Brain Health After 60 - What Actually Works (and What Does Not)

Forget miracle supplements. Here is what the research genuinely supports for protecting memory and thinking after 60 - movement, hearing, blood pressure, sleep, company. Oh, and what to stop spending money on!

Search for "brain health" and you will find a great deal of confident advice attached to a great deal of product - powders, pills, brain-training subscriptions, "neuro-enhancing" drinks. Very little of it is supported by good evidence, and almost none of it matters as much as a short walk, a hearing test and a blood pressure cuff.

The genuinely encouraging news is that the things which do work are mostly cheap, and many of them are the same things that protect your heart. This is a plain-English summary of where the evidence stands, written with no products to sell you.

What "brain health" actually means after 60

Some slowing is normal. From our fifties onward, processing speed, the ability to hold several things in mind at once, and the speed of recalling names all tend to decline gently. That is ordinary ageing, not disease, and it is not a straight line into dementia.

Dementia is different. It is a group of conditions in which memory, reasoning or behaviour decline enough to affect daily life. Age is the biggest single risk factor, and you cannot change that. But a substantial share of risk is influenced by things you can change - which is why researchers now talk about prevention rather than inevitability.

What the evidence genuinely supports

1. Move your body - this is the strongest lever you have

Of everything studied, regular physical activity has the most consistent evidence for protecting thinking skills. Both aerobic exercise - walking, swimming, cycling - and strength work appear to help.

The best-known trial is the Finnish FINGER study, which combined exercise, diet, cognitive training and vascular risk monitoring in people in their sixties and seventies, and found measurable benefit to thinking and memory. Note that it was the combination that worked, which is a useful clue - there is no single magic ingredient.

A practical target would be - 150 minutes of moderate activity a week, plus two sessions of strength work, plus breaking up long periods of sitting. If that sounds like a lot, start with ten minutes of walking after each meal - post-meal walks also help blood sugar control.

2. Control blood pressure, cholesterol and blood sugar

What is good for your heart is good for your head. High blood pressure in midlife is one of the most consistently identified risk factors for later cognitive decline, and the SPRINT MIND trial found that intensive blood pressure control reduced the risk of mild cognitive impairment.

If you have a monitor at home, this is a concrete reason to use it properly - our home blood pressure monitor guide covers technique and targets. If you have not had your cholesterol or blood sugar checked in a few years, book it. In 2024, untreated high LDL cholesterol was added to the list of modifiable risk factors for dementia by the Lancet Commission.

3. Get your hearing and vision checked - the most underrated step

Hearing loss is one of the largest modifiable risk factors for dementia, and it is the one people ignore for longest. The reason is probably a combination of social withdrawal, the effort of listening, and reduced stimulation - but whatever the mechanism, the association is strong and consistent.

The ACHIEVE trial, first published in 2023, found that hearing aids slowed cognitive decline in a subgroup of participants at higher risk. Whether or not you follow the trial details, the practical advice is simple: if you are turning the television up, struggling in noisy rooms, or asking people to repeat themselves, get a hearing test. Hearing aids are not a vanity item and they are not an admission of decline.

Untreated vision loss was also added to the Lancet Commission's modifiable risk factor list in 2024. If your eyesight has changed, get it checked and wear the glasses.

4. Keep challenging your mind - with genuine novelty

Mental stimulation helps, but not in the way the adverts suggest. Doing the same crossword every day makes you better at that crossword, and only modestly better at anything else. What appears to matter more is novelty and difficulty: learning something genuinely new, ideally with other people, and ideally something you are not naturally good at.

Good examples - learn a language, an instrument, take a dance class, join a choir, a camera club, start a course at your local adult education centre, or take a new route on your walk. If it feels slightly uncomfortable for the first few weeks, that is the point.

5. Stay socially connected

Social isolation and loneliness are associated with higher dementia risk, and the effect is large enough to be taken seriously. Conversation is cognitively demanding - it requires listening, memory, empathy, inhibition and quick thinking, all at once.

