Most patients with early Alzheimer’s disease not following guidelines for brain health

Researchers at the Mass General Brigham Neuroscience Institute found that most patients with early Alzheimer’s disease are not optimally adhering to recommendations for improving their brain health, including exercising, getting adequate sleep, preventing hypertension, and eating a heart-healthy diet. Results, published in The Journal of Prevention of Alzheimer’s Disease, show that fewer than 3% of the studied patients followed all 15 brain health recommendations the researchers examined. Both patients with early Alzheimer’s disease who pursued treatment with lecanemab, an anti-amyloid antibody medication for Alzheimer’s disease, and patients who did not pursue anti-amyloid therapy, had poor adherence to brain health recommendations, with no significant difference between those groups.

“Because patients pursuing anti-amyloid therapy were willing to receive lecanemab infusions every two weeks and tolerate the risks associated with this medication, we thought this highly motivated group might be pursuing every avenue available to protect their brain health,” said Kirk Daffner, MD, lead author of the study and a neurologist at the Mass General Brigham Neuroscience Institute. “The results show there is much more work to be done.”

Growing evidence links adequate physical activity, a healthy diet, sufficient sleep, social and cognitive engagement, controlled blood pressure and blood sugar, good vision and hearing, and low levels of alcohol consumption with a lower risk of cognitive decline and dementia. Brain Health Vital Signs, developed by Daffner, Seth Gale, MD, and colleagues, assesses 15 of these potentially modifiable factors to provide an overall brain health “score” and recommendations for improvement.

The researchers studied 150 patients with mild cognitive impairment or mild dementia due to Alzheimer’s disease who were seeking anti-amyloid antibody therapy and compared them with 117 patients with mild cognitive impairment or mild dementia who were not pursuing the therapy.

Among patients pursuing anti-amyloid therapy, more than 25% were not optimally adhering to 11 of the 15 studied brain health recommendations and more than 50% were not optimally adhering to four of the recommendations. Similar low adherence rates were observed in patients with early Alzheimer’s disease who did not pursue anti-amyloid therapy.

Patients most commonly fell short of the recommendation to get at least 25 minutes of physical activity per day on most days of the week (63% of patients pursuing anti-amyloid therapy did not meet this recommendation). Other especially challenging guidelines to meet included reducing stress and achieving low A1c levels, blood pressure and body mass index.

“There is a fairly robust, accepted evidence base that a certain set of behaviors and medical factors support brain health, but effective implementation in clinical care is still mostly missing,” said Seth Gale, MD, senior author and neurologist at the Mass General Brigham Neuroscience Institute. “While tools such as Brain Health Vital Signs can help patients and their providers better understand what they are doing well and where they can improve, it’s clear that structured, sustainable interventions are also necessary.”

The ongoing Brain Health Champion Study, led by Gale, Daffner and colleagues, with results from its first cohort of patients published in 2019, found that those who received six months of individualized brain health coaching markedly improved their adherence to recommended brain health behaviors. Daffner and Gale say that offering more effective tools to providers and their teams, grounded in health psychology-based techniques, may best help support behavior change in patients.

Nutrition strategies for concussion management

 Nutrition strategies for concussion management are being implemented by dietitians to support Australia’s elite collision sport athletes, new Griffith University research has found.

Lead author Dr Nathan Delang interviewed 14 Accredited Sports Dietitians who work across professional AFL, Rugby League, and Rugby Union teams to explore their practices and perspectives relating to concussion management.

“Concussion is so common in contemporary professional collision sports, typically once every three games, so it’s important to ensure optimal support is provided for athletes,” Dr Delang said.

“Most sports dietitians provided nutrition support either before and/or after concussion, with fish oil and creatine monohydrate the most commonly recommended supplements.

“Fish oil and creatine might support concussion recovery through several mechanisms from mitigating excessive neuroinflammation through to enhancing the availability of energy for supporting brain recovery and returning to exercise.

“All dietitians reported a food-first approach as central to recovery with a focus on energy intake, hydration, and healthy eating patterns to help athletes maintain their pre-injury nutrition status.”

Alongside fish oil and creatine, other supplements in use by professional teams included vitamin B2, tart cherry extract, curcumin, and vitamin D.

Professor Ben Desbrow from Griffith’s School of Allied Health, Sport and Social Work said while Australians sports dietitians were already using nutrition as part of concussion care, the practice was advancing faster than the evidence base.

