Unlocking Cognitive Fitness: 6 Steps to Optimize Brain Health

Written by: Dr. Katie Wadland, PT, DPT, Board-Certified Geriatric Clinical Specialist, Owner of Healthy Aging PT

As we age, it’s natural to notice changes in cognitive function—whether it’s misplacing your keys or taking longer to process information. While these changes can feel concerning, there’s plenty you can do to maintain and even improve your brain health. By focusing on building cognitive reserve, you can safeguard your mind and maintain your independence as you age. Think of cognitive reserve as a savings account for your brain. The more reserve you build, the more resilient you are to cognitive challenges.

The great news? Building cognitive fitness is possible at any stage of life, and it starts with these six proven steps.

1. Exercise for Brain Health

Exercise isn’t just for physical fitness—it’s for cognitive fitness, too! Regular physical activity stimulates neurotrophin release, enhances hippocampal neurogenesis, and improves blood flow to the brain, all of which help maintain cognitive function.

• The Science: A National Institute on Aging study found that individuals who exercise 1–4 times weekly reduce their risk of memory decline by 33%.

• Action Step: Engage in moderate-to-vigorous physical activity for at least 150 minutes weekly. Activities like brisk walking, resistance training, or swimming boost brain health and physical well-being. You can check out our list of curated exercise videos for some great (and free!) workouts you can do at home. 

2. Nutrition for Cognitive Health

Your diet plays a critical role in cognitive fitness. Whole-food diets like DASH, Mediterranean, and MIND reduce inflammation and support brain function.

• The Science: According to NIH research, diets rich in fruits, vegetables, and lean proteins are linked to better cognitive outcomes and reduced risk of Alzheimer’s disease.

• Action Step: Prioritize unprocessed, whole foods. Incorporate brain-boosting foods such as leafy greens, berries, nuts, and omega-3-rich fish. For more information about evidenced-based dietary patterns that support cognitive health, I suggest checking out the Harvard School of Public Health’s ‘Nutrition Source’ page. 

3. Sleep and Brain Function

Sleep is essential for brain health, supporting memory consolidation and overall cognitive function.

• The Science: Studies reveal that individuals sleeping 6–8 hours nightly maintain greater grey matter volume, which is crucial for cognitive fitness. Both insufficient and excessive sleep can harm brain health.

• Action Step: Create a sleep-friendly environment by keeping your bedroom cool, dark, and free from screens. Aim for a consistent 6–8 hours each night. For some more information, you can download this free E-Book from the NIH about Sleep for Older Adults. We keep these on hand and ready for any of our patients who need help getting their zzzz’s and it is our go-to resource.  

4. Stress Management for Healthy Aging

Chronic stress can damage the brain, but reframing how we view stress makes a big difference. A positive mindset can reduce the negative impact of stress on cognitive health.

• The Science: Research shows that reframing stress reduces its physiological effects, helping maintain cognitive resilience.

• Action Step: Practice stress management techniques such as mindfulness, journaling, or meditation. Reframing challenges as opportunities for growth supports both cognitive and emotional well-being. Looking for more? The Free Mindfulness Project has an awesome library of guided meditation and mindfulness exercises available for everyone.  

5. Social Connections and Brain Health

Meaningful social interactions aren’t just good for the soul—they’re essential for cognitive fitness.

• The Science: NIH studies show that loneliness increases the risk of dementia by up to 40%, while maintaining social connections helps preserve brain health.

• Action Step: Strengthen your social network by joining group activities, such as Wellness365, that combine fitness and fun with community-building. Want to hit two birds with one stone? Check out our in-person Group Fitness Classes to get your exercise in while engaging with like-minded peers for the added bonus social connection.

6. Lifelong Learning and Brain Health

Your brain thrives on novelty. Learning new skills, trying different hobbies, and exposing yourself to new experiences keep your mind sharp.

