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Dan Jones, a 56-year-old quality control inspector and bagpipe enthusiast, saw his world change when he was diagnosed with dementia in 2021. He began forgetting tasks, fumbling musical pieces, and waking up confused while traveling. But within a year of adopting a plant-based diet and other lifestyle changes as part of a clinical study, Jones found himself playing his bagpipes again in a parade—and regaining confidence in his memory.

His transformation is part of a small but promising study led by the Preventive Medicine Research Institute, which suggests that Alzheimer’s and early cognitive decline may be slowed—or in some cases, partially reversed—through targeted lifestyle interventions. The research, published in 2024, adds to a growing body of evidence linking diet, exercise, sleep, and emotional well-being to brain health, the Wall Street Journal reported.

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Lifestyle overhaul yields significant results

Jones was one of 51 participants in the study, which randomly assigned patients with early-stage Alzheimer’s or mild cognitive impairment to two groups: one that continued their usual habits and another that followed a strict regimen involving a vegan diet, daily exercise, stress management techniques, and group support sessions.

After 4½ months, 71% of participants in the lifestyle-change group showed improvement or no deterioration in cognitive function. In contrast, none in the control group improved, and 68% got worse. While the sample size was small, lead researcher Dr. Dean Ornish says the findings are encouraging and consistent with his past research on lifestyle’s effect on heart disease, cancer, and aging.

“The earlier you intervene, the less intensive the lifestyle changes likely need to be,” Ornish said. “It’s really giving new hope and new choices to people who didn’t have that before.”

Aging brain, but not helpless

Experts say that as Americans live longer, the risk of age-related diseases like Alzheimer’s will grow. A recent study estimates that new dementia cases in the U.S. will double by 2060. But research also shows that even modest activity—just 25 minutes of moderate to vigorous exercise weekly—can increase brain volume, a marker of better cognition.

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Rudolph Tanzi, professor of neurology at Harvard Medical School and a researcher on the Jones study, agrees: “Lifestyle matters.”

New tools to measure and slow brain aging

As more people seek proactive ways to guard against dementia, science is catching up with demand. Researchers at USC have developed an AI model that uses MRI scans to track how fast a brain is aging by measuring changes in key brain regions. Slower brain aging is tied to lower dementia risk, according to researcher Andrei Irimia.

Other tools are emerging too. In May, the FDA approved the first blood test to help diagnose Alzheimer’s in patients already experiencing memory issues. Companies like NeuroAge Therapeutics are developing more expansive (and expensive) biological age tests, combining blood analysis with MRIs, genetic testing, and memory games to produce personalized brain-age profiles.

However, many scientists warn that these commercial products need stronger validation before they are widely adopted. “I would be extremely cautious,” says Stanford neurologist Tony Wyss-Coray. “We need scientific evidence that what they measure is actually relevant.”

“I would have made changes earlier”

Jones didn’t take a brain-age test before his diagnosis, but says if such tools had been available, he would have embraced lifestyle changes much sooner. Now, he meditates daily, eats plant-based meals low in sugar, exercises regularly, and participates in support groups with his wife, Darla.

“You could not pay me to quit eating the way I eat now,” he said.

For Jones and many others, the findings offer a powerful message: aging and brain decline aren’t entirely beyond our control. With the right habits and support, it may be possible to reclaim some of what was feared lost.

The Alzheimer’s Association estimates over 7.2 million Americans aged 65 and older will live with Alzheimer’s by 2025, with the number projected to double by 2050.

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ST. LOUIS — The Alzheimer’s Association reports that for the first time, more than 7.2 million Americans aged 65 and older are estimated to be living with Alzheimer’s disease in 2025 — a number projected to nearly double by 2050. As Alzheimer’s Awareness Month wraps up, it’s critical to understand the early warning signs and learn how lifestyle choices could help delay a diagnosis or reduce your risk altogether.

Early symptoms to watch for

According to the Alzheimer’s Association, early stages of Alzheimer’s or Dementia may display subtle but significant changes:

Memory loss, especially forgetting recently learned information.