“Practitioners are confident with familiar products, such as creatine, which are often already in use as a physical performance aid,” he said.

“However, they want stronger evidence so they can confidently tailor nutrition advice for complex concussion cases.

“We need stronger clinical research and formal guidelines to support safe, consistent and equitable care for athletes.”

The paper ‘Concussion and nutrition in professional-level collision sports: Perspectives from Australian Sports Dietitians’ has been published in The Journal of Nutrition.

Avoiding 3 risk factors associated with living 13 more years without dementia

 Highlights:

• Having normal blood pressure, no diabetes and not smoking was associated with living nearly 13 years longer without dementia.

• The study does not prove that avoiding these vascular risk factors causes the delay in dementia; it only shows an association.
• A limitation of the study was that the assessment of risk factors happened once, so it focused on long-term outcomes after one assessment, not changes in risk factors over time.

Having normal blood pressure, no diabetes and not smoking was associated with living nearly 13 years longer without dementia, according to a study published August 5, 2026, in Neurology® Open Access, an official journal of the American Academy of Neurology.

The study does not prove that avoiding these vascular risk factors causes the delay in dementia; it only shows an association.

“Our findings support prevention of risk factors developing in midlife as a strategy for delaying the onset of dementia and maintaining brain health,” said study author Josef Coresh, MD, PhD, of NYU Grossman School of Medicine in New York. “Finding ways to prevent or delay dementia is crucial as the population ages as treatments remain limited.”

The study involved 12,409 people with an average age of 56 who were free of dementia. People were assessed for three risk factors for dementia: high blood pressure, diabetes and smoking. High blood pressure was defined as blood pressure higher than 140/90 mmHg or the use of medication to lower blood pressure.

The participants were followed for an average of 26 years. During that time, 3,008 developed dementia and 5,238 people died without developing dementia.  

People who had none of the risk factors lived without developing dementia nearly 13 years longer than people with all three of the risk factors. People with no risk factors lived for an average of 30.1 years after the start of the study without dementia. People with all three risk factors lived for an average of 17.5 years without developing dementia.

Female participants lived longer than male participants without developing dementia, regardless of how many risk factors they had. Female participants with all three risk factors lived an average of 18.1 years without developing dementia, compared to 16.6 years for male participants.

Coresh noted, “Women more often reach older ages and therefore experience many cases of late-onset dementia.”

White participants lived longer than Black participants without developing dementia, no matter how many risk factors they had. White participants with all three risk factors lived an average of 19.6 years without developing dementia, compared to 16.0 years for Black participants.

“People with all three risk factors were more likely to develop dementia or die at earlier ages from other causes, leading to shorter overall survival and fewer years with their thinking and memory abilities intact,” Coresh said. “Hopefully these results will help encourage people to stop smoking, manage their blood sugar and manage their blood pressure in midlife. Of course, other healthy habits such as eating better and being more active are also important.”

A limitation of the study was that the assessment of risk factors happened once, so it focused on long-term outcomes after one assessment, not changes over time.

One month on a vegan diet reduced aging and inflammation

 

Genome-wide analysis found a vegan diet reshaped the DNA methylation landscape associated with immune cell composition and health-related measures of biological aging.

Researchers from University of California San Diego and University of Freiburg in Germany have found that switching to a vegan diet for just one month can alter the body’s epigenetic landscape in ways associated with reduced inflammation and biological aging. In a randomized clinical trial, participants assigned to a vegan diet vs. a meat-rich diet showed changes in DNA methylation — a biological process that regulates whether genes are more or less active — that were linked to immune function, metabolism and cancer-related pathways. The findings, published on August 3, 2026 in MedComm, suggest dietary choices can rapidly influence molecular processes associated with long-term health.

“Our genes are not our destiny,” said Jerome Mertens, PhD, associate professor of neurosciences at UC San Diego School of Medicine and co-senior author of the study. “The remarkable finding isn’t simply that one diet outperformed another. It’s that the epigenome responded measurably in just four weeks, showing that our biology is far more dynamic — and responsive to everyday choices — than we often assume.”

Diet has long been linked to the risk of chronic diseases such as cardiovascular disease, diabetes and certain cancers. Yet scientists have only begun to understand how food influences the epigenome — the layer of chemical modifications that helps determine which genes are turned on or off without changing the underlying DNA sequence.

