Most people who ask how to keep their brain healthy are asking one of two things: what can I do to stay sharp, and how do I lower my chances of dementia. The answer to both is the same list, and it is shorter and more ordinary than the supplement aisle suggests.
The Lancet Commission on dementia, a panel of researchers that reviews the world's evidence, estimated in 2020 that about 40 percent of dementia cases are linked to risk factors that can be changed, and its 2024 update raised that to about 45 percent by adding two more (references 1 and 2). This page turns those factors into twelve habits, in plain language, with the evidence behind each. If you want to know why they work at the level of blood vessels, brain cells, and inflammation, that is covered separately in how lifestyle shapes neurological health. If you have multiple sclerosis, the MS-specific version is 16 lifestyle changes to protect your brain in MS.
One theme runs through the list: what is good for the heart is good for the brain. Several of the habits protect the small blood vessels that feed brain tissue, and the evidence shows they still help when started in your seventies or eighties.
1. Keep learning and challenge your brain
Education early in life is one of the strongest protective factors the Commission identified, and mentally demanding activity later in life appears to carry the same benefit. The explanation is cognitive reserve: a brain that has spent decades building connections can reroute around damage from ageing or early disease and keep functioning well, the way a city with many roads copes with one closure (reference 3).
You do not need to go back to school. What counts is doing things that make you think in new ways: learning a language or an instrument, reading outside your usual subjects, strategy games, a new recipe, a course, or a hobby with a real learning curve. Puzzles you have already mastered add little. The signal is effort and novelty, kept up over years.
2. Protect your hearing
Untreated hearing loss in midlife is one of the largest modifiable risk factors for dementia in the Commission's analysis, larger than most people expect. A brain that strains to decode sound has less capacity left for memory and thinking, and people who cannot hear well tend to withdraw from conversation, which removes the stimulation and social contact the brain relies on.
If you find yourself turning the television up or asking people to repeat themselves, get your hearing tested. Modern hearing aids are small and effective, and treating hearing loss keeps you in conversation and connected to the people around you. Whether it also protects memory is less settled: the largest randomized trial found no slowing of cognitive decline overall over three years, but a meaningful benefit in participants who started at higher risk. That is a good reason to treat hearing loss, not a guarantee that hearing aids prevent dementia. Protect the hearing you have by using earplugs around loud machinery, at concerts, and with power tools, and by keeping headphone volume moderate. Routine hearing checks after fifty are worth building into your health care.
3. Keep your blood pressure, blood sugar, and cholesterol in check
High blood pressure, diabetes, and high LDL cholesterol are three separate items on the Commission's list, and they share one mechanism. Each damages the small blood vessels that supply the brain. Over years that produces silent small strokes and white matter changes that erode memory and thinking, and it raises the risk of both vascular dementia and Alzheimer's disease (reference 4). Midlife is when the damage accumulates, and it is largely invisible until it is not.
The encouraging part is that treating these conditions lowers the risk. You do not need to know the target numbers by heart; you need to know your own numbers, have them checked regularly, and work with your primary care doctor to bring them into the healthy range. That usually means the same habits that appear elsewhere on this list, food that is low in salt and refined carbohydrate, regular movement, and less alcohol, plus medication when habits alone are not enough. If you have been prescribed medication for blood pressure, diabetes, or cholesterol, taking it consistently is one of the most direct things you can do for your brain's blood supply. If you have prediabetes or a family history of diabetes, acting now prevents a problem rather than managing one later.
Visual guide
Senses and circulation are part of brain care
- Hearing: Have hearing difficulties assessed and treated.
- Vision: Regular eye care helps address correctable vision loss.
- Vascular health: Discuss blood pressure, blood sugar, and cholesterol management.
4. Maintain a healthy weight and diet
Obesity in midlife is linked to a higher risk of dementia, mostly because it drives the blood pressure, blood sugar, and inflammation problems above. The goal is a weight you can maintain through eating well and moving, not a number reached by a crash diet. Even modest weight loss improves blood pressure and blood sugar.
