Cognition and Seniors: How to Keep Your Brain Fit and What That Means for Your Health

Aug 21, 2024

Fact Checked

Learn about the importance of cognitive health in older adults and how to nurture a healthy mind.

Edited by: Donya Currie, MA, Senior Editor at NCOA

Reviewed by: Kathleen Cameron, BSPharm, MPH, Senior Director, NCOA Center for Healthy Aging

Key Takeaways

As we age, it’s normal to experience some memory loss and slower cognitive processing, but not to the point of significantly interfering with daily functions.
More than 55 million people worldwide are living with dementia, affecting an estimated 9.9% of people ages 75–84 and 29.3% of those 85 and older.
Approximately two out of three Americans experience cognitive impairment at an average age of 70 years.
Exercising, eating a balanced diet, getting adequate sleep, and engaging in mentally stimulating activities can help reduce the risk of cognitive decline.
Studies suggest that using hearing aids to treat age-related hearing loss can help slow the development of cognitive problems.

Over time, the brain undergoes a series of chemical and physical changes that can contribute to decreased concentration, reduced comprehension, and memory loss. For people with a genetic predisposition or other risk factors, like diabetes or high blood pressure, this can develop into a cognitive impairment, like dementia or Alzheimer’s.

No matter how old you are, keeping your mind stimulated and your body active can help reduce your risk of cognitive impairment. ^[1]

What is cognition?

Cognition refers to the mental processes of the brain that create thoughts, collect knowledge, and apply those thoughts and knowledge to new experiences. Essentially, it’s how we can perceive and understand the world around us.

Cognitive decline, also called subjective cognitive decline, occurs when a person’s ability to use those mental processes decreases. This may result in frequent confusion or memory loss. According to Alzheimer’s Disease International, more than 55 million people worldwide are living with dementia, ^[2] affecting an estimated 9.9% of people age 75–84 and 29.3% of those 85 and older. ^[3] While not every person who ages will experience cognitive decline, for some, it’s the earliest symptom of Alzheimer’s disease and other types of dementia.

While we can attribute some decline to genetics, some will naturally occur as we age, and other aspects of our physical health can more heavily impact our cognition over time. ^[4] For example, if a person loses hearing or vision, they become less connected with stimuli around them. This decreases their ability to collect information and apply it to new experiences. Research shows that midlife hearing loss increases the risk of developing dementia by double any other single factor. ^[5]

Diabetes, heart disease, high blood pressure, and other health conditions can also have a substantial impact on how the brain functions, especially if they go untreated. ^[6] For example, each of the above conditions can cause changes in blood vessels in the brain and increase your risk of a stroke, which can alter your cognitive function. Keeping your body balanced with a healthy diet, physical exercise, and regular mental stimulation can help reduce your risk of cognitive decline as you age. ^[7]

What to know about cognitive decline

While aging is the leading risk factor for cognitive decline, awareness of other risk factors and symptoms can help you determine if you’re a good candidate for a medical screening. ^[8] Screening is generally suggested by the American Academy of Family Physicians when a person reaches age 65. Still, early screening may be a good option for you if someone in your family has developed a cognitive impairment, like Alzheimer’s, as they’ve grown older. ^[8]

“Cognitive screenings can also help determine whether further cognitive testing should be done,” noted Natali Edmonds, a board-certified geropsychologist and founder of Dementia Careblazers. “The short, quick screenings done during a primary care or neurology visit are not meant to diagnose dementia, but bring attention to anything requiring further investigation.”

Risk factors for cognitive decline:

Age
Certain genetic strains
Diabetes
Hypertension
Cardiovascular disease
High cholesterol
Smoking
Untreated hearing loss
Sleep apnea
Depression
Physical weakness
Low social support
Loneliness
Limited education

List of cognitive changes in seniors

Memory loss
Difficulty judging the amount of time or sequence of steps to complete a task
Difficulty performing daily living tasks (like meal preparation, bathing, or managing finances)
Not showing interest in usual hobbies or activities
Behavior changes (seeming a little more socially “inappropriate” or aloof)
Difficulty focusing