Difficulty solving problems or planning, such as managing bills.

Challenges with familiar tasks, like cooking or using appliances.

Trouble with reading comprehension, speech, or driving.

Noticeable mood or judgment changes, such as poor decisions or withdrawal.

Confusion about time or place.

These symptoms could also indicate mild cognitive impairment and warrant a medical consultation.

Ways to delay or lower your risk

Although there’s no guaranteed prevention, the CDC reports nearly 45 % of dementia cases may be preventable or delayed with healthy habits. The CDC lists some strategies:

Stay physically active – Aim for at least 150 minutes/week of moderate exercise. That’s about 20 minutes per day.

Treat diabetes – Managing blood sugar protects your brain and arteries.

Control blood pressure – High blood pressure can damage blood vessels in the brain.

Prevent or correct hearing loss. Hearing aids may help preserve mental acuity and help you maintain social interaction, which is great for brain health.

Avoid excessive drinking and smoking. These behaviors raise dementia risk.

Maintain a healthy weight and diet, get enough sleep and stay socially engaged.

Early detection matters

The Alzheimer’s Association reports 79% of Americans say they’d want to know if they have Alzheimer’s before symptoms interfere with daily life.

92 % say they’d take medication that could slow disease progression.

Early detection paves the way for biomarker tests, new treatments, and lifestyle modifications that may extend quality of life.

Seeing signs? Next steps

With over 55 million people worldwide living with dementia, and up to 70% of these with Alzheimer’s disease, ¹⁻² the sad reality is that many of us will have a loved one who has been impacted by this devastating disease. The symptoms of Alzheimer’s, which include memory loss, personality changes and difficulties with communication, are both distressing and have a significant impact on those affected, their families and society more broadly. Yet as many as 75% of people with dementia are not diagnosed worldwide.¹

The journey to Alzheimer’s diagnosis can be long and complicated, with people often facing up to a two-year wait.³ However, the importance of diagnosis is becoming increasingly clear. With new treatments on the horizon, which have the potential to slow this devastating disease, early diagnosis supports access to these medicines when they are at their most effective, early in the disease spectrum. Additionally, early diagnosis enables families to support implementing lifestyle changes, which growing evidence suggests can slow disease progression,⁴ as well as any life planning or changes that may help to improve their quality of life further down the road.

It’s really about timing. Given the fact that I have a disease that progressively declines to a point where I’m no longer the person I that used to be. Jeff USA, who lives with Alzheimer’s disease.

It is also important to note that there are many reasons a person might experience memory-related symptoms. Diagnostic testing also has an important role to play in ruling out Alzheimer’s disease, enabling further investigations into other possible causes and opening up access to other potential support and treatment avenues. Current diagnostic methods for Alzheimer’s disease used alongside clinical examination include cerebrospinal fluid (CSF) testing and/or PET scans of the brain. Despite the reliability of these tests in diagnosing Alzheimer’s, they have historically been difficult to access. It is also important to tackle the stigma associated with Alzheimer’s disease, which leads to reticence from some people, and even doctors, to seek a diagnosis.

We [people with Alzheimer’s disease] are quite misunderstood about what we can, or can’t do, or who we are Helen Ireland, who lives with Alzheimer’s disease.

Adopting multiple healthy habits can reduce your risk of type 2 diabetes, yet new research reveals that managing body weight remains the key driver, especially across different ethnic groups.

Study: Prospective association of a Lifestyle Risk Factor Index with type 2 diabetes in the Multiethnic Cohort. Image Credit: New Africa / Shutterstock

In a recent study published in the European Journal of Nutrition, a group of researchers investigated the relationship between a composite Lifestyle Risk Factor Index (LSRI) and the incidence of type 2 diabetes mellitus (T2DM) in a multi-ethnic population.

