Your Brain Is Begging for These Three Things: A Neuropsychologist's Prescription for Cognitive Resilience

When Dr. Janina Kamm, a clinical neuropsychologist and assistant professor at The Chicago School, was asked what she wishes everyone would do to protect their brain health, she did not recommend expensive supplements, brain-training apps, or exotic biohacks. Instead, she pointed to three deceptively simple habits: regular physical exercise, consistent quality sleep, and meaningful social connection [1].

Her advice arrives at a moment of mounting urgency. An estimated 7.2 million Americans aged 65 and older are now living with Alzheimer's disease — a figure that crossed the seven-million threshold for the first time in 2025 [2]. Globally, dementia cases are projected to nearly triple from 57.4 million in 2019 to 152.8 million by 2050 [3]. The economic toll is already staggering, with U.S. health and long-term care costs for dementia projected at $384 billion in 2025, on a trajectory to approach $1 trillion by mid-century [2].

Yet the science increasingly suggests that a significant share of this suffering is not inevitable. The 2024 Lancet Commission on dementia prevention identified 14 modifiable risk factors — including physical inactivity, sleep problems, and social isolation — that collectively account for approximately 45% of all dementia cases worldwide [4]. The three pillars Dr. Kamm highlights sit squarely at the center of that evidence base.

The Science of Neuroplasticity: Why These Three Matter

The unifying concept behind Dr. Kamm's recommendations is neuroplasticity — the brain's ability to form new neural connections, reorganize existing pathways, and adapt its structure and function throughout life [1]. Once thought to be largely fixed after adolescence, the brain is now understood to remain remarkably malleable well into old age.

"It can change throughout your life," Dr. Kamm told Fit&Well, emphasizing that neuroplasticity is not just relevant for recovering from injury but is fundamental to everyday learning, emotional regulation, and cognitive resilience [1].

Research from Harvard Health confirms this view: even at age 60 and beyond, the brain retains a remarkable capacity to reorganize neural circuits and adapt to new experiences [5]. The key question is not whether the aging brain can change, but whether we are giving it what it needs to do so.

Dr. Kamm's three recommendations target distinct but interconnected biological systems that collectively determine how plastic — how adaptable and resilient — your brain remains as you age.

Pillar One: Move Your Body

Dr. Kamm recommends moderate-intensity exercise for 30 minutes, five times per week. She suggests activities like brisk walking, light cycling, swimming at a comfortable pace, and dancing — forms of movement that are accessible to most people regardless of fitness level [1].

The evidence supporting exercise as a brain-health intervention is extensive and growing. A 2025 study from Wake Forest Baptist Medical Center found that even light exercise could help slow cognitive decline in people at risk of Alzheimer's disease [6]. A comprehensive meta-analysis published in PMC found that exercise interventions led to measurable improvements in cognitive function and quality of life among Alzheimer's patients, underpinned by "physiological, neuroimmune, and psychosocial mechanisms" [7].

The biological pathways are increasingly well understood. Aerobic exercise triggers the release of brain-derived neurotrophic factor (BDNF), a protein critical for the growth and maintenance of neurons. It increases blood flow to the hippocampus — the brain's memory center — and reduces inflammation, a key driver of neurodegeneration [5]. The U.S. Department of Health and Human Services recommends at least 150 minutes of aerobic exercise per week, a target that aligns precisely with Dr. Kamm's prescription [5].

Yet one in four American adults remain physically inactive, according to CDC data from 2017–2020 [8]. The consequences extend far beyond the brain: the CDC has attributed 8.3% of deaths among nondisabled adults aged 25 and older to physical inactivity, and the economic burden of insufficient activity amounts to an estimated $117 billion annually in healthcare costs [8].

Source: GDELT Project

Data as of Mar 10, 2026CSV

The inactivity problem worsens with age — precisely when the brain is most vulnerable. Physical inactivity prevalence rises from 25.4% among adults aged 50–64 to 35.3% among those 75 and older [8]. For brain health, this represents a critical failure: the period when exercise-driven neuroplasticity could be most protective is exactly when people are least likely to be active.

Pillar Two: Protect Your Sleep

Dr. Kamm's second recommendation focuses on sleep, and her reasoning highlights a system most people have never heard of: the glymphatic system. During sleep, particularly during slow-wave (deep) sleep, the brain's interstitial spaces expand by up to 60%, allowing cerebrospinal fluid to flush out metabolic waste products — including beta-amyloid and tau proteins, the toxic plaques associated with Alzheimer's disease [9].

"The brain consolidates new learning and has a glymphatic system working to remove metabolic waste during sleep," Dr. Kamm explained, warning that "chronic sleep deprivation impairs the brain's ability to form and stabilize new connections from learning" [1].

The research underscores how devastating poor sleep can be for the brain. An NIH study using positron emission tomography found that a single night of sleep deprivation led to approximately 5% more amyloid beta accumulation in participants' brains [9]. The glymphatic system's waste-clearance function slows by up to 90% during sleep deprivation [9]. Brain-derived neurotrophic factor (BDNF) levels — the same growth factor boosted by exercise — drop by 30% when sleep is compromised, undermining the neuronal circuit strengthening that occurs during REM sleep [10].

