The study, published in the journal Neurology, took a “life-course approach” to explore “how intellectually enriching experiences across the entire lifespan, not just in old age, shape long-term cognitive outcomes,” says lead author Andrea Zammit, PhD, an assistant professor in the department of psychiatry and behavioral sciences at Rush University Medical Center in Chicago.
“We also examined whether these benefits persisted even when people have underlying Alzheimer’s disease pathology in the brain,” she says. “This helps us better understand cognitive resilience, which is why some people remain sharp even though they have an underlying disease.”
Lifelong Enrichment Was Connected With Healthier Brains
The latest research examined nearly 2,000 adults from northeastern Illinois who participated in the Rush Memory and Aging Project. Their average age was 79.6, and most were women. The subjects didn’t have dementia at the start of the study.
Participants answered surveys to determine their levels of cognitive enrichment at three life stages, enabling researchers to calculate a total “enrichment score” for each person:
- Early enrichment (before age 18), including being read to or reading books, having newspapers and atlases at home, and learning a foreign language
- Middle-aged enrichment, including having magazine subscriptions, dictionaries, and library cards and visiting museums or libraries
- Later-life enrichment, including reading, writing, and playing board games
Over eight years of follow-up, the researchers determined that subjects in the top 10 percent of lifetime cognitive enrichment had a 38 percent percent lower risk of developing Alzheimer’s and a 36 percent lower risk of developing mild cognitive impairment compared with people in the lowest 10 percent.
Higher lifelong enrichment was associated with an up to seven-year delay in mild cognitive impairment and an up to five-year delay in dementia onset.
Researchers also examined brain donations from a small group of participants who passed away. People with higher lifetime enrichment had better memory and thinking skills and slower decline prior to death even when their brains showed Alzheimer’s-related changes.
The researchers note that the study doesn’t prove that lifelong learning decreases Alzheimer’s risk; it just shows an association. The self-reported nature of the surveys are another limitation of the study, says Dr. Zammit, as some people may not have accurately recalled past activities. The subjects of the study may also not be representative of the broader population, which could also affect any takeaway.
Why Lifelong Enrichment May Lower Alzheimer’s Risk
Decades of research have shown that the more you challenge your brain, “the stronger and more resilient it becomes,” says Majid Fotuhi, MD, a neurologist and author of The Invincible Brain, who was not involved with the new study.
“We also know from neuroscience that the brain remains ‘plastic’ across the lifespan,” Dr. Fotuhi adds. “When we learn new skills, languages, or complex tasks, we strengthen neural networks involved in memory, attention, and executive function.”
This contributes to “cognitive reserve,” or the brain’s ability to function despite age-related changes, he explains. “In short, lifelong learning appears to help build a more durable brain.”
Building stronger, more efficient brain networks “can allow people to maintain their cognitive skills for longer, even in the presence of accumulating pathology,” Zammit says.
There’s evidence that mental stimulation affects brain structure and function: strengthening synaptic connections, expanding neuronal networks, and potentially increasing thickness or volume in the hippocampus and cerebral cortex, the areas of the brain related to memory and higher cognitive function, Fotuhi says.
Which Activities Are Most Beneficial?
Foreign language instruction in childhood, and activities such as reading, writing, visiting the library, and playing board games in midlife and later life showed the strongest benefits in the latest study, Zammit says.
“This is an encouraging message because these are everyday, accessible behaviors, not dependent on income or access to expensive resources,” she says.
Activities that are challenging, novel, and meaningful can “drive neuroplasticity,” or the brain’s ability to grow, change, and rewire at any age, Fotuhi says. He also recommends playing a musical instrument, taking a class, writing regularly, or mastering a new hobby.
“Equally important is enjoyment,” he adds. “Activities that bring joy increase motivation and are more likely to be sustained over time. Positive engagement also supports healthy dopamine signaling and may reduce chronic stress, both of which improve brain health and resilience.”
It’s Never Too Late to Engage Your Brain
Cognitive health in older age is shaped by a lifetime of learning and intellectual engagement, Zammit says.
It’s never too late (or too early) to start challenging your brain. Zammit says the study noted benefits of enrichment participation at every life stage, but a “life-course trajectory” starting in childhood offers the greatest long-term advantage.
The brain remains dynamic and responsive throughout life, Fotuhi says. “You can maintain and improve your brain at any age.”
However, cognitive stimulation works best as part of a broader brain-health strategy, he says, combined with regular physical exercise, a healthy diet, good sleep, stress reduction, and a positive mindset.