To explore these effects, researchers analyzed genome-wide DNA methylation patterns in blood samples from 48 healthy adults who participated in a randomized dietary intervention. After following the same standardized diet for one week, participants were randomly assigned to either a vegan diet or a meat-rich diet for one month. Both diets were designed to provide similar calorie intake, allowing researchers to isolate the effects of diet composition rather than weight loss.

The team examined more than 800,000 methylation sites across the genome before and after the intervention. Rather than looking for changes in individual genes alone, the researchers focused on broader biological patterns that changed in response to diet.

The researchers also found evidence that the vegan diet shifted the immune system toward a less inflammatory state. DNA methylation analyses predicted lower proportions of neutrophils — immune cells that drive inflammation — and higher proportions of CD4 T cells, which help regulate immune responses. Those predictions closely matched blood cell measurements collected during the original clinical trial.

“That agreement told us we weren’t just seeing changes on a computer screen — we were detecting real and meaningful biological changes,” said Lukas Karbacher, UC San Diego School of Medicine neuroscience graduate student and first author of the study.

The findings build on earlier evidence that plant-based diets can influence immune function while providing additional insight into the molecular changes that accompany those effects.

In addition to immune signals, the researchers found that the vegan diet was associated with increased promoter methylation in genes involved in several cancer-related and cell growth pathways. Increased promoter methylation can reduce the activity of genes within these pathways, suggesting the diet may influence cellular processes involved in growth and proliferation. The researchers also observed changes consistent with reduced activity in lipid metabolism pathways and increased activity in pathways related to insulin signaling, DNA repair and cellular stress responses.

Perhaps the most striking finding concerned biological aging itself. For this, the researchers examined biological age using epigenetic clocks — a mathematical biomarker that estimates a person’s biological age based on DNA methylation patterns rather than years lived. Two clocks designed to predict health outcomes suggested participants following the vegan diet experienced a deceleration in biological aging over the one-month study period. A third clock, optimized to predict chronological age rather than health outcomes, showed a different pattern, highlighting that epigenetic clocks measure different aspects of aging.

“These findings reinforce the idea that not all measures of biological aging capture the same biology,” said Mertens. “The clocks associated with disease risk and overall health consistently pointed in the same direction, suggesting the dietary changes were influencing pathways tied to health rather than simply the passage of time.”

The researchers caution that the study was relatively small, involving 48 healthy adults, and lasted only one month. Because the observed DNA methylation changes were modest and spread across hundreds of thousands of sites in the genome, larger and longer studies will be needed to confirm the findings and determine whether the molecular changes translate into measurable reductions in disease risk.

While the findings do not demonstrate that a vegan diet prevents cancer or reverses aging, they provide new insight into how dietary choices may rapidly influence the biological processes that underlie inflammation and age-related disease.

“Our study adds to growing evidence that nutrition can shape biology at the molecular level,” said Max Storz, MD, from University of Freiburg Medical Center and co-senior author of the study. “The next step is to understand whether these epigenetic changes persist over time and whether they translate into meaningful improvements in long-term health. That will require larger clinical studies, but these findings provide an important foundation.” Storz also stressed that the findings are not the result of reduced calories, but rather a matter of diet composition.

Link to the full study: [A vegan diet epigenetically modulates inflammatory pathways and biological aging: Genome-wide DNA methylation analysis of a one-month isocaloric vegan versus meat-rich dietary intervention]

Pet dog microbiota may protect young children from respiratory tract infections

 Children who have been in contact with dogs in early childhood are on average healthier and require fewer antibiotic courses than children without such contact. The protective association is explained, at least in part, by the spread of dog-associated microbes in the home.

In the recent study, the presence of specific dog-associated microbes in the home were linked to fewer respiratory tract infections, fewer antibiotic courses and more healthy weeks during the child’s first year of life. The richness and diversity are higher in homes with a dog than in homes without a dog, but these general characteristics of the microbiota were not associated with the incidence of respiratory tract infections or morbidity in the child.

The study shows that certain dog-associated microbes or their combinations can explain up to one quarter of the protective effect of dog ownership on children’s respiratory tract infections, antibiotic use and the number of healthy weeks during the first year of life.

The protective effect of a dog ownership remained also after accounting for other factors known to influence childhood infection risk, including family size, living environment and exposure to tobacco smoke. In addition to the dog’s microbiota, a more outdoor-oriented lifestyle in dog-owning families, shared responsibilities related to caring for the dog and partly similar dietary habits shared among dog owners may influence the microbiota in the home and among its inhabitants, and thereby the development of the child’s resistance to pathogens. These factors were not examined in this study.

