What is your biggest fear when it comes to your health? For those over 50, being diagnosed with Alzheimer’s disease (AD) is near the top of the list. And for good reason. AD is a condition that impacts more than memory, thinking, and behavior; it robs people of themselves. The onset can be insidious and hard to clearly determine—“Is my partner just stressed, or is their change in irritability and focus something that needs addressing?” is a regular concern expressed in doctors’ consulting rooms.
Is it or isn’t it?
Often, the precursor to a diagnosis of AD is mild cognitive impairment (MCI), an umbrella term that covers more than just age-related memory changes and deteriorating cognitive processes. This diagnosis can hold sufferers and their families in a tense stand-off with their future. The question of whether these changes in behaviors will resolve or if they are the beginning of a permanent change is a high level of uncertainty to live with. MCI is far from a guarantee—49 percent of MCI diagnoses remain stable and do not progress to a diagnosis of AD within five years. But as relatives and patients, it can be hard to shake the fear of hearing that you have something that is Alzheimer’s adjacent.
Current treatments
One of the key challenges for medical professionals, as well as carers and patients, has always been the frustration of living with a diagnosis that is so life-altering yet with limited options for management. The prescribed medications that have been used for the last 20 years have offered stagnating results when it comes to improving symptoms. The personal toll of caring for a relative with AD can impact families for decades, emotionally, physically, and financially.
The future is brighter
There is a change afoot at both ends of the AD diagnostic spectrum. At this summer’s Alzheimer’s Association International conference in Toronto, the results of the POINTER study were presented following publication in JAMA. These reassured us that lifestyle changes can reduce our risk of developing Alzheimer’s disease, even when we are at risk. As the Lancet commission report showed in 2024, there are 14 modifiable risk factors that can reduce our risk of developing AD throughout our lives, but the results from POINTER showed that making lifestyle changes as older adults can have a significant positive impact.
Lifestyle and brain health
The community-based study looked at over 2,000 older adults who were at risk for cognitive decline and divided them into two groups. The Intervention Group engaged in supervised lifestyle-based interventions, including exercise, dietary counseling following the MIND diet, cognitive and social activities incorporating volunteering, structured games, and intergenerational activities. The participants in the Self-Guided Group received similar recommendations but had fewer interactions or structure to their activities.
Results
Whilst the Intervention Group experienced greater cognitive benefits, showing a significant protective effect on cognition as individuals age, the results showed these cognitive benefits across both study groups. These improvements were consistent across different demographics, as well as those with known risk factors for AD, such as APOE status, and those with impaired cardiovascular health.
Disease-modifying treatment
At the interventional end of the spectrum, as of May 2025, the FDA has approved the use of biomarker testing for pTau217/BetaAmyloid 1-42 ratios for those over 55 with symptoms of AD. This will allow clinicians to exclude AD from presentations of altered cognition as well as provide information about an individual’s risk earlier in the disease process.
There are disease-modifying therapies now available that have been shown to impact and even remove the buildup of amyloid beta. This toxic form of amyloid protein accumulates in the brain, resulting in a buildup of amyloid plaques and negatively impacting brain cell function, and has long been known as causative in the pathology of this life-altering condition.
The time to act is now
As is often the case in the case of science, there are practitioners and scientists with differing views on the roles of these medications when it comes to real-life outcomes for patients. Only time and more research will tell, but what we do know is that there are free-to-access, everyday actions that can alter the trajectory for those at risk of Alzheimer’s disease. From regular exercise to improving our diet to maintaining social and cognitive activity throughout our lifetime, we can reduce our risk of developing this life-destroying condition starting today.
Start protecting your brain health today
- Have your hearing tested. Loss of hearing in older adults can cause cognitive decline, which may lead to dementia. Studies have shown that people with moderate to severe hearing loss are up to five times more likely to develop dementia.
- Ensure you are getting at least 20-30 minutes of physical exercise a day. This supports blood flow to the brain and improves mood, resilience to stress, and heart health.
- Find ways to remain interested and interesting; whether it is reading, gardening, or helping out in a local store, social interaction is key to maintaining healthy brain cell functioning.
- Seek help for your sleep problems; poor, disrupted sleep can impair your day-to-day mood and thinking, as well as increase your risk of AD.
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