• The Science: NIH-supported studies highlight that engaging in novel activities throughout life helps maintain cognitive reserve and delay decline.

• Action Step: Get curious and commit to trying one new activity each month, whether it’s taking a class, visiting a new place, or trying a new hobby. We are lucky to live in a great area - with the city, the mountains, or the beach all with in an hours drive, there is always a new adventure you can try. Looking for something closer to home? Check out your local Senior Center and Library calendars to see if they have any lectures or workshops that might pique your interest. I’ve linked my hometown’s centers above, but check out the centers closest to you!

Building a Brain-Healthy Lifestyle

Cognitive fitness isn’t a one-time achievement; it’s a lifelong commitment. By incorporating exercise, nutrition, quality sleep, stress management, social engagement, and novelty into your routine, you can boost your cognitive reserve and maintain your independence. Through our Wellness365 program, Healthy Aging Physical Therapy provides tailored support to help you achieve these goals. Our program is always individualized to meet your needs, but can include things like supported fitness to build up your physical resilience and support your brain health, nutrition guidance to enhance your cognitive and physical wellness and education about stress management strategies to maximize your emotional balance.

Your journey to better cognitive fitness begins today. Want to take Let’s the first step together? If you live in one our service areas, we’d love to help! Check out out Wellness365 Page for more information and to get signed up today!

References

1. Augusto-Oliveira, M., et al. (2023). Exercise Reshapes the Brain: Molecular, Cellular, and Structural Changes Associated with Cognitive Improvements. Molecular Neurobiology, 60(12), 6950-6974.

2. Puri, S., et al. (2023). Nutrition and Cognitive Health: A Life Course Approach. Frontiers in Public Health, 11.

3. Tai, X.Y., et al. (2022). Impact of Sleep Duration on Executive Function and Brain Structure. Communications Biology, 5(201).

4. Seward, B.L. (2017). Managing Stress: Principles and Strategies for Health and Well-Being. Jones & Bartlett Learning.

5. Sutin, A.R., et al. (2020). Loneliness and Risk of Dementia. The Journals of Gerontology: Series B, 75(7), 1414–1422.

6. Karsazi, H., et al. (2024). Which Intellectual Activities Are Related to Cognitive Reserve? Psychological Research.

7. National Institute on Aging (NIA). Brain Health and Cognitive Reserve. (Available at: https://www.nia.nih.gov)

8. Harvard Health Publishing (n.d.). Cognitive Health and Aging: How Exercise and Nutrition Protect the Brain. (Available at: https://www.health.harvard.edu)

Be like a kid.

Sometimes the best advice comes from the least expected places. This week, I bring you wise words from my seven year old, as she taught me how to ‘relax’ by dancing on our back deck:

 “Let me show you how to be a kid. You just do the things your body tells you to do - the fun things!”

Healthy kids don’t have to set aside time to exercise, because exercise is simply part of their everyday life. They move constantly. They fidget, they chase their friends, they play sports and take gymnastics classes and dance. 

As adults, sometimes, we too often stop doing all the ‘fun things’ our body tells us to do. We replace the fun things with work, and stress, and sitting and to-do lists. We have to schedule exercise in, just to get it done.

But what if we started looking at exercise like a kid again? 

Did you know that most of the things to do count as exercise - even some of the things you do for fun? Anytime you are up and out of your chair, you are burning energy. Self-care, household tasks and leisure activities and hobbies - they all require movement. The intensity of each activity varies, but the concept is very much the same - and becomes even more important, for older adults. Older adults spend as much as 7-10 waking hours a day sitting. Have you ever seen a kid sit for 7 hours straight without being duct taped to a chair? (I know I haven’t..)