“The results strengthen our understanding that the microbial environment during early childhood plays an important role in the development of child’s immune system. It has been suggested that in the future it may be possible to modify the home microbiota in ways that promote health. Our study shows that dog ownership already does this today,” says paediatrician Jenni Mäki.

“Respiratory tract infections in early childhood are a significant risk factor for asthma. When some of children’s respiratory tract infections can be prevented with dog-associated microbes, this may also reduce the child’s risk of developing asthma later in life,” says chief researcher Anne Karvonen.

High intensity exercise key to maintaining healthy bones

 When it comes to maintaining healthy bones, how intensely we exercise may matter more than how much we exercise, according to researchers at Semmelweis University. Their study, published in Sports Medicine – Open, found that bone formation was stimulated most effectively by activities involving explosive movements, rapid changes of direction, and turning. The findings could help improve exercise programs designed to maintain bone health and prevent osteoporosis. 

Researchers at Semmelweis University analyzed the results of 24 clinical studies involving a total of 1,238 healthy adult participants. Rather than tracking changes in bone mineral density, the studies measured substances in the blood that indicate whether the body is actively building new bone tissue. These so-called biomarkers can reflect the effects of exercise within just a few weeks, providing feedback much earlier than bone density measurements.  

“What makes our study unique is that we examined not only the type of exercise – whether endurance, resistance, or combined training – but also exercise intensity, frequency, and duration. Our goal was to determine which forms of exercise stimulate bone metabolism most effectively and which appear to be less beneficial from this perspective,” said dr. Péter Ferdinandy, Vice-Rector for Science and Innovations at Semmelweis University and senior author of the study. 

The most effective activities were high-intensity sports involving frequent explosive movements, rapid changes of direction, and turning. Recreational football and handball, for example, were associated with increases of up to 45–46 percent in the levels of substances linked to bone formation. In contrast, walking, step aerobics, and traditional gym-based resistance exercises were generally less effective.  

What should you keep in mind?
It is important not to start a high-intensity exercise program suddenly or without proper preparation. This is particularly true for people with cardiovascular, musculoskeletal, or metabolic diseases, as well as those living with osteoporosis. Before beginning a new type of exercise or a more demanding training program, they should consult their treating physician, general practitioner, or a sports medicine specialist to ensure that the activity and its intensity are appropriate for their individual health status.

“The most surprising finding was that resistance training did not produce a significant effect on markers of bone metabolism, even though several professional guidelines recommend this type of exercise for maintaining bone health. Likewise, low- or moderate-intensity endurance exercise, such as walking or jogging, showed no meaningful long-term effect,” explained Viktória Barna, PhD student at Semmelweis University and first author of the study.

This, of course, does not mean that walking or lower-intensity physical activity is without health benefits. However, if the goal is to keep bones strong and healthy for as long as possible, they appear to require a greater mechanical stimulus. 

“According to the World Health Organization, regular physical activity offers numerous health benefits. However, our findings suggest that low-intensity exercise alone is not sufficient to stimulate bone metabolism. High-intensity exercise may trigger early beneficial changes in bone formation, potentially helping to slow bone loss and support healthy ageing,” summarized dr. Nóra Sydó, clinical specialist and co-author of the study. 

The health stakes of feeling connected

 Calling a friend after a long day. Showing up to a neighbor's dinner when you'd rather stay home. Lingering a little longer in a conversation that didn't need to last. Such ordinary, even trivial, moments. But to psychologist Susan Charles, Associate Dean of Graduate Programs in the School of Social Ecology, they may be among the most consequential health decisions a person makes.

Charles has been awarded a $2,550,958 grant from the National Institute on Aging to investigate how the daily rhythms of feeling socially connected, or disconnected, shape the way our bodies and minds hold up over time.

Her project, “Linking Daily Dynamics of Social Connection to Physical and Cognitive Functioning,” could fundamentally change how doctors, therapists and public health officials approach loneliness and social isolation.

The health stakes of feeling connected

Most people intuitively understand that having close relationships is good for them. Decades of research confirmed it. But, Charles argues that science has been limited by looking at social connection in only one way — as a fixed trait, a general level of sociability that a person either has or doesn't have.