The long-term implications are sobering. Research has linked mid-life sleep disruption to cognitive decline later in life, and prolonged deprivation has been associated with 10–15% prefrontal cortex atrophy over months, resembling patterns seen in mild cognitive impairment [10].

Despite this evidence, more than 35% of American adults consistently get less than seven hours of sleep per night — a figure that has remained stubbornly unchanged from 2013 to 2022 [11]. Adults aged 45 to 64, a critical window for brain-health intervention, have a 39% rate of insufficient sleep [11].

Pillar Three: Stay Socially Connected

Dr. Kamm's third recommendation may be the most surprising to those expecting a tip about crossword puzzles or brain-training software: maintain regular social connections. Social interaction, she explains, engages multiple brain systems simultaneously — language processing, emotional regulation, memory retrieval, and attention — making it one of the most comprehensive cognitive workouts available [1].

The epidemiological evidence is compelling. A 2025 longitudinal study drawing on harmonized data from five major aging studies across 24 countries and 101,581 participants found a clear association between social isolation and accelerated cognitive decline [12]. A study published in the journal Neurology found that loneliness was associated with a 10-year increase in dementia risk, with socially isolated individuals showing measurable differences in early neurocognitive markers [13].

A 2025 meta-analysis published in Nature examining 126 studies and more than 1.25 million older adults found that the global prevalence of loneliness among older adults is 27.6% — meaning more than one in four older people worldwide are experiencing a condition now recognized as a significant risk factor for cognitive decline [14]. Persistent loneliness, particularly among women aged 70 and older, was associated with higher rates of both dementia and cognitive decline [15].

The mechanisms go beyond cognitive stimulation. Social isolation triggers changes in cortisol secretion and has been associated with alterations in brain volume, including reduced white and grey matter and hippocampal changes [12]. A 2025 study examining dementia patients found that lonely patients scored 0.83 points lower on cognitive assessments at diagnosis, while socially isolated patients experienced a 0.21-point-per-year faster rate of cognitive decline [16].

Source: The Lancet Public Health / Global Burden of Disease Study 2019

Data as of Mar 10, 2026CSV

Beyond the Big Three: The Broader Prevention Landscape

While Dr. Kamm's three pillars form a powerful foundation, they exist within a broader context of modifiable risk factors. The 2024 Lancet Commission report, the most comprehensive analysis of dementia prevention to date, expanded its list of modifiable risk factors from 12 to 14, adding untreated vision loss and high LDL cholesterol to the existing catalogue that includes low education, hearing loss, hypertension, smoking, obesity, depression, diabetes, excessive alcohol consumption, traumatic brain injury, air pollution, and social isolation [4].

The Commission's central finding — that 45% of dementia cases are theoretically preventable — represents an enormous opportunity [4]. But it also raises uncomfortable questions about why prevention receives so little investment compared to pharmaceutical interventions.

Recent research has also expanded the toolkit. A landmark February 2026 study, funded by the National Institutes of Health and tracked over two decades, found that eight to ten sessions of cognitive speed training, combined with booster sessions, reduced dementia risk by approximately 25% [17]. The study, which followed 2,802 participants, is the first randomized clinical trial to track dementia outcomes over 20 years [18]. The key was that the training was adaptive — adjusting difficulty based on individual performance — suggesting that not all mental exercise is created equal.

The Investment Gap

The United States spends more per capita on healthcare than any other developed nation — $12,586 per person in 2022, roughly double what the United Kingdom, France, or Japan spends [19]. Yet much of this spending goes toward treating diseases after they develop, not preventing them.

Source: World Bank

Data as of Feb 24, 2026CSV

For brain health specifically, the disparity between the cost of prevention and the cost of treatment is stark. The total lifetime cost of care for a single person with dementia is estimated at $405,262 [2]. Nearly 12 million Americans currently provide unpaid care for people with Alzheimer's or other dementias, contributing more than 19 billion hours of care annually — valued at over $413 billion [2].

By contrast, Dr. Kamm's three recommendations cost little to nothing. A daily 30-minute walk, consistent sleep hygiene, and regular social engagement require no prescription, no insurance coverage, and no specialized equipment. The barrier is not access but awareness and habit formation.

What Comes Next

The convergence of neuroscience research, epidemiological data, and clinical practice is painting an increasingly clear picture: the brain is not a passive organ that inevitably deteriorates with age. It is a dynamic, adaptable system that responds to how it is treated.

Dr. Kamm's advice is notable not for its novelty but for its specificity and its grounding in the concept of neuroplasticity. "A brain that stays plastic is more resilient," she has said, noting that maintaining neuroplasticity "promotes emotional flexibility" and makes people "better able to manage stress and quicker to acquire new skills" [1].

With global dementia cases on track to triple by 2050 and costs already in the hundreds of billions, the stakes of ignoring this evidence grow by the year. The three pillars — move, sleep, connect — are not a guarantee against cognitive decline. But the weight of science suggests they are the closest thing to one that currently exists.

The question is not whether these interventions work. It is whether enough people will adopt them before the dementia wave arrives.