Be kind to your brain and you may lower your risk of stroke and dementia. You also may experience less cognitive decline as you age. This is what the World Federation of Neurology hopes to impart on World Brain Day on July 22 with support from the American Academy of Neurology. The theme this year is “Advancing Brain Health and Prevention.”
“If we control risk factors, such as high blood pressure, diabetes, high cholesterol, and obesity, and adopt healthy habits, including physical and cognitive exercises, good nutrition, and adequate sleep throughout our lives, our brains will be healthier longer,” says David W. Dodick, MD, FAAN, co-chair of the federation's 2024 World Brain Day Committee.
To help readers honor World Brain Day, we asked neurologists to offer suggestions on how to keep the brain healthy all day long. We hope you'll incorporate these habits on July 22 (if not before) and then adopt and maintain them for the rest of your life.
Morning
Wake up naturally. Toss the alarm clock and allow yourself to wake up when you've had enough sleep. If you need to use an alarm, “make sure you give yourself enough hours [of sleep] so you feel refreshed when you wake up,” says John R. Absher, MD, FAAN, professor of neurology at the University of South Carolina School of Medicine/Prisma Health in Greenville. Most people need between seven and seven and a half hours of sleep per night to perform at their best. “If the brain is adequately rested, it's more likely to consolidate memories, which primarily occurs during sleep,” says Dr. Absher. “Evidence also suggests that sleep clears waste products from the brain, allowing it to reset and function normally the next day.”
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Brush your teeth. Poor oral health, particularly gum disease, is linked to a higher risk of cognitive decline, stroke, and Alzheimer's disease and other dementias, according to several recent studies. Brush your teeth at least twice a day and floss regularly. A study in Scientific Reports in March 2024 found a link between a preponderance of oral bacteria and an increased risk of developing Alzheimer's disease. “Oral health care is important,” says Seth Keller, MD, FAAN, a New Jersey neurologist who is past president of the American Academy of Developmental Medicine and Dentistry. “Untreated and unrecognized gum and dental disease may complicate behaviors associated with dementia and exacerbate swallowing problems.”
Move first. “Exercise generates ketones, which could help get the brain stimulated,” says Jeffrey Burns, MD, director of the memory care clinic and the neurocognitive division of neurology at the University of Kansas Health System in Kansas City. The brain normally uses glucose for fuel, but when you fast—including the time between your last meal the night before and your first meal the next morning—glucose becomes scarcer, and the brain turns to ketones for fuel. Ketone levels in the blood increase during exercise and remain markedly elevated after a workout. A study in the International Journal of Molecular Sciences in 2020 suggests that ketones change the brain's metabolism and may protect against conditions like Alzheimer's disease. Try for 150 minutes of aerobic exercise a week, which can be broken down into five 30-minute sessions.
Lift weights. Several studies have demonstrated a link between resistance training and cognitive function, including one in the Journal of Exercise Nutrition and Biochemistry in 2017 that found that low-intensity strength training combined with walking was more effective at improving cognitive function than either high-intensity aerobic exercise or high-intensity strength training. A study in NeuroImage: Clinical in 2020 of 100 patients with mild cognitive impairment found that progressive resistance training resulted in long-term cognitive improvements and prevented further degeneration. “Muscle mass is linked to brain volume,” says Dr. Burns. The National Institute on Aging recommends doing strength- training exercises for all muscle groups at least twice a week for 30 minutes.
Eat breakfast. Skip the bacon and sausage, which are overly processed and high in unhealthy fats. Choose steel-cut oats with fruit and Greek yogurt or cheesy scrambled eggs with one slice of whole wheat toast. A diet high in carbohydrates can create amyloid—a protein characteristic of Alzheimer's disease—in the brain, says Dr. Burns. “Low-carbohydrate diets have been linked to healthier brains.” If you like coffee, enjoy a cup, he adds. Caffeine boosts mood and increases alertness. It also may help protect against neurodegenerative diseases, according to a study published in Frontiers in Aging Neuroscience in 2021.
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Midmorning
Read the paper. Do anything that stimulates your brain, says Dr. Burns. That includes doing crossword puzzles, completing sudoku puzzles, solving Wordle, perusing news stories, and reading books. A study in NEJM Evidence in October 2022 found that adults who tried to solve computerized crossword puzzles showed greater cognitive improvement than those who played other digital games. But, Dr. Burns says, “there's nothing magical about crossword puzzles. Spend an hour in the morning doing any activity that gets you thinking.”
Remain engaged with work. Even if you've stopped working, you can stay involved in your field, says Linda Hershey, MD, PhD, FAAN, a retired neurologist most recently with the University of Oklahoma Health Sciences Center. Dr. Hershey is a volunteer faculty member at the university and gives annual lectures. She also edits professional publications. “Every morning after breakfast, I finish a sudoku, then go to my computer and work. Studies show that people who use the computer regularly have a lower rate of getting Alzheimer's,” says Dr. Hershey, who adds that deadlines keep her on track.
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Enjoy a hobby. “The human brain is unique in its capacity for innovation and creativity,” says Janet Jankowiak, MD, a geriatric and behavioral neurologist in Needham, MA. “The brain grows when confronted with novelty, developing new synapses,” she says. Think about something you've always dreamed of doing, she suggests. That may be painting, playing music, sewing, dancing, learning a new language, writing, or telling stories. Dr. Jankowiak revived her long-dormant sewing skills to take up artistic quilting in her late forties. That same year, she joined a synchronized swimming team after years of dabbling in the sport. And now she's writing a book about resiliency among older synchronized swimmers.