Aging and the brain

Our brains go through changes in size, vascular makeup, and cognition as we get older. Not only does the physical size of the brain decrease about 5% per decade after age 40, but the levels of hormones and neurotransmitters decrease as well. ^[9] Hormones help regulate the glands throughout the body that are responsible for physical and mental processes and development. ^[10] Neurotransmitters carry messages between the body’s neurons that allow us to perform bodily functions, like eating, walking, and talking. ^[11]

Aging also comes with reduced cerebral blood flow, which means less oxygen and fewer nutrients are carried to the brain, making it harder for the neural network to repair itself during a brain injury. ^[12] As these decreases occur, it becomes harder for the brain to make connections, resulting in slower mental and physical functions. Over time, the less your brain works to function, the weaker it becomes.

Download our PDF Cognition and Older Adults below.

Physical health is cognitive health

Keeping your body in good physical health directly supports your mental and cognitive health. A study from Neurology Journal identified the following healthy lifestyle habits and their preventive impact on developing Alzheimer’s:

Not smoking
Engaging in 150 minutes or more per week of moderate physical activity
Maintaining light-to-moderate alcohol consumption
Eating a high-quality Mediterranean diet
Engaging in mentally stimulating activities

The research found that people who engaged in four to five of these behaviors had a 60% lower risk of developing Alzheimer’s compared to those who engaged in only one or none. Those who engaged in two or three had a 37% lower risk. ^[13]

Maintaining an active and healthy lifestyle “is especially important because Alzheimer’s disease can start to form in the brain a decade or more before clinical symptoms present themselves,” Edmonds added. “Anything we can do to improve our lifestyle can improve brain health and potentially delay or prevent dementia.”

Hearing

Age-related sensory loss can impact how the brain processes information. For example, people with age-related hearing loss, called presbycusis, will perceive sounds as muffled or less clear. This can make conversations difficult to follow and learning frustrating or even impossible. Ultimately, hearing loss impacts the brain’s ability to understand information, make sense of environmental sounds, and communicate with others. If the brain is processing less stimuli and learning less information, it begins to weaken, leading to cognitive decline.

Studies show that using hearing aids to treat age-related hearing loss can help slow the development of cognitive problems. ^[14] If you want to take the first step in learning more about your hearing health, you can start by taking a free online hearing assessment. From there, you can visit an audiologist’s office, get diagnostic testing, and learn more about hearing aids and whether they’re right for you. You can stay on top of your hearing health by attending regular check-ups with an audiologist and consistently using prescribed devices.

Diabetes

A survey from the American Diabetes Association shows that 37.3 million adults in the United States have diabetes, 8.5 million of which are undiagnosed. ^[15] While some people are born with diabetes (Type 1 diabetes), people can develop Type 2 diabetes as they age, often due to diet and lifestyle choices resulting in excess blood sugar levels. The risk of dementia increases with the duration and severity of diabetes. ^[16] Some effects of high blood sugar are easily noticed—for example, experiencing episodes of hyperglycemia (increased thirst, blurred vision, and feeling weak or tired). ^[17] Other effects occur over time, like damage to the blood vessels in the brain. ^[18] This causes reduced blood flow to the brain and can increase the risk of vascular dementia .

While there is currently no cure for diabetes, medications and other lifestyle changes can help manage the symptoms. ^[19]

First and foremost, take any prescribed medication for your disease. One of the most successful management tools is physical activity. Choosing to take the stairs instead of the elevator and making time to walk around the home or outside can get your body moving and disrupt long periods of sedentary activity.

Secondly, eat a healthy and balanced diet of unprocessed foods, like fresh vegetables and whole grains, and limit foods with added sugars.

Finally, manage your stress. Choosing activities like yoga or reserving time for fun tasks throughout the day can help keep your mind clear and relaxed.

Obesity

Obesity is a risk factor for developing vascular dementia, as well as physical atrophy (a gradual decline of effectiveness) of the brain, which ultimately causes cognitive decline. ^[20] Increased body mass index (BMI) is associated with decreased brain volume, along with white and gray matter atrophy throughout the essential centers of the brain.