Background

Every 1 in 10 adults globally is living with diabetes, and by 2045, over 780 million people are expected to be affected, and more than 90% will have T2DM. Both genetics and modifiable lifestyle factors, such as smoking, physical activity, unhealthy diet, and alcohol, influence T2DM. T2DM is associated with various complications, such as chronic kidney disease, eye damage, peripheral neuropathy (causing amputation of lower extremity), and significantly higher all-cause and cardiovascular mortality, as well as blindness and limb amputations.

Studies show that combining these behaviors into a lifestyle index may better predict disease risk than evaluating them individually. However, previous studies focused on short follow-up periods. The substantial economic impact of T2DM, through both direct medical expenses and indirect costs such as reduced work capacity and life expectancy, underscores the need for effective prevention. Hence, further research is needed to understand how combined lifestyle behaviors influence T2DM risk across diverse populations over time.

About the study

The present prospective cohort study utilized data from the Multiethnic Cohort (MEC), which included 215,903 adults aged 45-75 years from Hawaii and California, representing five ethnic groups: African American, Native Hawaiian, Latino, Japanese American, and European American. After excluding participants with incomplete data, those with T2DM at baseline, and ethnicities outside the five main groups, 165,383 individuals remained for analysis.

Researchers used a baseline questionnaire to collect data on demographics, body mass index (BMI), smoking status, alcohol consumption, physical activity, and dietary habits. Ethnicity assignment was based on a priority ranking when mixed ancestry was reported. It should be noted that data on lifestyle factors were collected at baseline and not updated for changes over time.

T2DM cases were identified via self-reported diagnoses, medication usage, and Medicare claims data up to 2016. The primary exposure was the LSRI, a composite score (0-4) that awarded one point for each of the following: not currently smoking, engaging in ≥150 minutes of moderate to vigorous activity per week, consuming less than 2 (men) or 1 (women) alcoholic drinks per day, and adhering to at least 3 of 7 cardiometabolic dietary recommendations.

These seven dietary recommendations included: ≥3 servings per day of fruits, ≥3 servings per day of vegetables, ≥3 servings per day of whole grains, ≥2 servings per week of fish, ≤1.5 servings per day of refined grains (with only 3% of participants meeting this guideline), ≤1 serving per week of processed meat (24%), and ≤1.5 servings per week of non-processed red meat (with only 6% adherence).

Cox regression models were used to calculate hazard ratios (HRs) and confidence intervals (CIs), adjusting for age, education, and BMI. Subgroup analyses were conducted by sex and ethnicity to explore variations in T2DM risk associations.

Adherence to LSRI components and dietary recommendations (%) by ethnic group. Adherence by ethnic group: (a) LSRI components and (b) dietary recommendations in percent (%) 1≥3 of 7 foods, no current smoking, ≤ 2 (men) or ≤ 1 (women) alcoholic drinks/day, ≥ 150 min/week physical activity 2Servings: ≥3 per day of fruits, ≥ 3 per day of vegetables, ≥ 3 per day of whole grains, ≥ 2 per week of fish, ≤ 1.5 per day of refined grains, ≤ 1 per week of processed meat, and ≤ 1.5 per week of non-processed red meat

Study results

Over a mean follow-up of 17.2 years, 44,518 participants (27%) developed incident T2DM. The largest ethnic group was Japanese American (29%), followed by European American (27%), Latino (22%), African American (16%), and Native Hawaiian (7%). The average LSRI score was 2.73, with most participants scoring 2 or 3 points.

Although only 22% of participants met dietary adherence guidelines, adherence was highest among moderate alcohol consumers (86%), followed by those who were no current smokers (84%) and those meeting physical activity recommendations (81%).

Adherence to most individual dietary components was very low, with the exception of fish intake. For reference, only 3% of participants met the recommendation for refined grains, and just 6% for non-processed red meat, with intermediate adherence for fruits (24%), vegetables (22%), and processed meats (24%), and highest adherence for fish (73%).

