A Multi-Pronged Approach for Cognitive Decline

A Lancet report has calculated that more than a third of dementia cases could be preventable, many through lifestyle change.1

How can you help your patients with fears of or diagnosed cognitive decline?

A recently published longitudinal study assessed lifestyle factors to determine their contributions to cognitive function later in life.2 The authors conclude that there might be a cumulative effect of small incremental improvements across a wide range of lifestyle factors, suggesting a “multivariate recipe for cognitive ageing.”2

A 2017 meta-review also supports this multi-pronged approach for normal cognitive decline treatment.3 Twelve lifestyle interventions were each found to enhance cognitive function, sometimes in as little as a month.3 For example, significant results were seen with intellectual challenges like solving crosswords four times a week (47% decrease of dementia risk).4 In other studies, either making music5 or just listening to Buddhist hymns regularly over four months showed significant cognitive improvement.6

When 60 patients with subjective cognitive decline were asked to practice Kirtan Kriya meditation for 12 minutes a day for three months, they showed significant improvement in memory and cognitive performance over that time and beyond, when they were no longer held to their practice.7 Even less structured activities have positive mental effects. For instance, crafting, playing games, socializing,8 and educational games9 are all linked to reduced risk of cognitive decline. Multimodal cognitive decline treatment likely offers stronger protection than any single intervention.

In the following video, IFM educator Monique Class, MS, APRN, BC, talks about how psychosocial factors influence inflammation and offer options for cognitive decline treatment.

Monique Class MS, APRN, BC, is a certified family nurse practitioner, clinical nurse specialist in holistic health, and wellness educator at The Center for Women’s Health, where she inspires and supports patients of all ages to implement lifestyle change for health and well-being.

For patients concerned about cognitive decline, the additive effect of multiple healthy interventions may be the best approach. Importantly, cognitive training may transfer to mitigating physical decline over time.10 These treatments are not only cost effective, they have few negative side effects. Although questions have been raised about the strength of the research on cognitive training,11 given the lack of other treatment options and the emerging evidence, it may be appropriate for some patients.

The lifestyle interventions listed in this article are only a subset of the many potential interventions, including nutrition, stress management, toxin assessment, and much more.

Learn More About Mitochondrial Function

explore other ways to support patients with cognitive Decline


  1. Livingston G, Sommerlad A, Orgeta V, et al. Dementia prevention, intervention, and care. Lancet. 2017 Jul 19. pii: S0140-6736(17)31363-6. doi:10.1016/S0140-6736(17)31363-6.
  2. Corley J, Cox SR, Deary IJ. Healthy cognitive ageing in the Lothian Birth Cohort studies: marginal gains not magic bullet. Psychol Med. 2017 Jun 9:1-21. doi:10.1017/S0033291717001489.
  3. Klimova B, Valis M, Kuca K. Cognitive decline in normal aging and its prevention: a review on non-pharmacological lifestyle strategies. Clin Interv Aging. 2017;12:903-10. doi:10.2147/CIA.S132963.
  4. Verghese J, Lipton RB, Katz MJ, et al. Leisure activities and the risk of dementia in the elderly. N Engl J Med. 2003;348(25):2508-16. doi:10.1056/NEJMoa022252.
  5. Mansens D, Deeg DJH, Comijs HC. The association between singing and/or playing a musical instrument and cognitive functions in older adults. Aging Ment Health. 2017 May 19:1-8. doi:10.1080/13607863.2017.1328481.
  6. Tai SY, Wang LC, Yang YH. Effect of music intervention on the cognitive and depression status of senior apartment residents in Taiwan. Neuropsychiatr Dis Treat. 2015 Jun;11:1449-54. doi:10.2147/NDT.S82572.
  7. Innes KE, Selfe TK, Khalsa DS, Kandati S. Meditation and music improve memory and cognitive function in adults with subjective cognitive decline: a pilot randomized controlled trial. J Alzheimers Dis. 2017;56(3):899-916. doi:10.3233/JAD-160867.
  8. Krell-Roesch J, Vemuri P, Pink A, et al. Association between mentally stimulating activities in late life and the outcome of incident mild cognitive impairment, with an analysis of the APOE-4 genotype. JAMA Neurol. 2017;74(3):332–38. doi:10.1001/jamaneurol.2016.3822.
  9. Fissler P, Kolassa IT, Schrader C. Educational games for brain health: revealing their unexplored potential through a neurocognitive approach. Front Psychol. 2015 Jul;6:1056. doi:10.3389/fpsyg.2015.01056.
  10. Ross LA, Sprague BN, Phillips CB, O’Connor ML, Dodson JE. The Impact of Three Cognitive Training Interventions on Older Adults’ Physical Functioning Across 5 Years. J Aging Health. 2018;30(3):475–498. doi:10.1177/0898264316682916
  11. van Heugten CM, Ponds RW, Kessels RP. Brain training: hype or hope? Neuropsychol Rehabil. 2016 Oct;26(5-6):639-44. doi:10.1080/09602011.2016.1186101

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