“Our understanding of social connection and its strong association with health is based largely on studies assessing social experiences using static, trait-like measures of general levels of thoughts and activities,” Charles notes. “Yet, feeling socially connected varies from day to day, fluctuating as much as other commonly recognized daily emotional experiences.”

In other words, the same person who feels warmly surrounded by community on Tuesday might feel profoundly alone by Thursday.

Charles believes such fluctuations may hold the key to understanding how social life gets under our skin, quite literally.

She draws a vivid picture of what this might look like in an ordinary life.

“Daily decisions to call a friend, or to go to a social function even though you are tired from a long day at work may not seem like health decisions,” Charles says, “but these times of social connection influence well-being.”

The effects, she explains, are both immediate and cumulative. A shared laugh can ease distress and trigger feelings of safety and contentment. Showing up for a regular dinner with a neighbor means you leave your house, stay physically active and engage in the kind of conversation that demands mental effort — tracking information, forming arguments, retrieving memories. Over time, those moments compound.

“Consistent positive social connection enhance health, affecting myriad health outcomes from physical symptoms to gene expression,” Charles adds.

Small daily changes, she points out, have the potential to create a “ripple effect” that contributes to longer-term outcomes — for better or for worse.

To test these ideas, Charles is turning to one of the most extraordinary longitudinal datasets in social science: the Midlife in the United States study, known as MIDUS.
The project draws on two longitudinal daily diary datasets spanning nearly 20 years. In one dataset, participants completed nightly phone interviews every day for a week, across three separate waves in 2002, 2014, and 2023. A second dataset captures two waves of daily diary data spanning about a decade, with waves beginning in 2012 and 2023.

Altogether, the study follows more than 2,900 adults ranging in age from 24 to 97.

In addition to the daily diary interviews, participants completed extensive surveys, underwent cognitive assessments and some even flew to a medical facility where they provided blood and urine samples, completed physical fitness tasks and submitted to a battery of biomarker testing.

“Any single facet of this study is interesting to study,” Charles says, “but together we have an unprecedented view into how their daily lives unfold and are related to multiple measures of cognitive, physical and mental health.”

Charles will delve deep in her search for evidence of social connection’s effects.

The professor and her research team plan to examine cortisol, often called the “stress hormone,” with chronically high levels linked to cognitive decline and poor physical health.

Charles also will analyze inflammatory markers, gene expression profiles, and even biomarkers of biological age acceleration — measures of how fast a person’s cells are aging relative to their chronological age.

The biological story she hopes to tell connects the social world to a phenomenon scientists call “inflammaging,” the age-related increase in chronic low-grade inflammation now understood to play a central role in multiple health conditions, including cardiovascular disease, diabetes, certain forms of dementia and arthritis.

“We will examine biomarkers that have been related to poorer health — chronically high inflammation, high levels of cortisol, and gene expression related to inflammation and viral load — and see how these biomarkers are related to the levels and consistency of daily social connection,” Charles explains.

If daily patterns of feeling connected, or disconnected, can be shown to move those biological needles, the implications for preventive medicine could be substantial.

Why age changes everything

The study’s age range: from young adults in their mid-20s to nonagenarians. Charles is particularly interested in how the relationship between social connection and health shifts as the body grows more vulnerable.

“We know from nearly 100 years of research that social connections are vitally important for people of all ages,” she says. “In this study, we are particularly interested in how patterns of social connection change over time in later life, and how social connections may vary in their relationship with health among people with less robust physical systems.”

As chronic illness and functional disability become more prevalent with age, she argues, the stakes of social isolation grow higher — and so does the potential benefit of meaningful daily connection.

The United States Surgeon General has called loneliness and social isolation a public health epidemic, and the COVID-19 pandemic accelerated trends toward isolation that were already underway.

Against that backdrop, Charles sees her study as doing something more than documenting a problem. She wants to change the conversation around it.

“Our research reframes a message from warning people about the risks of social isolation to acknowledging the power of positive social connections,” she says. “We will be examining different contexts to reveal when and under what circumstances social connections increase our health.”

Her goal is simple but potentially transformative: to make social connection a recognized daily health behavior, as concrete and actionable as exercise or diet.

“Social connection should be listed as a daily health behavior for everyone,” Charles says. “Every finding that links social connection to better physical and cognitive functioning will reinforce and strengthen this message, as well as identify those most at risk for both social isolation and for the health risk of lack of social connection.”