The incidence of T2DM was inversely associated with LSRI scores. Participants scoring 4 points had a 16% lower risk of T2DM compared to those scoring 0-1 (HR = 0.84; 95% CI: 0.80-0.88), even after adjusting for BMI. Every increase in 1-point, LSRI was associated with a 6% reduced risk of developing T2DM (HR = 0.94; 95% CI: 0.93-0.95).

Among individual components, no current smoking and adequate physical activity showed strong inverse associations with T2DM in all models, while moderate alcohol consumption was surprisingly linked to a 19% increased risk. It is important to note that the “moderate alcohol” group (≤1 drink per day for women, ≤2 for men) also included abstainers.

Dietary adherence, although low, was weakly associated with a reduced risk of T2DM in models excluding BMI, but not in BMI-adjusted models. Sensitivity analyses using an LSRI composed only of smoking and physical activity yielded similar or slightly stronger inverse associations with T2DM, indicating that these two factors were the primary drivers of the composite index.

When examined across different ethnic groups, higher LSRI scores significantly correlated with lower type 2 diabetes risk among African Americans (27% reduction for highest versus lowest LSRI), Latinos (18%), and European Americans (14%). However, no significant association was found among Japanese Americans or Native Hawaiians after BMI adjustment. Physical activity adherence was notably lower among Latinos and African Americans, while dietary adherence was generally poor across all groups, with only fish consumption exceeding 50%.

BMI had a stronger association with T2DM risk than LSRI. Participants categorized as obese (BMI over 30 kg/m²) were over three times more likely to develop T2DM compared to those with a normal weight. The effect of BMI also varied across ethnic groups, being especially pronounced in Japanese Americans and Native Hawaiians, possibly due to differences in visceral fat distribution.

Conclusions

To summarize, this study highlights the value of combining modifiable lifestyle behaviors such as non-smoking, physical activity, moderate alcohol consumption, and a healthy diet into a composite LSRI to assess T2DM risk. A higher LSRI score was linked to significantly lower T2DM incidence, particularly among African American, Latino, and European American groups. However, not all lifestyle factors had equal influence, and BMI played a stronger role in predicting diabetes risk.

The LSRI was not associated with T2DM risk in Japanese Americans or Native Hawaiians after BMI adjustment, underscoring the importance of considering physiological differences, such as visceral fat distribution, in T2DM development in these groups.

A key limitation is that the LSRI assumes equal weighting of each component, which may not accurately reflect their true importance for T2DM risk, and lifestyle was only assessed at baseline rather than over time. These findings suggest the need for culturally tailored public health strategies that promote sustainable lifestyle improvements while also addressing obesity to effectively reduce Type 2 diabetes mellitus (T2DM) across diverse populations.

Lance Kocherhans, who has Alzheimer’s disease and is treating it with Leqembi, works on a puzzle at home in South Jordan on Wednesday, June 4, 2025.

Lance Kocherhans wasn’t especially surprised when his children told him they were worried about his memory.

It had never been razor sharp, he said good-naturedly. “I literally do not know the words to any songs, though I know the music to all of them.” And his dad was diagnosed with dementia when he was about 80 and spent his last years in memory care.

Kocherhans’ husband told him he was sometimes substituting a wrong word for a word he really meant or leaving words out. He’s a big fan of early intervention and of being realistic, so he went to see a geriatrician, who gave him a battery of memory and skills tests, with tasks like count backwards from 100 by 7s. “I got to 93 and stopped. Who can even do that anyway?” he said.

His geriatrician sent him for a bigger battery of tests with a psychologist and he was diagnosed with mild cognitive impairment.

That didn’t throw him, either. He started going in every year for testing to see how he was doing. Then two years ago, the doctor ordered a PET scan to see what his brain looked like.

That was a different story.

The day the results of the PET scan came back, he was alone in a hotel room in Montana, on a trip for his job selling medical devices. He looked online for his results and when he saw the words “consistent with Alzheimer’s,” he said that “I remember I kind of froze up, stuck my face in a pillow and screamed. I started to bawl. I was scared to death.”