 If we all choose to incorporate movement throughout our days, we wouldn’t have to stress so much about ‘exercising’ or getting your steps in or whatever else we’re doing to cross it off our to-do lists. It all counts and it all helps you be a healthier, more active person. Many of these activities even has an assigned ‘MET’ (metabolic equivalent) designed to help us understand how much energy it typically burns - and how much it ‘counts’ towards your daily exercise:

I’m not sharing these to give you something else to calculate each day, but to help you understand that any and all movement COUNTS and is GOOD FOR YOU. Want an even easier way to understand how much your activity counts towards exercise? Next time something you are doing that requires movement, try using this Rate of Perceived Exertion scale. The beauty of this scale is that it takes into account that what might be challenging to one person may be less challenging to the next. We all start from different places and our levels of reserves (physiological and functional) vary and using this scale helps to reflect this:

If you find yourself working between a 0-3, you are performing light exercise. If you are feeling a 4-6, you are performing moderate intensity exercise. If an activity has you pushing 7-9, you are working at a vigorous level. Long story short, if you garden for 30 minutes and FOR YOU, this feels like a 5/10 - you just completed 30 minutes of moderate intensity exercise. THIS is how we get healthy.

Move like a kid. Do things you enjoy. Listen to your body. Exercise is Medicine - and all Movement is Exercise. 

#haept #stronger #fitter #functional #fallprevention #balance #neuro #geriatrics #physicaltherapist #physicaltherapy #doctorsofphysicaltherapy #mobilePT #geros #olderadults #healthyaging #optimalaging #successfulaging #exerciseismedicine #movementisexercise

Have an (Exercise) Snack..

If you’ve met me, been treated by me or ever visited my social media, you’re probably already aware that I strongly believe that Exercise is Medicine and that every adult should strive to meet the recommended 150-300 minutes a week of moderate intense exercise to prevent disease and better manage chronic conditions. However, only 1 of every 3 American Adults meet this recommendation, the rest, achieving less than that recommended dosage on a regular basis and placing themselves at increased risk for cardiovascular disease, diabetes and more. 

A new study, published by Preventative Medicine Reports looks at a new approach to encouraging regular exercise in older adults. Given many older adults cite lack of time as a prohibiting factor, this study looked at prescribing exercise ‘snacks’ or small bouts of regular exercise every day. Participants in this study completed one minute of functional exercise (30 seconds of body-weight push ups and 30 seconds of squats), each and every day for 24 weeks. 75% of these of this group completed at least half of the sessions, and as a group, significant improvements were noted at the end of the trial in maximal push-up and squat performance.

You can read this study in it’s entirety here: 

Feasibility and impact of a 1-minute daily functional exercise regimen prescribed to older adults by their primary care physician - ScienceDirect

Take-home message? Even a little effort can yield positive results. Every day, I work with people limited by pain, disability and fear. Issuing an exercise program, and expecting compliance, to an older adult who hasn’t participated in regular exercise since they were young or who associates exercise with pain, fatigue or fall risk is one of the biggest challenges faced by Physical Therapists on a daily basis. 

I frequently apply this idea of exercise ‘snacks’ to my patients, to help them gradually adjust to a more active lifestyle and too help them learn to see that exercise doesn’t have to be painful, exhausting or scary. I try to link these small bouts of exercise with everyday habits to make  remembering to exercise second nature, and improve compliance. Whether you’re older and trying to get more active, or a therapist or other healthcare professional trying to help your client become healthier, you can try my top five favorite exercise snacks to get the ball rolling.

1. Sit to Stands - Every time you stand up off a chair, do it 5 times instead.

2. Counter Push Ups - Every time you walk by the kitchen sink, do 10 Counter Push Ups.

3. Single Leg Stand - Every time you brush your teeth, try to stand on one leg as long as you can.

4. Loaded Carries - After each meal, carry a soup cans in each hand and walk 5 laps back and forth across the kitchen.

5. Wall Angels - Put a post it note on a spot in the hallway and every time you pass it, perform 5 Wall Angels.
   

#haept #stronger #fitter #functional #physicaltherapist #physiotherapist #physicaltherapy #physiotherapy #doctorofphysicaltherapy #exercise #health #wellness #aging #healthyaging #optimalaging #successfulaging #exerciseismedicine #functionalstrength #balance #fallprevention #strengthtraining #freetalks #knowledgeispower #exercisesnacks

the HAE series: the Pulmonary system part III

Part III, and my favorite part to write, reviews the concrete steps we can take to prevent pulmonary disease and slow age-related changes to the lungs.

