memory loss.

Being explored by many health professionals and patients, lifestyle medicine recommends lifestyle changes to manage or treat chronic neurocognitive diseases and helps patients and their families practice healthy behaviors to improve their quality of life. of life. The six pillars of lifestyle medicine are stress management, plant-based nutrition, avoidance of hazardous substances, physical activity, social connections, and restful sleep, which target major neurocognitive risk factors. known, including depression, hypertension, type 2 diabetes mellitus, insulin resistance, smoking, obesity, and hypercholesterolemia.

plant based nutrition

Studies have reported that increased incorporation of whole foods into the diet has a positive impact on cognition. Lifestyle medicine recommends the Dietary Approach for Systolic Hypertension (DASH), Mediterranean Dietary Intervention, and Mediterranean DASH for Neurodegenerative Delay (MIND).

The Mediterranean diet is abundant in nuts, fruits, legumes, vegetables, cereals, and olive oil, with moderate portions of dairy and alcohol, and significantly reduced consumption of red and processed meats, sweets, and saturated fats. The included food groups are believed to provide fiber and micronutrients necessary for neurocognitive health.

The DASH diet, which was developed to treat high blood pressure, also emphasizes the inclusion of plant-based foods and limits intake of sweets, cholesterol, sodium, short fatty acids, and total fat. Studies have found that the DASH diet produced improvements in verbal memory, although improvements in visual memory were not seen. However, participants who have consistently followed the DASH diet have reported improvements in semantic and episodic memory and global cognition over time.

The MIND diet combines the DASH and Mediterranean diets and was designed to treat neurocognitive degeneration and dementia. A longitudinal study from Australia reported that strict adherence to the MIND diet resulted in a 53% reduction in the risk of Alzheimer’s disease.

Physical activity

Mobility and physical activity have been shown to slow the progression of Alzheimer’s disease and other neurocognitive disorders. In addition to reducing risk factors for neurocognitive impairment, such as hyperlipidemia, cardiovascular disease, type 2 diabetes, and metabolic syndrome, physical activity is also thought to increase irisin and fibronectin domain-containing protein 5 type III ( FNDC5) in the hippocampus. Irisin is involved in increasing glucose tolerance and improving energy expenditure, while FNDC5 plays an important role in neuronal function. Together, these two proteins can improve memory, neuronal cell survival, and synaptic integrity by stimulating the expression of brain-derived neurotrophic factor in the hippocampus.

Stress management

Research shows that high perceived stress is associated with all-cause dementia and mild cognitive impairments, especially late-onset Alzheimer’s disease. However, studies have found that a single traumatic or stressful event is not correlated with dementia, but successive events and psychosocial stress have been linked to increased risk of severe dementia later in life. Psychosocial stressors include the loss of a loved one or support system, inadequate food or housing, lack of social connections, and mental illness in family members.

Avoidance of dangerous substances

The three significant dangerous substances that lifestyle medicine recommends avoiding are alcohol, nicotine, and benzodiazepines. While conflicting results have linked alcohol use and cognitive decline, one longitudinal study linked alcohol use disorder with an increased risk of early-onset dementia. Although contrasting studies claim that moderate alcohol consumption is associated with a lower risk of dementia, the definition of moderate or light alcohol consumption remains controversial.

In addition, studies show that current and ever-smokers (who have been and continue to smoke) are at significantly increased risk of neurocognitive impairment. Benzodiazepines, especially the short half-life classes, have also been linked to an increased risk of dementia, especially among women. This is especially important since older adults often use benzodiazepine medications.

restful sleep

Insomnia, obstructive sleep apnea, movement disorders, and overall poor quality of sleep are associated with type 2 diabetes, obesity, cardiovascular disease, depression, and further cognitive decline. Reduced sleep has also been linked to amyloid-β accumulation in Alzheimer’s disease and increased oxidative stress in patients with vascular dementia. The authors believe that diagnosis and treatment of sleep disorders could reduce the risk of cognitive decline.

social connections

Studies using MRIs have shown that increasing weekly social interactions significantly increases brain volume and improves performance on neuropsychology tests. Patients who had large social groups also had larger tonsil volumes. Furthermore, cohort studies among older women showed that lower social support was associated with a two-fold increase in the incidence of all-cause dementia.


Overall, the review suggested that daily interventions encompassing the six pillars of lifestyle medicine could not only delay or slow the progression of neurocognitive deficits, but also improve cognitive function. The authors recommended that primary care physicians resource and educate patients who are at risk of neurocognitive decline about the benefits of lifestyle medicine.

Magazine reference:

  • Jaqua, E., Biddy, E., Moore, C. & Genise, B. (2023). The impact of the six pillars of lifestyle medicine on brain health. cure, 15(2), e34605., health#!/

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