Practically, this means protecting your connections rather than expecting them to happen. A regular weekly arrangement, a class, volunteering, a walking group, or simply ringing one person a day. If your social life shrank after retirement or bereavement, rebuilding it is not a luxury - it is a health intervention.

6. Sleep well, and get snoring investigated

Poor sleep and untreated sleep apnoea are both linked to cognitive problems. If you snore heavily, wake unrefreshed, or your partner notices you stop breathing, speak to your GP. Treatment can make a real difference to daytime thinking, mood and energy.

General sleep hygiene helps too: a consistent wake time, daylight early in the day, less alcohol in the evening, and a cool, dark bedroom.

7. Eat a Mediterranean-style diet

Dietary evidence is harder to pin down than exercise evidence, but the pattern is consistent - diets rich in vegetables, fruit, whole grains, beans, nuts, olive oil and fish, and low in processed meat and highly processed food, are associated with better cognitive outcomes. The MIND diet - a hybrid of Mediterranean and DASH eating - has shown promising results in observational studies, with weaker evidence from trials.

There is no need for exotic ingredients. Tinned sardines, frozen spinach, lentils and porridge oats are cheap and fit the pattern perfectly.

8. Manage depression and long-term stress

Depression in later life is both a risk factor for cognitive decline and a treatable condition that can itself cause memory problems. If you have lost interest in things, sleep badly, or feel persistently flat, that deserves treatment in its own right - and treating it often improves thinking too.

What probably does not work

• Brain-training apps, on their own. You may get better at the games, but the transfer to everyday memory is generally small or nonexistent. They are fine as a hobby, poor as a prescription.
• Most supplements marketed for memory. Ginkgo, high-dose vitamin B (unless you have a diagnosed deficiency), and most omega-3 preparations have not shown convincing preventive benefit in trials.
• Coconut oil, "detox" products and alkalising diets. No credible evidence.
• Hormone replacement therapy for prevention. Not supported for cognitive protection.
• Alcohol as a protective measure. Any apparent benefit in the research has largely disappeared in better-designed studies, and heavy drinking clearly harms the brain.
• Doing nothing because "it is all genetics". Genetics matters, but it is not destiny. Lifestyle factors are estimated to account for a substantial share of dementia risk.

So how should you use puzzles?

Puzzles are enjoyable, they give a sense of progress, and they are also easy to do with other people - all of which is worth something. What they are not is a proven dementia preventative on their own.

The sensible way to use them is to choose ones that are genuinely challenging, vary them so you keep meeting new problems, and do them socially where possible. If you enjoy quizzes, crosswords, jigsaws and word games, keep going - our own memory and quiz books exist precisely because we think that kind of daily mental exercise is a pleasure worth protecting. Just do not let a puzzle book stand in for a walk, a hearing test and a blood pressure check.

A realistic week

• Every day: a 20-minute walk, ideally outdoors in daylight; one conversation with someone outside the house; 10 micrograms of vitamin D in the darker months
• Most days: a puzzle, a chapter, or 15 minutes of learning something new
• Twice a week: strength work - chair sit-to-stands, resistance bands, or a class
• Once a week: something social in the diary, ideally with a bit of learning attached
• Once a year: blood pressure and cholesterol review, eyesight check
• Once, if you have noticed any difficulty hearing: book a hearing test

When to see a doctor

Book an appointment if memory or thinking problems are affecting daily life - repeating questions, struggling with familiar tasks, getting lost on familiar routes, difficulty following a conversation, or a change in personality or judgement. Take a family member with you if you can; they often notice things you do not.

Seek urgent help for sudden confusion, or confusion alongside a fever, a fall, a new medication, or a urinary infection. Sudden changes are often caused by something treatable, and they should never be put down to "just age".

The honest bottom line

There is no supplement that competes with a brisk walk, a treated blood pressure, a hearing aid worn consistently, decent sleep and a full social diary. Those five things are boring, cheap and genuinely protective. Everything else is detail - and the earlier in later life you start, the more they are worth.

This article is for general information and is not medical advice. If you are worried about your memory or someone else's, speak to your GP. The Alzheimer's Society and Alzheimer's Research UK both offer free, reliable information and support.