You can improve brain health even in your 90s, study finds

For decades, it was a given that cognitive decline would happen with growing age. A new study published in Scientific Reports suggests that this assumption might need to be rethought.

Researchers at the Centre for Brain Health at the University of Texas at Dallas tracked 3,966 adults between the ages of 19 and 94 over three years. What they found flipped a widely held view about brain health, measured across thinking ability, emotional stability, and social connectedness, which kept improving across the entire study period, including among participants in their eighties and nineties.

The study, titled "Measuring and Increasing the Brain Health Span across Adulthood: A Public Health Imperative," was published in Scientific Reports, a Nature journal. The study worked on data from the Brain Health Project, an online initiative launched by the centre in 2020.

What the study measured

Participants used an online platform that offered brief training sessions, some as short as five minutes. Their progress was tracked using a tool called the Brain Health Index (BHI), which measures three dimensions: Connectedness, which looks at a person's sense of social and purposeful engagement; Clarity, which covers thinking and reasoning ability and emotional balance, which tracks mental well-being.

The index was assessed every six months, giving researchers seven data points across the three years. The gains were quite significant. By the final assessment, participants showed an overall improvement that the researchers described as reflecting a very large effect size. Each six-month interval produced statistically significant growth.

The study's abstract noted that results "demonstrate sustained improvements in overall BHI and component factors, independent of baseline scores."

Who benefited and how much

One of the more striking findings concerned participants who scored lowest at the start. Those in the bottom quarter showed the steepest improvement over time. The study acknowledged that those who started with higher scores also showed comparable gains. Nobody stopped improving simply because they were already doing well.

The gains held regardless of age, gender, or education level. A 70-year-old and a 30-year-old saw broadly similar benefits. The study noted that this "reinforces the idea that adults can optimize their brain health at any age and supports the recommendation to begin proactive brain health practices early in adulthood and continue throughout the adult lifespan."

The study also measured how actively participants used the platform's tools, which included cognitive training modules, daily habits, virtual coaching, and educational resources. Participants were divided into low, modest, and high utilisation groups.

The difference between groups was clear. High engagement produced the greatest gains. Low engagement produced the least. Participants who began with low engagement but increased their use in the second six months showed stronger improvements by the one-year mark. Those who remained low utilisers "had no change on their brain health indices through one year."

The pattern did not vary by age or gender. A more engaged older woman and a more engaged younger man were equally likely to improve. The study noted that "higher utilisation entailed consistent engagement with the online tools, assessments, coaching sessions, strategy-based micro-learnings, and habit-tracking, and was associated with greater gains in brain health over the 3-year follow-up period."

The study argued that what drives improvement is not simply repeated exposure to training content, but the development of self-agency, the belief that one can actively shape one's own brain health. The study stated that the "most plausible explanations concern the possibility that learning strategies to control one's brain function and brain health make participants feel more empowered and in control." Those who internalised these strategies kept using the platform, creating a reinforcing cycle of improvement.

“The results may not generalise to less educated individuals,." the study noted, arguing "support the potential for scalable, technology-driven interventions to help reduce years of cognitive decline while maximising brain performance across the lifespan."

What are experts thinking?

Dr Atri Chatterjee, Associate Professor at the Department of Neurology, Vardhaman Mahavir Medical College and Safdarjung Hospital, Delhi, said the improvement seen in the study was not the result of brief online training alone, but a cumulative effect of multiple measures working together to improve brain health. He cautioned that there were no shortcuts.

“Sustained cognitive effort improves cognitive reserve and preserves brain health,” he said.

Dr Chatterjee said poor public literacy, low health literacy, and a lack of scientific rationalism were wide social challenges regarding brain health as a public health priority that needed to be addressed alongside any intervention. 

“The findings are rational,” he added. “But such studies needed to be replicated across different populations before stronger conclusions could be drawn.”

This story is done in collaboration with First Check, which is the health journalism vertical of DataLEADS