“Exercise your brain,” experts advise those hoping to delay dementia. But how? A more accurate description would be: stretch your brain.

Doing a crossword puzzle a day can make you good at crossword puzzles, simply put. Instead, growing research shows that a variety of habits and hobbies function as cognitive training, building knowledge and skills that can strengthen parts of the brain as we age.

Lifelong learning against Alzheimer’s

A recent study linked a lower risk of Alzheimer’s and cognitive decline with lifelong learning, that is, intellectually stimulating experiences – reading and writing, learning another language, playing chess, solving puzzles, visiting museums – from childhood to retirement.

“They stretch your brain and your thinking. You’re using different cognitive systems,” explained neuropsychologist Andrea Zammit of Rush University in Chicago, who led that study.

If you didn’t adopt what Zammit calls cognitively enriching activities early in life, it’s not too late to start. Midlife represents an important window for protecting brain health, and scientists are examining a wide range of possibilities for staying mentally agile, from learning music to bird watching to brain-training games.

“It’s not about one activity. It’s more about finding meaningful activities that you are passionate about,” Zammit said, and sticking with them rather than doing them sporadically.

Physical health is also essential for brain health. That is why experts also recommend intense physical exercise, controlling blood pressure, sleeping well and even getting vaccinated in advanced stages of life.

There is no magic formula to prevent dementia or the normal cognitive decline of aging, warned Dr. Ronald Petersen, an Alzheimer’s specialist at the Mayo Clinic. However, lifestyle changes offer the chance to “slow the pace of decline,” he said.

Cognitive reserve: the resilient brain

Zammit’s study on lifelong learning included nearly 2,000 older adults – ages 53 to 100 – who initially did not have dementia and were followed for eight years. The researchers asked them about educational and cognitively stimulating activities in their youth, middle age and old age, and administered a battery of neurological tests.

Some were later diagnosed with Alzheimer’s, but it appeared five years later in those who had the highest level of lifelong learning, compared to those who had the least, according to Zammit’s team in the journal Neurology. Additionally, staying more mentally active in middle age and beyond was associated with a slower rate of cognitive decline.

Most interesting, Zammit noted, were the findings from the autopsies of 948 participants who died during the study: Even when their brains showed the characteristic markers of Alzheimer’s, the most cognitively “enriched” people showed better memory and thinking skills, and slower decline before their death.

Scientists call this cognitive reserve. It means that learning strengthened neural connections in various regions, helping the brain become more resilient and able to compensate for damage caused by aging or disease, at least for a time.

Brain training and processing speed

Rush’s study cannot prove causality: it shows an association between cognitive stimulation and dementia risk. Other studies offer similar clues, such as those linking brain health to playing a musical instrument.

Another study suggested that brain “speed training”—using an online program that requires identifying images while the screen displays increasing distractions—might also be beneficial. A study funded by the National Institutes of Health is examining whether long-term computerized exercises aimed at improving attention and reaction time have any benefits.

That brain processing speed affects our ability to multitask or drive, explained Jessica Langbaum of the Banner Alzheimer’s Institute. For now, she recommends choosing activities that force you to think on your feet, such as joining a book club to combine individual reading with discussion and social connection.

Cardiovascular health to prevent dementia

Many chronic health problems that appear in middle age can increase the risk of Alzheimer’s or other forms of dementia in later stages. High blood pressure, for example, damages blood vessels, which harms the heart and reduces blood flow to the brain. Poorly controlled diabetes can lead to harmful inflammation in the brain.

That’s why the key recommendations for cardiovascular health – exercising regularly, eating plenty of fruits and vegetables, avoiding obesity, and controlling diabetes, hypertension, and high cholesterol – are also good for brain health.

An additional step: get vaccinated against shingles. Not only does it prevent that painful rash, but recent research shows that vaccinated people have a lower risk of developing dementia.

FEW (AP, Neurology)