Lifestyle Factors

First and foremost, cessation of smoking and avoidance of second hand smoke is, of course, the number one lifestyle modification you can make to protect your pulmonary system. Smoking is the greatest risk factor for developing COPD. Those who smoke more than 10-15 ‘pack years’ (1 pack of cigarettes per day for a year is ‘1 pack year;’ 2 packs of cigarettes for 1 year is ‘2 pack years.’) are at higher risk to develop COPD and the exposure to secondary hand smoke and other environmental irritants and air pollution can also increase your risk. Visit SmokeFree.org for some amazing tools to help you or your loved one quit.

Exercise and the Pulmonary System

Exercise also can have significant impact on the risk of developing, and the management of, pulmonary disease. Both aerobic exercise and strengthening activities play a role in your pulmonary health. Participating in the recommended 30 minutes of moderate exercise most days of the week works to improve the way the body is able to access and utilize oxygen. Aerobic exercise strengthens the cardiovascular system; with a stronger heart and healthier vascular system, the blood stream can transport the oxygen-rich blood with increase ease and efficiency. Participation in a regular strengthening program improves gas exchange within the musculoskeletal system. When the blood stream reaches the muscle, a stronger muscle is able to more quickly and efficiently extract the oxygen, which it can then use to make energy and contract more successfully.

Lastly, focused breathing exercises can improve the muscle function of the structures responsible for the act of breathing. These include the diaphragm, located under the lung set, the intercostal muscles found between the ribs and the accessory breathing muscles, located throughout the neck and abdomen that help with the work of breathing. These muscles, in particular, tend to become overused and overdeveloped in pulmonary disease states that frequently lead to dyspnea or shortness of breath. Physio-pedia has an excellent set of videos that illustrates how these muscles work together to support the cycle of breathing here if you want to check it out.

Respiratory Training

There are three exercises I typically take my patients through to strengthen both breath control and respiratory strength. Pursed lip breathing, belly breathing and straw breaths all work to teach proper breath sequence, timing and help to strengthen the muscles responsible for the cycle.

To perform pursed lip breathing, try following these steps:

1. Take a slow inhale through your nose, counting to 3-4 seconds as you go.

2. Pause, then exhale this breath through pursed lips (like you’re holding a straw) trying exhale slowly, doubling the time you spent on the inhale. If you inhaled for 2 seconds, exhale for 4. If you made it 4 seconds, exhale for 8.

This exercise can be used proactively to strengthen, and also reactively, to address shortness of breath. You can watch a video of pursed lip breathing here. Pursed lip breathing is especially important to people with COPD; this extended exhale allows the breather to exhale trapped carbon dioxide more effectively, further normalizing the breathing pattern and improving the associated feeling of shortness of breath.

Diaphragmatic breathing, or belly breathing, helps to normalize the breathing pattern, and better utilize the diaphragm, leading to deeper and more effective breathing patterns. In states of respiratory distress, instinct tends to trigger short, quick, repeated breathing. However, this pattern is less effective than deeper, diaphragmatic breathing and tends to exacerbate the shortness of breath instead of alleviating it. Practicing this technique at rest is helpful, so it can be used more effectively in states of dyspnea with less effort and more ease. To perform a proper diaphragmatic breath, follow these steps.

1. Sit comfortably with feet flat on the floor, or lay down flat in bed. Place hands on your belly and try to relax your body.

2. As you breathe in slowly through your nose, imagine filling your lungs to the very bottom and watch your hands rise as your belly expands.

