If you want to stay mentally sharp as you age, experts have three pieces of advice: Get more exercise, control your risks for cardiovascular disease and work with your doctor to head off medical conditions and drug side effects that might impair your thinking.
While you might also benefit from some other strategies — including staying socially active, getting enough sleep and engaging in stimulating activities from reading to music-making to formal brain-training games — the evidence for those approaches is not as strong. And there's no good evidence that any drug or supplement will help.
That's the gist of the advice in a new, authoritative report on "cognitive aging," the changes in memory, thinking speed, decision-making, problem-solving and learning that most people notice as they age. The report, released Tuesday by an expert panel appointed by the non-profit Institute of Medicine, focuses on the sorts of changes that do not signal dementia but can nonetheless interfere with daily life.
"The brain ages in all of us, but there's wide variability in the way the brain ages," says committee chair Dan Blazer, an emeritus professor of psychiatry at Duke University Medical Center in Durham, N.C. Aging can have some positive effects along with the well-known negative effects, he adds: Wisdom and knowledge may increase, even while memory and attention decline.
The best-studied ways to slow the decline, according to the report:
Exercise. Physical activity studies in middle-aged and older adults show that those who step up their exercise routines improve their scores on thinking tests. Still unclear: what kinds of exercise, in what doses, at what time of life, are best.
Improve cardiovascular health. People with healthy hearts and blood vessels tend to maintain healthier brains and are at lower risk for strokes, a major cause of cognitive impairment. So control your blood pressure, cholesterol and weight, and don't smoke.
Watch out for medical conditions and medications that can impair thinking.Conditions from diabetes to sleep apnea and medications such as some sedating antihistamines, sleeping pills and antidepressants, have been linked with cognitive decline. Many people also decline during hospitalization and after surgery. So work with your medical providers to limit the harm.
"There is s message of hope in this report," Blazer says. "There are things that can be done."
If you do try a brain-training computer program or game, the report says, you should know that the skills you hone on those programs might not transfer to real life activities. That is, even if you master a memory game, you still might forget your grocery list.
The report calls for government agencies, consumer groups and others to do more to regulate and offer reliable information on products that make memory-enhancement and other claims.
In a recent survey by AARP, 93% of respondents said brain health was very or extremely important, but few said they knew how to protect it.
The new report, co-sponsored by the advocacy group, "empowers consumers to take control of their health," AARP chief policy officer Debra Whitman said in a written statement. "By living a healthy lifestyle that includes being physically active and intellectually and socially engaged, you can positively help your brain's health as you age."