Above-average BMI is also a risk factor for sleep apnea, which can increase your risk of developing a neurocognitive disorder. ^[21] Similar to managing diabetes, maintaining a healthy diet (high in whole foods and low in processed foods) and staying active on a regular basis can help control obesity. Taking short walks throughout the day can help boost your metabolism and burn calories.

Alcohol intake

People who have had a high alcohol intake throughout their lives can develop Korsakoff’s syndrome. Korsakoff’s is a cognitive impairment that affects your ability to problem-solve and retain memory, also called anterograde amnesia, which is an inability to remember new information for more than a few seconds. ^[22] Other symptoms associated with alcohol use disorder include difficulty learning new information and reduced visuospatial abilities .

Generally, the severity of symptoms is related to a person’s duration and degree of alcohol use. ^[23] In other words, those who have consumed less alcohol over a lifetime are less likely to have symptoms than a person who has consumed a lot of alcohol over their lifetime. Decreasing the amount of alcohol you drink can benefit your mental and physical health.

You can start by setting limits for yourself, whether it’s limiting the number of days per week you drink or limiting the number of drinks per day. Finding support from friends, family, your community, and mental health professionals can help you hold yourself accountable and stick to your goals.

Best ways to improve cognitive function

Not everything is in our control when it comes to aging, but you can empower yourself to take care of your mental and physical health. The first step is to make healthy lifestyle choices to improve physical and brain health.

Eat a nutrient-rich diet

Eating antioxidants found in the following fruits and vegetables can help combat oxidative stress and prevent damage to brain cells:

Blueberries
Cranberries
Strawberries
Broccoli
Spinach
Carrots

These foods high in omega-3 fatty acids support brain function and help reduce inflammation: ^[24]

Coldwater fatty fish (salmon, tuna, herring, and mackerel)
Nuts and seeds (flaxseed, chia seeds, and walnuts)
Plant oils (canola oil and flaxseed oil)

Edmonds added that the MIND diet can promote brain health and may reduce dementia. ^[25] The MIND diet is a combination of the Mediterranean diet and the DASH diet .

Get regular physical activity

Regular physical activity increases blood flow throughout the body, which helps deliver oxygen and nutrients to the brain, ultimately supporting cognitive function. It also reduces the risk of vascular diseases that can impact brain health. The Centers for Disease Control and Prevention (CDC) recommends adults 65 and older get at least 150 minutes per week of moderate-intensity activity, or 75 minutes of vigorous activity, plus two days of muscle-strengthening activities, and activities to improve balance. ^[26] A few simple ways to increase your daily exercise include:

Taking the stairs instead of an elevator or escalator
Replacing a Sunday drive with a Sunday walk
Engaging in 10 minutes of physical activity (walking in place, lifting light weights, doing calisthenic exercises) for every hour per day that you’re sedentary
Choosing activities that are enjoyable for you
Joining a gym or other community-based facility to find exercise companions

Remember that it may take some time to build up to these recommendations and that any amount of activity is beneficial.

Get enough sleep

Sufficient sleep, defined as 7 to 9 hours per night of quality sleep, is essential for memory consolidation and cognitive processing. During deep sleep, the brain clears waste products associated with Alzheimer’s, including beta-amyloid. ^[27] Restorative sleep can also help regulate mood and emotional well-being, preventing cognitive decline associated with chronic stress. Try a few of these tips to improve your sleep:

Reduce blue-light exposure before bed to lower stimulation that can prevent falling asleep (for example, putting down the phone and turning off the TV an hour before you plan to fall asleep).
Set a sleep schedule and stick to it, which will help your body sink into a natural circadian rhythm that promotes better sleep.
Make sure your mattress is comfortable and supportive. For recommendations, read our review of the best mattresses for back pain.
Reduce caffeine and alcohol intake in the hours before bed to prevent insomnia.
Avoid long naps during the day.