There is no single brain food, and no supplement has matched the effect of an overall eating pattern. The best-studied pattern is the Mediterranean diet: vegetables, fruit, beans, whole grains, nuts, olive oil, and fish, with little red meat, sweets, or ultra-processed food (reference 5). The MIND diet is a variant that emphasizes leafy greens and berries. The practical habits are simple. Fill most of the plate with plants, eat fish a couple of times a week, choose olive oil and nuts over fried and processed fats, keep portions sensible, and make water your default drink. Fad diets and detox programs are not part of the evidence.
5. Limit alcohol
Heavy drinking over years shrinks brain tissue, impairs memory and judgement, and raises dementia risk enough that the Commission added it to the list in 2020. Alcohol also raises blood pressure, disturbs sleep, and causes the falls and head injuries that appear later on this list.
There is no amount of alcohol that is good for the brain, and growing evidence that there may be no fully safe level. If you do not drink, there is no reason to start. If you do, keep it light, stay within the national dietary guideline limits, have alcohol-free days, and never binge, since a heavy night does more harm than the same amount spread across a week. Many people notice better sleep, mood, and concentration within weeks of cutting down. If cutting down is proving hard, tell your doctor; there is effective help.
6. Do not smoke
Smoking narrows the arteries that feed the brain, raises stroke risk, and drives the inflammation and oxidative stress that damage brain cells. Smokers have a clearly higher risk of dementia than people who have never smoked.
Quitting works at any age. People who stop, even later in life, lower their risk of cognitive decline compared with those who continue, and stroke risk falls within a few years. Nicotine replacement, prescription medication, and counselling each raise the chance of success, and combining them raises it further, so ask your doctor for a plan rather than relying on willpower. Second-hand smoke counts too. Most ex-smokers needed several attempts, so a slip is a reason to try again, not to give up.
7. Stay physically active
Regular physical activity is associated with better memory and thinking in later life and a lower risk of dementia. Exercise increases blood flow to the brain, lowers inflammation, and releases growth factors that help brain cells survive and form new connections. It also improves sleep, mood, weight, blood pressure, and blood sugar, so it works on half of this list at once.
National guidelines suggest around 150 minutes a week of moderate activity, the level at which you breathe harder but can still talk, plus strength work twice a week (reference 6). Brisk walking, cycling, swimming, and dancing all count. Strength and balance training matters more as you get older because it prevents the falls that cause head injuries. If you have not been active, a ten-minute walk today is a real start; build from there. Choose something you enjoy, make it social if you can, and fold movement into the day: stairs, a farther parking spot, a walk after dinner.
8. Stay socially connected
Social isolation in later life is linked to a higher risk of memory loss and dementia, and loneliness now has a place beside smoking and inactivity in public-health thinking. A conversation exercises language, memory, attention, and the reading of faces and emotions all at once, and relationships buffer the stress and low mood that themselves harm the brain.
Keep in touch with friends and family on a schedule rather than when you happen to think of it. Join something with regular contact: a class, a club, a faith community, a walking group, a volunteer role. Group exercise does two habits at once. Time with younger people, whether grandchildren or through mentoring, is stimulating in both directions. If you are lonely, reaching out is hard, and it is usually welcomed, because the other person is often lonely too.
9. Take care of your mental health, sleep, and stress
Depression, especially untreated depression later in life, is a modifiable risk factor for dementia in the Commission's analysis. It is a medical condition with physical effects on the brain, including sustained stress hormones that affect memory circuits, and treating it, with therapy, medication, or both, protects thinking as well as mood (reference 7). Persistent sadness, loss of interest, constant worry, or subtle trouble concentrating are reasons to talk to your doctor, not to wait.
Sleep belongs here too. The brain clears waste and consolidates memory during sleep, and chronic poor sleep worsens mood, concentration, and long-term risk. Aim for enough sleep to wake rested on a regular schedule. Loud snoring, gasping in sleep, or daytime sleepiness despite a full night can mean sleep apnea, which is treatable and one of the most fixable contributors to brain fog we see. Persistent insomnia deserves treatment in its own right.