He still had to call home and let the people he loved most know.

Another scan a short time later confirmed the diagnosis: Alzheimer’s dementia. By then, the now 66-year-old South Jordan man had collected himself, strapped his sense of humor back in place and was ready to fight for time he still has with his family, connection to others and the life that he loves.

That’s the first thing he wants you to know. There’s life after diagnosis.

Lance Kocherhans, who has Alzheimer’s disease and is treating it with Leqembi, poses for a portrait at home in South Jordan on Wednesday, June 4, 2025. | Kristin Murphy, Deseret News

All in on a club he didn’t want to join

Jim Herlihy, a regional spokesman for the Alzheimer’s Association, will tell you that Kocherhans finds himself in good, if reluctant, company. About 7.4 million people in the U.S., including 38,300 in Utah, live with Alzheimer’s disease.

While there’s no cure, recent years have brought those with Alzheimer’s some reason to hope that had long been missing. Studies have shown some steps people can take proactively and earlier in life that may reduce the risk of Alzheimer’s or slow the disease’s progress. Herlihy said that “about 40% of all cases of Alzheimer’s can be influenced by our behaviors — one way or the other.”

And newish medications are beginning to impact the neurocognitive decline, slowing it down when taken early enough, though they don’t reverse what’s already been lost or halt the disease’s progression.

Utah Alzheimer’s Association spokesman Jeremy Cunningham told Deseret News that two recent drugs are making a significant difference in the lives of some people with early-stage disease by slowing down their decline modestly.

Kocherhans knows all of that. So he moved from being diagnosed to starting treatment without hesitation — after he got over a brief period of despondency. He mourned, then chose to pull himself out of the funk.

He loves his family, which includes his spouse, four children and 11 grandchildren. His kids are all nearby, including one who moved back to Utah to be part of whatever time Kocherhans has left.

Lance Kocherhans, who has Alzheimer’s disease and is treating it with Leqembi, jokes around with his neighbor Stoney Fonua in Kocherhans’ yard in South Jordan on Wednesday, June 4, 2025. | Kristin Murphy, Deseret News

He’d spent more than 35 years selling medical devices to hospital labs and had planned to retire at the end of last year anyway. When he got the news his condition had advanced to Alzheimer’s, he retired a few months early, determined to chase the things that were important to him, like time with family and treatment, travel and yard work — which he happens to love.

Not running from treatment

One of his first steps was arranging to start taking one of the newest drugs, Leqembi, which is made by Biogen and Eisai. Given by an hour-long infusion, it reduces the amyloid plaques believed to be a hallmark of Alzheimer’s disease. But it’s only given in the early stages, which include mild cognitive impairment when symptoms don’t impact life much and the next phase, mild Alzheimer’s dementia, when symptoms such as trouble keeping track of finances and doing some familiar tasks are beginning to show. The company says when people start getting lost and confused, “Leqembi may no longer be right for you.”

The drug has been shown to push that day back for some people. But while it may buy someone with Alzheimer’s precious time, it won’t stop its progression. People also have to be willing to risk side effects, most often mild but sometimes serious. Kocherhans notes that he gets a little tired right after an infusion, but that’s about it. So he takes a nap.

That’s another thing Lance Kocherhans wants people to know. There’s no point delaying diagnosis of a progressive disease like Alzheimer’s. Maximizing the quality of your time hinges on getting started with the tools that could help. They won’t be available later.

He wasn’t wild about the needle sticks, though, so he had a port put in so that they can plug into that instead of him. One and done.

Treatments are not inexpensive, although a Biogen spokesperson warns against listing any one patient’s out-of-pocket cost. The list price is about $26,500 a year, but it all depends on your insurance coverage, copay assistance and eligibility for other programs that lower cost. What people pay can vary a great deal.

Not done living

Something else Kocherhans wants you to know? Life doesn’t end with diagnosis. He travels a lot with loved ones, and has planned trips in the next few months to Washington, D.C., and Costa Rica.