Take part in mentally challenging activities

Engaging in challenging mental activities supports the brain by enhancing synaptic connections and improving cognitive reserve, making the brain more resilient to aging-related changes. ^[28] Continual cognitive engagement fosters neuroplasticity , helping to counteract cognitive decline. To boost your brain health, try one of these activities on your own or with a friend:

Taking on a jigsaw puzzle
Trying sudoku or a crossword puzzle
Starting a new book
Learning a new language
Learning to play an instrument
Listening to music
Taking a course you find interesting (some states, such as Virginia, offer free tuition at state colleges for older adults who qualify)

Go to the doctor

Regular health check-ups and appropriate management of chronic diseases and conditions reduce the risk of vascular diseases that can affect brain health. Also, early detection and treatment of health issues, such as hypertension or diabetes, can prevent cognitive decline. You should also stay informed when you’re prescribed new medications. Regular conversations with your doctor and your pharmacist can help you avoid drug interactions that may negatively impact cognitive function.

Get social

Being social provides cognitive stimulation, challenging the brain to process information and maintain mental agility. When we talk to each other, this exercises language and communication skills, which support cognitive functions, like memory and attention. Participating in group activities and sharing experiences can enhance your ability to recall and create new memories.

“Loneliness, which is also a risk factor for dementia, isn’t necessarily about having a ton of friends or going out, it’s about the feeling of being lonely,” Edmonds explained. “For some people, not having many friends but having a pet may be enough to avoid loneliness.”

A few other ways to be more social include:

Joining a local senior or community center to get together with friends and meet new people
Staying in touch with friends and setting up weekly phone calls
Using social media platforms to stay connected to friends and family
Reaching out to neighbors and setting up a time to enjoy an activity together

Practice mindfulness and meditation

Regular meditation and mindfulness practices reduce stress and promote relaxation, protecting the brain from the harmful effects of chronic stress. Meditation increases gray matter density ^[29] in brain regions associated with learning, memory, and self-awareness, potentially slowing down age-related brain atrophy. ^[30] Mindfulness training improves attention, focus, and memory, ultimately promoting everyday cognitive functioning.

Explore new ways to add mindfulness to your daily life, such as:

Taking classes at a local yoga studio (many offer meditation sessions and gentle yoga courses to improve mind-body connection and balance)
Looking online for videos and apps that take you through a meditation session
Finding a space in your home to sit comfortably and practice meditation on your own

Beware of misleading information

Facing cognitive decline, dementia, and Alzheimer’s can be difficult and emotional, which may make some people vulnerable to scams and misleading information. Since no cure currently exists for cognitive impairments, we sometimes look for solutions and promises from companies alleging a product can help reverse or “cure” symptoms. Generally, any company, product, or smartphone application that claims to give a quick way to prevent or reverse cognitive decline is providing misleading information.

The Food and Drug Administration (FDA) regulates products that are considered “food” and products that are considered “drugs.” The FDA defines drugs as products “intended for the treatment, cure, mitigation, or prevention of disease.” All other products are considered “food.” If a product falls under the drug category, it must undergo the FDA approval process before it gets marketed to consumers, and the FDA must affirm all labeling and claims.

If a company labels its product as a “dietary supplement” instead, it falls under the “food” category and doesn’t need to undergo FDA approval. ^[31] Even though the FDA does have specific quality requirements for “supplements,” ^[32] it doesn’t approve claims or other labeling language before such products get marketed to the public. ^[33] This makes it easier for supplement companies to make unrealistic product claims. More often than not, these misleading companies will refer to their products as “dietary supplements” and will sell their products on the internet rather than in a storefront.

To help protect consumers, the FDA has a portal for reporting products with misleading marketing. If the FDA investigates a product and finds the company mislabeled the product or had misleading claims, it will add the product and company information (company name, website, and social media accounts) to its Health Fraud Product Database. To check a specific product or category of products, you can use the search bar on the database.

Screen capture of products found in a search for “memory” on the FDA’s Health Fraud Product Database.

Products often promoted in a misleading way

Some products commonly marketed using misleading practices, include:

Aromatherapy or essential oils
Aromatherapy patches
Herbal or dietary supplements

Another way to protect yourself against a misleading claim is to discuss the product with your doctor. “It’s important to report all medications (including over-the-counter medications) to your doctor,” Edmonds said. “Some medications available over the counter can add to confusion in older adults. These are often products with diphenhydramine.” Diphenhydramine is an antihistamine medicine, such as Benadryl, that relieves allergy symptoms. ^[34] Diphenhydramine is also found in many over-the-counter sleep aids, such as those with a PM on their label. It is considered inappropriate for use in older adults due to its adverse effects, including those that impact cognition.

