Just as challenging the body with weight-bearing exercise makes bones stronger and helps to slow bone loss with aging, challenging the brain with cognitive exercise can make it more resilient and help delay the onset of Alzheimer’s.

But how much of an effect does it have? How many extra healthy cognitive years will it give us? And is it too late to start if we’re already in our senior years?

Professor Robert Wilson decided to find out…

Those who’ve had a good education have every reason to believe the accumulated knowledge it furnishes them with, called cognitive reserve, will provide a buffer against cognitive decline and dementia.

Research shows people with high levels of disease markers, such as amyloid plaques and tau tangles, who have more years of education don’t decline as rapidly as people with the same indications of brain disease who have lower levels of education.

At least that’s what the numbers seemed to show. Then along came a study led by Professor Wilson, a neuropsychologist with the Rush Alzheimer’s Disease Center in Chicago, which turned the tables on this belief.

Early Education Has No Role in Alzheimer’s Prevention 

His study, published in the journal Neurology in 2019, suggested education doesn’t play a role in determining the age at which Alzheimer’s disease starts or how fast it progresses.

“This finding that education apparently contributes little to cognitive reserve is surprising, given that education affects cognitive growth and changes in brain structure,” explains Prof. Wilson.

“But formal education typically ends decades before old age begins, so late-life activities involving thinking and memory skills such as learning another language or other experiences such as social activities, cognitively demanding work and having a purpose in life may also play a role in cognitive reserve that may be more important than remote experiences such as schooling.”

Since education didn’t help protect the brain against Alzheimer’s disease, Prof. Wilson wanted to find out if other cognitive activities would, and if so, how many years they can stave off dementia.

You Can Delay Dementia by Five Years 

For his latest study, published in the journal Neurology in July, he and his research group examined data on 1,903 cognitively healthy people with an average age of 79.

Prof. Wilson’s team gave these participants annual examinations, which included a number of cognitive tests. In addition, they questioned the participants regarding their engagement in a variety of brain-challenging activities that included reading books, playing cards or board games, solving puzzles, as well as cognitive activities in childhood, adulthood and middle age.

Participants also agreed to a brain autopsy if they died during the study period.

After seven years, 457 participants developed Alzheimer’s and 695 died. After adjusting for other factors that affect dementia risk, Professor Wilson and his team found that those participants who engaged in cognitive activities just a few times a year in old age developed the condition at the age of 89 on average.

But for those who engaged in these activities several times a week in old age, the onset of Alzheimer’s was delayed five years— to age 94.

The pathology findings showed no link between how active the participants were cognitively and markers of Alzheimer’s disease and related brain disorders.

Brain Responds Even in Your 80s 

“It is important to note, after we accounted for late life level of cognitive activity, neither education nor early life cognitive activity were associated with the age at which a person developed Alzheimer’s dementia,” said Prof. Wilson.

This supports the finding of his earlier study.

“Our research suggests,” he added, “that the link between cognitive activity and the age at which a person developed dementia is mainly driven by the activities you do later in life.

“[So] the good news is that it’s never too late to start doing the kinds of inexpensive, accessible activities we looked at in our study. Our findings suggest it may be beneficial to start doing these things, even in your 80s, to delay the onset of Alzheimer’s dementia.”

I confess I’m surprised by Prof. Wilson’s findings, since there is quite a bit of statistical evidence based on large populations to show that higher education levels are associated with lower rates of dementia. I don’t know how he reconciles his results with these stats.

It seems likely to me that educated people are more likely to engage in mentally challenging activities throughout their lives, and it may indeed be the case that it’s the lifelong aspect, not the “brain workouts” during their youth, that helps shield them from dementia. It also seems likely that more educated people enjoy higher incomes and better medical care.

As always, life is complicated and many factors affect the way we age. It’s hard to tease out just one variable and isolate it from the big picture. Anyway, I’m a firm believer in challenging yourself mentally, and these findings support that view no matter how you interpret them.


  1. https://www.rushu.rush.edu/news/education-may-not-protect-against-dementia-previously-thought
  2. https://www.aan.com/PressRoom/Home/PressRelease/4909 

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