Since ancient times, people have thought that getting older meant inevitable cognitive decline. Even Cicero, the Roman senator from ancient times, said “It is alleged that memory fails in old age. That it does so, I freely grant.”
But what if that’s note true? What if there are specific actions we can take in our everyday life to improve our brain health, and maintain or even sharpen our cognitive function? What if instead of aging being a downwards trajectory of decline, we could change that trajectory – to hold on to what we have, our even build a better brain?
A ground-breaking study gives those with elevated Alzheimer’s risk a new path for changing the trajectory of their brain health. The researchers reported a significant improvement in global cognition from a coached intervention, which used the BrainHQ brain training app from Posit Science (on a schedule of 45-60 minutes per week), along with guidance on physical exercise and nutrition. The results were simultaneously published in The Journal of the American Medical Association (JAMA) and announced at the Alzheimer’s Association International Conference in Toronto on July 28th, 2025.
The trial, which is the largest to date on whether lifestyle changes can help prevent Alzheimer’s disease, was funded by the Alzheimer’s Association and enrolled 2,111 older adults (aged 60-79) at elevated risk for Alzheimer’s (due to medical and family history) and randomized participants into a coached lifestyle intervention or a health education group for two years.
“This breakthrough result shows that just about anyone at risk for Alzheimer’s – and that’s most of us – can change the trajectory of their brain health for the better,” noted Dr. Henry Mahncke, CEO of Posit Science. “You can adopt a structured set of brain-healthy activities – including brain training with BrainHQ, better nutrition, and regular exercise – and substantially improve cognitive function, rather than face an inevitable future of decline.”
The study randomly assigned people at elevated risk for Alzheimer’s into one of two groups. The first group – referred to as “structured” by the researchers – received one or two monthly coaching sessions over two years, with guidance on how to use BrainHQ brain training, engage in aerobic and resistance exercise, and eat a brain-healthy diet. The second group – referred to as “unstructured” – met once every four months and received general encouragement to lead a healthier lifestyle.
The researchers found the structured group improved their cognitive function substantially over the two-year period. The unstructured group improved as well – however the improvements in the structured group were significantly larger. The structured group had gains of a half a standard deviation, which for an average performer at the 50th percentile would mean moving to nearly the 70th percentile.
This study is one of the World Wide FINGER studies, based on the 2015 FINGER Study in Finland. That first FINGER study found a lifestyle intervention – focused on brain exercise, physical fitness, diet, and monitoring risk factors (e.g., blood pressure) – improved cognitive function in older adults at risk for dementia.
This new study confirms and extends prior studies of BrainHQ.
The 2024 J-MINT PRIME Tamba study from Japan (using BrainHQ’s Japanese version) showed significant gains in cognition even among those at elevated risk of dementia. That study compared three lifestyle interventions from the J-MINT FINGER trial in Japan (diet, physical exercise, and brain exercise) against a control and found a 41% gain in a standard measure of global cognition in the BrainHQ group. Other FINGER studies underway in Latin America, Australia, Portugal, Holland, and Italy are also using BrainHQ.
In 2020, an Australian study found a lifestyle intervention of BrainHQ, physical activity, and the Mediterranean Diet, as compared to an education control, showed a significant decline in a well-regarded Alzheimer’s risk index.
That followed a 2017 report from the 2,832-person, US-based, ACTIVE Study, which looked at 10-year incidence of dementia in participants (average age 74 at study commencement), who had trained a total of just 10-18 hours on a BrainHQ exercise in the first 1-3 years of the study, as compared to two other types of brain training and to a control group. The researchers found only the BrainHQ group had a significantly lower incidence of dementia when compared to the control group – 29% lower overall and 48% lower when looking at the subgroup asked to complete 18 hours of training.
“These results have big implications for everyone with an aging brain,” commented Dr. Mahncke, “but also have big implications for policymakers. It’s time we acknowledge cognitive decline and dementia aren’t inevitable – they’re often the result of preventable chronic health conditions. If we implement the right policies at health plans and Medicare, we can encourage more brain healthy lifestyles – saving trillions of dollars and yielding a benefit beyond dollars – more brain-healthy time with loved ones.”
So, what can you do to put this new science to work on behalf of your own brain?
- Get regular physical exercise – in US POINTER, people engaged in aerobic exercise, four days a week for 35 minutes, strength training two days per week for 15-20 minutes, and flexibility training two days per week for 10-15 minutes. These three complementary forms of exercise are important for physical and brain health.
- Eat brain healthy meals and snacks – in US POINTER, people followed the principles of the MIND diet, emphasizing eating healthy greens and whole grains daily, adding fish to their diets weekly, and snacking on healthier foods, such as nuts and berries.
- Train your brain with BrainHQ – in US POINTER, people trained with BrainHQ, an online brain training program with over a dozen different brain training exercises, at least three times weekly, for 15-20 minutes per session.
And get some help sticking to your brain health resolutions! In US POINTER, people met with a coach at least monthly to help them set achievable goals and stay motivated to improve their brain health. Your local gym might have personal trainer sessions available who can help with physical exercise and nutrition advice, and BrainHQ has a customer delight team and brain health coaches who can help you get started with brain training.
This study will surprise a lot of people and change a lot of minds. But perhaps we should have known this was possible. What Cicero, the Roman senator, said next was that brain decline occurs “principally, where it has not been properly exercised, or with those who naturally have no strength of brain”— noting that those who exercise their brains “will pretty well retain it.”
Two thousand years ago, in ancient Rome, Cicero proposed there were ways to stay sharp as we age. This study has now illuminated the path about how to do it.