If you’re looking for opportunities to try new treatments, clinical trials investigate new drugs for treating cognitive impairments. The FDA can help determine if you’re a good candidate for a clinical trial, and if you are, can help you find one that’s best for your circumstances.

Bottom line

Aging is natural and comes with many ups and downs. While memory loss and thinking at a slower speed can be frustrating, these are often a normal part of getting older. As with any new changes or worsening symptoms, you should talk to your doctor if you notice a decrease in your ability to make decisions or recall information. You can take care of your brain and reduce your risk of cognitive impairment by making healthy lifestyle choices, like getting regular exercise, eating a balanced and unprocessed diet, and engaging in challenging mental activities.

Have questions about this review? Email us at reviewsteam@ncoa.org.

Sources

Mandolesi, Laura, et al. Effects of Physical Exercise on Cognitive Functioning and Wellbeing: Biological and Psychological Benefits. Frontiers in Psychology. April 27, 2018. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5934999
Alzheimer’s Disease International. Dementia Statistics. Retrieved Oct. 6, 2023. Found on the internet at https://www.alzint.org/about/dementia-facts-figures/dementia-statistics
Langa, Kenneth M., et al. A Comparison of the Prevalence of Dementia in the United States in 2000 and 2012. JAMA Internal Medicine. July 1, 2017. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5195883
Kremen, William S., et al. Genetics and Neuropsychology: A Merger Whose Time Has Come. Neuropsychology. January 2016. Found on the internet at https://pubmed.ncbi.nlm.nih.gov/26710091
Azeem, Abdul, et al. Hearing Loss and its Link to Cognitive Impairment and Dementia. Frontiers in Dementia. June 15, 2023. Found on the internet at https://www.frontiersin.org/articles/10.3389/frdem.2023.1199319/full
National Institute on Aging. Cognitive Health and Older Adults. Oct. 1, 2020. Found on the internet at https://www.nia.nih.gov/health/cognitive-health-and-older-adults
Centers for Disease Control and Prevention. Physical Activity Boosts Brain Health. Feb. 24, 2023. Found on the internet at https://www.cdc.gov/nccdphp/dnpao/features/physical-activity-brain-health/index.html
American Academy of Family Physicians. Screening for Cognitive Impairment in Older Adults: Recommendation Statement. June 15, 2020. Found on the internet at https://www.aafp.org/pubs/afp/issues/2020/0615/od1.html
Markov, Nikola T., et al. Age-Related Brain Atrophy Is Not a Homogenous Process: Different Functional Brain Networks Associate Differentially With Aging and Blood Factors. Proceedings of the National Academy of Sciences. Dec. 2, 2022. Found on the internet at https://www.pnas.org/doi/10.1073/pnas.2207181119
Women’s Brain Health Initiative. The Effects of Hormones on Brain Health. Dec. 8., 2022. Found on the internet at https://womensbrainhealth.org/think-tank/better-thinking/the-effects-of-hormones-on-brain-health
The University of Queensland. What Are Neurotransmitters? Retrieved Oct. 4, 2023. Found on the internet at https://qbi.uq.edu.au/brain/brain-functions/what-are-neurotransmitters
American Association of Neurological Surgeons. Cerebrovascular Disease. Retrieved Oct. 6, 2023. Found on the internet at https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Cerebrovascular-Disease
Klodian, Dhana, et al. Healthy Lifestyle and the Risk of Alzheimer Dementia: Findings from 2 Longitudinal Studies. Neurology. July 28, 2020. Found on the internet at https://pubmed.ncbi.nlm.nih.gov/32554763
National Institutes of Health. Hearing Aids Slow Cognitive Decline in People at High Risk. Aug. 8, 2023. Found on the internet at https://www.nih.gov/news-events/nih-research-matters/hearing-aids-slow-cognitive-decline-people-high-risk
