Practical Approaches to Lifestyle Interventions for Enhancing Brain Health in Older Adults

This review focuses on ways that clinicians can work with middle-aged and older adults to help them develop brain healthy lifestyles. We emphasize the importance of being proactive in working to reduce middle-aged and older adults’ risks for cognitive decline and dementia. We discuss practical strategies that clinicians can employ in everyday practice, including shared decision-making, psychoeducation, and support for patients’ efforts at behavior change.We begin the discussion by emphasizing the importance of brain health as people age, even when they are typically considered middle-aged. The review continues with a review of three key techniques which, when integrated into clinical practice, may be effective in supporting patients’ efforts at developing brain healthy lifestyles. Shared decision-making is a strategy to work with patients to provide them with the best possible information about their brain health while at the same time taking into consideration their preferences and individual situations. Psychoeducation can be used effectively to help patients learn about activities that can reduce their risk for cognitive decline and dementia. In the section on psychoeducation, a conceptual framework for understanding brain health activity mechanisms is proposed to help organize information given to patients. The last key element of the suggested intervention is an active approach to behavior change strategies, overlapping with psychoeducation but going further with ongoing follow-up about goals, self-monitoring, and problem solving about barriers to change and behavior maintenance.A final section provides a preliminary path diagram that presents hypothesized mechanisms by which an intervention based on the model might be evaluated. It helps integrate the various elements of the model while highlighting potential moderators of intervention effect in implementation. In this integration of these three approaches, this review presents a practical framework for healthcare professionals, caregivers, and middle-aged and older adults to support brain healthy lifestyles.