Some form of cognitive decline may be a natural part of aging, but there are meaningful steps we can take to reduce our risk and prevent or delay disease. According to Lauren Bennett, PhD, ABPP-CN, director of neuropsychology at Hoag’s Pickup Family Neurosciences Institute, dementia and other cognitive problems, including Alzheimer’s disease, start 20 to 25 years before the first symptom. While aging and genetics are significant contributors to neurodegeneration, research suggests that up to 40–45% of dementia risk may be reduced through modifiable lifestyle factors such as exercise, diet, cognitive engagement, and vascular health management. In other words, what you do today determines your brain health later in life. At a recent EmpowHER Wellness event—an intimate salon series that serves as an extension of Hoag’s HER Summit—Dr. Bennett spoke to guests about the impact of small, everyday changes. 
 
For women in particular, Dr. Bennett underscores the importance of setting intentions and strong boundaries to prioritize self-care. Roughly two-thirds of individuals with Alzheimer’s disease are women. This higher prevalence in women is due to a combination of factors: women typically live longer than men, which increases the likelihood of developing age-related cognitive decline; women are more likely to assume caretaking roles for kids and aging parents, contributing to increased stress; and during menopause, the loss of estrogen, a hormone with neuroprotective properties, may increase the risk of Alzheimer’s disease.

Small, actionable steps are a great way to begin implementing larger lifestyle changes into your day-to-day routine. Here are a few areas of health and wellness to consider: 
 

1.  Hearing loss. It may come as a surprise, but hearing loss accounts for approximately 7-9% of dementia risk. Because the brain’s hearing center is located next to the hippocampus—the part of the brain responsible for memory and learning—untreated hearing loss can cause these areas of the brain to atrophy faster, increasing the risk of cognitive decline. The good news? Hearing aids may help lower this risk. Get your hearing checked regularly, and your brain will thank you! 

2.  Metabolic health. High LDL cholesterol, obesity, diabetes, and hypertension cause chronic inflammation, oxidative stress, plaque formation, and vascular damage, which can reduce blood flow to the brain and contribute to cognitive decline. Over time, these conditions increase the risk of stroke, vascular dementia, and Alzheimer’s disease. Eating a diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats (like omega-3s) can help reduce inflammation, improve vascular health, and lower the risk of cognitive impairment. While lifestyle changes can significantly improve or even reverse some metabolic conditions, advanced vascular damage and neurodegeneration may be less reversible.

3.  Social activity. Social isolation is associated with reduced cognitive engagement, increased stress, and lifestyle factors that may negatively impact brain health. Conversely, maintaining strong social connections through interactions with friends, family, and community can enhance cognitive stimulation, support emotional well-being, and promote a sense of purpose, all of which are linked to better brain function and a lower risk of cognitive decline.      

4.  Cognitive activity. Crossword puzzles and other word and number games can provide cognitive benefits, particularly in memory and language processing, but they engage fewer areas of the brain compared to more complex activities. Learning a new language, playing a musical instrument, volunteering, or planning complex tasks like a travel itinerary engage broader cognitive processes, promote neural plasticity, and are linked to improvements in memory, reasoning, and problem-solving skills. These activities encourage more dynamic brain networks and can have a greater impact on cognitive resilience and long-term brain health.

5.  Exercise. Physical activity improves blood flow, delivering more oxygen and nutrients to the brain and promoting healthy brain function, including the growth of new brain cells and the formation of new synaptic connections. Regular exercise also reduces stress and chronic, low-grade inflammation, both of which are beneficial for brain health. Simple actions, like parking farther away from your destination or taking the stairs instead of the elevator, can help increase daily movement, but more substantial benefits are achieved through consistent, moderate to vigorous physical activity, such as walking or cycling.

Thanks to philanthropy, the Women’s Health Institute at Hoag, under the leadership of Allyson Brooks, MD, FACOG, Ginny Ueberroth Executive Medical Director Endowed Chair, continues to elevate women’s health services to support women through each of life’s stages, including menopause and beyond. A transformative $50 million gift from the late Newport Beach philanthropist Richard Pickup in 2023 is also changing the course of memory and cognitive disorders care at Hoag and nationwide. Together with the community, Hoag is enhancing the longevity and vitality of residents across Orange County.

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