One of the hardest things, he said, has been seeing what people post in support groups about caring for someone with dementia. Information is power, but he’s learned it can also be really sad. The disease impacts people differently and some people become mean and combative, as some of the posts chronicle. But that’s not everyone, he points out. He knows there’s great variation, because he’s cared for his dad and an in-law and others. They have all been different.

He doesn’t know what personality changes lie in his future and that’s a worry. But he knows that he’s embracing life to its fullest right now.

He says he’s doing all right. He’s active physically, he sleeps well and wakes up rested, and he’s out and about a lot. He thinks there’s a chance Alzheimer’s is something he will die with, rather than of. He’s good with that.

Lance Kocherhans, who has Alzheimer’s disease and is treating it with Leqembi, does yard work at home in South Jordan on Wednesday, June 4, 2025. | Kristin Murphy, Deseret News

Do what you can and start early

In honor of Alzheimer’s and Brain Health Awareness Month in June, the Alzheimer’s Association is circulating a 10-point list of proactive actions that people can take. The neurocognitive disease is the sixth-leading cause of death in the U.S. and the numbers are expected to get worse. It’s the only leading disease without a clear prevention or cure, killing more Americans annually than breast and colon cancer combined.

The 40% that might be changed somewhat by lifestyle choices matters. Among the habits the association says everyone should develop:

Break a sweat. Get the blood flowing to your brain and body, make your heart pump and build muscles. Plenty of research finds that physical activity could reduce risk of cognitive decline.

Continue to learn. Take a class online or study a language. Learn to play a musical instrument. Stretch and work your brain. The more you work it, the more that brain has to work with if there’s cognitive decline.

Do not smoke. It’s one of the worst things you can do if you want to avoid cognitive decline. If you smoke, quit. And like the other suggestions, it’s never too late to improve your odds.

Keep your blood pressure top number below 135. A World Health Organization study found people with high blood pressure that’s not treated have a 36% higher risk of Alzheimer’s. If your blood pressure is high, consult a health care provider and do something about it.

Avoid head injuries, which can raise the risk of cognitive decline. Wear a seatbelt, use a helmet when playing contact sports or riding a bike and prevent falls. Working on balance is a good idea.

Eat a healthy diet that’s low in fat and high in vegetables and fruits. Some diets, such as the Mediterranean and the Mediterranean-DASH (it stands for dietary approaches to stop hypertension) are believed to reduce risk.

Get good sleep and plenty of it. Insomnia, sleep apnea and other sleep-related problems are believed to harm cognition.

If you have diabetes, bring it under control. While researchers still debate the exact connection between type 2 diabetes and Alzheimer’s, poorly controlled blood sugar is believed to increase the risk of Alzheimer’s.

Use your mind and stretch it. Exercise and stump your brain. The association said to build a piece of furniture, complete a puzzle, be artistic, play games that make you think strategically. The group notes that challenging your mind may have short- and long-term benefits for your brain. It’s not a tricky task. For instance, you can challenge your brain by brushing your teeth with your non-dominant hand and taking different routes when you travel.

Lance Kocherhans, who has Alzheimer’s disease and is treating it with Leqembi, works on a puzzle at home in South Jordan on Wednesday, June 4, 2025. | Kristin Murphy, Deseret News

Finally, mind your weight and keep it healthy. An analysis of multiple studies shows that obesity between the ages of 35 and 65 can increase dementia risk in later life by about 30%.

It’s good to remember, too, that things that benefit the brain benefit the heart and body. It runs both ways. Do those things and you’ll be healthier overall.

Cunningham adds socializing to the to-do list. “People laugh at that, but not isolating is really, really important,” he said. Withdrawing also happens a lot with dementia.

He also notes that besides treatment advances, there have been diagnostic gains. For instance, a blood test can now bolster the search for the telltale signs of amyloid plaques. That, in conjunction with other tests, provides valuable diagnostic information.

The last thing Kocherhans wants you to know? Being afraid doesn’t help. So do what you can while you can.