For everyday stress, whatever reliably lowers yours counts: exercise, time outdoors, a breathing or mindfulness practice, music, hobbies, pets, time with people you like. Ten minutes a day done consistently does more than an occasional retreat.
10. Get your eyes checked
Untreated vision loss was added to the Commission's list in 2024. The reasoning mirrors hearing: a brain that receives less input has less to work with, and people who cannot see well read less, drive less, and go out less. Cataracts, glaucoma, and diabetic eye disease are all treatable, and cataract surgery in particular has been associated with a lower risk of dementia.
Have your eyes examined regularly, at least every couple of years after sixty and more often if you have diabetes. Keep your prescription current. Treat the treatable conditions rather than adapting to them.
11. Protect your head from injury
Moderate and severe head injuries roughly double to quadruple the risk of dementia later in life, and repeated milder concussions appear to add up over time (reference 8). Prevention is mostly common sense applied consistently.
Wear a helmet when cycling, skiing, skating, or riding a motorcycle, and a seatbelt every time you are in a car. As you get older, falls become the main cause of head injury, so keep the home well lit and clear of loose rugs and clutter, fit grab bars and stair rails, and use a cane or walker if balance is an issue. Alcohol and sedating medications raise the risk of falls, so be cautious with both. If you do hit your head hard enough to black out or feel confused afterward, see a doctor, and give the brain time to recover before risking another knock. Our concussion page covers what recovery involves.
12. Minimize exposure to air pollution
Fine particulate pollution from traffic, industry, and wildfire smoke is linked to faster cognitive decline and a higher risk of dementia, most likely through inflammation set off by particles that reach the bloodstream and the brain. The Commission added it to the list in 2020. Living in Los Angeles, this is not an abstract concern.
You cannot control the air outside, but you can reduce your dose. Check the air quality index on smoky or smoggy days and move strenuous exercise indoors or away from busy roads when it is high. A good air purifier in the bedroom and regularly replaced HVAC filters lower indoor levels. Avoid wood smoke and second-hand tobacco smoke. Supporting cleaner air in your community, from public transport to policy, protects everyone's brain in the long run.
Visual guide
Protect the brain through everyday care
- Stay engaged: Keep learning, maintain social connections, and address hearing or vision loss.
- Keep moving: Choose regular physical activity that suits your ability.
- Care for blood vessels: Manage blood pressure, blood sugar, and cholesterol with your clinician.
When to see a neurologist
Everything above is for a healthy brain. It is not a substitute for an evaluation if something has already changed. Memory or thinking problems that other people have noticed, that affect work or daily tasks, or that arrived with other symptoms such as headaches, numbness, or unsteadiness should be assessed, because many causes are treatable and the treatable ones are easier to fix early. Our memory loss and brain fog pages describe what an evaluation looks for. You can request a visit in Beverly Hills or Los Angeles, or by video anywhere in California.
Conclusion
Twelve habits is a long list, and nobody adopts them all at once. Pick the one or two that are furthest from where you are today, often hearing, blood pressure, or movement, and build from there. Every change counts, most of them protect the heart as well as the brain, and the evidence is clear that it is never too early, and never too late, to start.
Frequently asked questions
References
- Livingston G, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 2020.
- Livingston G, et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet, 2024.
- Harvard Health. What is cognitive reserve?
- Mayo Clinic. Vascular dementia: symptoms and causes.
- Verywell Mind. How the Mediterranean diet can impact your dementia risk.
- Centers for Disease Control and Prevention. Adult activity: an overview.
- Alzheimer's Research UK. Depression and dementia risk.
- Shively S, et al. Dementia resulting from traumatic brain injury. Archives of Neurology, 2012.
- Age UK. What is good for the heart is good for the brain.
- National Institute on Aging. Cognitive health and older adults.
- Lin FR, et al. Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomised controlled trial. The Lancet, 2023.
- Lee CS, et al. Association between cataract extraction and development of dementia. JAMA Internal Medicine, 2022.