Centers for Disease Control and Prevention. National Diabetes Statistics Report. June 29, 2022. Found on the internet at https://www.cdc.gov/diabetes/data/statistics-report/index.html
Livingston, Gill, et al.. Dementia Prevention, Intervention, and Care: 2020. Report of the Lancet Commission. July 30, 2020. Found on the internet at https://pubmed.ncbi.nlm.nih.gov/32738937
Yale Medicine. Hyperglycemia. Retrieved Oct. 6, 2023. Found on the internet at https://www.yalemedicine.org/conditions/hyperglycemia
Centers for Disease Control and Prevention. The Effects of Diabetes on the Brain. May 21, 2022. Found on the internet at https://www.cdc.gov/diabetes/library/features/diabetes-and-your-brain.html
Centers for Disease Control and Prevention. Living Well With Diabetes. June 20, 2022. Found on the internet at https://www.cdc.gov/diabetes/library/features/living-well-with-diabetes.html
Dye, Louise, et al. The Relationship Between Obesity and Cognitive Health and Decline. Proceedings of the Nutrition Society. Sep. 11, 2017. Found on the internet at https://www.cambridge.org/core/journals/proceedings-of-the-nutrition-society/article/relationship-between-obesity-and-cognitive-health-and-decline/8D58FA03B576F4E4A2AB18208930192B
Guay-Gagnon, Martin, et al. Sleep Apnea and the Risk of Dementia: A Systematic Review and Meta-Analysis. Journal of Sleep Research. October 2022. Found on the internet at https://pubmed.ncbi.nlm.nih.gov/35366021
National Institute of Neurological Disorders and Stroke. Wernicke-Korsakoff Syndrome. Found on the internet at https://www.ninds.nih.gov/health-information/disorders/wernicke-korsakoff-syndrome
Medline Plus. Wernicke-Korsakoff Syndrome. Found on the internet at https://medlineplus.gov/ency/article/000771.htm
National Institutes of Health: Office of Dietary Supplements. Omega-3 Fatty Acids. July 18, 2022. Found on the internet at https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer
Morris, Martha Clare, et al. MIND Diet Associated with Reduced Incidence of Alzheimer’s Disease. Alzheimer’s & Dementia. Sept. 11, 2015. Found on the internet at https://pubmed.ncbi.nlm.nih.gov/25681666
Centers for Disease Control and Prevention. How Much Physical Activity Do Older Adults Need? April 13, 2023. Found on the internet at https://www.cdc.gov/physicalactivity/basics/older_adults/index.htm
Spira, Adam, et al. Self-Reported Sleep and β-Amyloid Deposition in Community-Dwelling Older Adults. JAMA Neurology. December 2013. Found on the internet at https://pubmed.ncbi.nlm.nih.gov/24145859
Kolb, Bryan and Gibb, Robbin. Brain Plasticity and Behaviour in the Developing Brain. The Journal of the Canadian Academy of Child and Adolescent Psychiatry. November 2011. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3222570
McGreevey, Sue. Eight Weeks to a Better Brain. The Harvard Gazette. Jan. 21, 2011. Found on the internet at https://news.harvard.edu/gazette/story/2011/01/eight-weeks-to-a-better-brain
Hölzel, Britta K., et al. Mindfulness Practice Leads to Increases in Regional Brain Gray Matter Density. Psychiatry Research. Nov. 10, 2010. Found on the internet at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3004979
U.S. Food and Drug Administration. Drugs@FDA Glossary of Terms. Nov. 14, 2017. Found on the internet at https://www.fda.gov/drugs/drug-approvals-and-databases/drugsfda-glossary-terms
U.S. Food and Drug Administration. Dietary Supplements. Dec. 12, 2021. Found on the internet at https://www.fda.gov/consumers/consumer-updates/dietary-supplements
U.S. Food and Drug Administration. Information for Consumers on Using Dietary Supplements. Oct. 21, 2022. Found on the internet at https://www.fda.gov/food/dietary-supplements/information-consumers-using-dietary-supplements
Sicari, Vincent and Zabbo, Christopher. Diphenhydramine. StatPearls. July 10, 2023 Found on the internet at https://www.ncbi.nlm.nih.gov/books/NBK526010

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