3. As you exhale, watch your hands fall back down and your belly return to resting state.

This video link will show you diaphragmatic breathing in action.

The third exercise worth mentioning is straw breathing. It is similar to the pursed lip breathing above, but can sometimes be a little easier to coordinate. To perform, find a plastic straw and sit comfortably in a chair. Breathe in slowly through your nose, then exhale fully with lips wrapped tightly around the straw. Try to repeat 5 times and rest.

All three of these exercises are best performed when you are calm and at rest. Try to choose a time to perform them each day to create a habit; spending 5 minutes focused on each one 3-5 times a day can be extremely beneficial and will make using these strategies with the onset of shortness of breath more automatic and let you return to a resting state with increased ease.

the time I had to participate in family yard work day…

totally not my house, but the weeds were the same…

I’m not a fan of yardwork. I won’t go so far as to say I hate it, but I don’t get any joy from it. I don’t love the dirt, I’m not a huge fan of the bugs and every time I’ve ever put effort into creating a garden, it has become absolutely decimated by hungry rodents in less time than it took to plant the stupid thing. But lo and behold, last week, I found myself begrudgingly taking part in family yard clean up day. And by ‘family’, I mean me and my husband weeding and raking and mowing and scooping and wheel-barrowing for 6 hours straight after my kids pulled weeds for 10 minutes declared it was too hot and went inside for popsicles. But I digress.

‘So, Katie, why are you posting about yard work in your PT blog?’ Welllll…during the 6 lovely hours I spent weeding and raking and mowing and wheelbarrow pushing, I had a lot of time to think. And I thought a lot of about functional strengthening. I’ve been on a functional strengthening kick lately. I’ve come to love how it feels in my own body to focus on functional strengthening exercises, and have begun to utilize this form of exercise more and more often into my therapy sessions with my patients. I love it because it just plain makes sense. Why work a one single plane exercise, when you can use a movement, that not only involves all the major muscle groups, but mimics every day movements to encourage carryover to function? If I’ve already started to lose you, you may want to take a moment and read back to my initial post on functional strengthening What is ‘Functional Strengthening' and Why Does it Matter?'

Now I’m not sure what your weeds are like, but let me tell you, our yard has been overrun by some monsters lately. These things have vines and flowers and they are expansive. It took some serious effort to get these bad boys out of the ground and I soon found myself doing what felt like weighted squats and deadlifts and before I knew it, I was involved in a complete functional strengthening workout - right in the middle of my front yard. I spent the next few hours analyzing each task and found myself in awe and wonder of how much each yardwork task involved the six primary functional movement patterns. These movements, the squat, the lunge, push, pull, hinge, and twist were involved in every task I completed - and the workout I got was pretty damn impressive considering it didn’t involve a single weight, band, or kettlebell or anything else I normally use to get my strengthening done.

Functional Movement Patterns

◦The Squat

◦The Lunge

◦Push

◦Pull

◦Hinge

◦Twist

Without further ado, I present to you, a full yard cleanup workout plan:

Squat: Instead of sitting to weed, squat and pull, squat and pull, squat and pull and repeat. Take two steps to the right and perform your second set.

Lunge: Find a large hill. Push the mower up said hill and enjoy endless alternating forward lunges. You’re welcome.

Push: Put aside the ride-along and push a mower across your yard. Bonus points if it isn’t self-propelling. Load a wheelbarrow with weeds, then push to dump them behind your fence for the sled-push version of this exercise.

Pull: Rake. Rake. Then rake some more. This exercise can also be used in fall to get rid of excess leaves.

Hinge: Once you have completed your raking super-set, keep your back straight and hinge at the hips to pick up the piles of your yard crap.

Twist: Twist to load these piles into your wheelbarrow, then return to your Push set as a finisher.

Be sure to tune in next week for my next installment of things I think about when I’m bored ‘How to Workout While Also Getting your Laundry Done.’

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