Midday
Prepare a light lunch. As you age, it's important to watch calories to avoid putting on weight, says Dr. Hershey. Now that she's in her late seventies, her lunches are more like snacks. Consider a green salad with added protein such as egg, chicken, or fish. Or enjoy a bowl of hot soup in winter or cold soup in summer with a slice of whole grain bread or crackers. Or whip up a small serving of whole grain pasta with fresh vegetables, says Madhureeta Achari, MD, FAAN, a neurologist at Integrated Neurology in Houston.
Practice mindfulness. Stop what you're doing, block out the noise around you, and just be in the moment. “Focus on your value and worth and the things that make you special. Take in what others around you bring to your life,” suggests Dr. Absher. “Rest and down time, in addition to sleep, give you a chance to recenter and take a break from the chaos.” A study in Neural Plasticity in November 2020 suggested that a brief mindfulness meditation may increase the volume and density of gray matter in the brain. Gray matter helps us make decisions, retain information, and manage emotions.
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Get outside. A study in JAMA Network Open in December 2022 reported that exposure to some natural environments such as parks and other greenery may reduce the risk of hospitalizations among older adults with Parkinson's disease and Alzheimer's disease and related dementia. “Being outside is good for your brain,” says Dr. Achari, noting the beneficial effects of vitamin D from sunshine.
Midafternoon
Connect with others. “Social engagement is absolutely key to brain health,” Dr. Jankowiak says. It may come through places of worship, the Y, senior centers, libraries, book clubs, recreation centers, or coffee shops, among others.
Extend kindness. Share a meal with someone who feels isolated. Offer to do grocery shopping for someone who has broken a leg or has other mobility impairments. “Volunteering or doing things for others makes you feel good, too,” says Dr. Jankowiak.
Make a doctor's appointment. Your health in midlife is a good predictor of your health in old age, so it's important to identify problems like high blood pressure, high cholesterol, high blood sugar, and obesity early on and take steps to remedy them, says Steven T. DeKosky, MD, FAAN, endowed professor of Alzheimer's research at the University of Florida College of Medicine in Gainesville. High blood pressure has been linked to an increased risk of developing dementia, according to a study published in JAMA Network in 2019. Research published in The Lancet in August 2021 showed a link between high cholesterol levels in midlife and the development of dementia 10 years later. Even unaddressed vision and hearing loss negatively affect the brain in later life, so get your eyes and ears tested, suggests Dr. DeKosky.
Reduce your eco footprint. A 2023 study by the National Institutes of Health concluded that exposure to a certain type of air pollution—fine particulate matter—leads to an increased risk of dementia. Wearing an N95 mask while outside is an effective way to avoid ingesting fine particulate matter. Be mindful of the planet by driving less, planting flowers and trees, using environmentally safe paints and cleaning products, and mulching or composting leaves and yard waste. Protect yourself indoors by using air purifiers. To effect change on a larger scale, write to your elected officials and ask them to support specific air-friendly policies or propose other solutions.
Evening
Eat a balanced dinner. “Every time you sit down to eat, ask yourself, ‘Am I getting protein, fat, and carbs?’” says Dr. Achari, who suggests including yogurt or fresh vegetables with evening meals. “Cut up some tomatoes, throw them in a bowl with olive oil and salt and pepper and basil, and let them sit. Four hours later they've broken down, and you can add hot pasta for a quick, healthy dinner,” she says.
Take a postdinner stroll. “Many studies show that physical activity is important for the brain, probably because it relates to increased blood flow,” says Dr. Hershey. Exercise also helps reduce high blood pressure, diabetes risk, and high cholesterol, she adds. A 2023 meta-analysis in Sports Medicine found that taking a walk as soon as possible after a meal was better for controlling blood sugar than doing so after a longer interval or before a meal.
Stimulate your brain. “When you take in new information before sleep, you're more likely to retain it because it's closer to the memory consolidation that happens during rest,” Dr. Absher explains. Check out free courses online, take a night class, schedule a book club dinner, or watch a movie and discuss it.
Nighttime
Keep a study journal. Spend time learning something new and write about it, says Dr. Achari. “It can broaden your horizons, enhance your language, and expand the people and things you know,” she says. She spent three months learning about race cars after seeing the movie Gran Turismo. “The topic can be big or small, but challenge yourself to learn and remember.”
Read before going to bed. Immerse yourself in a novel or nonfiction book, says Dr. Jankowiak. She recommends The Book of Joy: Lasting Happiness in a Changing World by the Dalai Lama, Desmond Tutu, and Douglas Carlton Abrams for its powerful and inspiring messages. A study published in International Psychogeriatrics in January 2021 concluded that reading may protect cognitive function in later life. “Frequent reading activities were associated with a reduced risk of cognitive decline for older adults at all levels of education in the long term,” the authors wrote.
Ensure a good night's sleep. To fall asleep quickly and stay asleep through the night for at least seven hours, follow this advice from Beth A. Malow, MD, FAAN, director of the sleep disorders division at Vanderbilt University Medical Center in Nashville. Exercise at some point during the day but not too close to bedtime. Turn off cell phones and screens at least an hour before retiring. Establish a calming ritual such as taking a warm bath. Avoid caffeine after lunch. Be careful not to overindulge in alcohol, which can contribute to night wakings. She also recommends keeping the bedroom dark, quiet, and cool and addressing any sleep disorders such as sleep apnea and insomnia.
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