Unlike many of the diseases of our modern world, dementia has limited treatment options. While some medications might slow the progression, their effect is limited, and as of now, dementia has no cure.
But research shows that around 45 percent of dementia cases, and potentially more, can be avoided with lifestyle modifications. This is why neurologists are always encouraging their patients to eat a healthy diet, maintain social connections and exercise regularly.
In fact, exercise is widely considered to be one of the most effective ways to boost brain health. And you don’t have to run a marathon to get the benefits — walking works great.
“Walking boosts blood flow to the brain and specifically to the hippocampus, which is the memory center that is most affected with Alzheimer’s,” says Dr. Milica McDowell, co-author of the book “Walk.” “Walking boosts brain and nerve growth factors, which help our neurons stay healthy.”
And there’s actually a specific number of steps per day that could cut your dementia risk in half, according to the recent research. McDowell breaks down what that number is, why walking should be considered the “sixth vital sign” and how to start walking if you’ve been sedentary for a long time.
How many steps?
According to a 2022 Journal of the American Medical Association study of over 78,000 people, those who walked around 9,800 steps per day were 51 percent less likely to develop dementia, and even 3,800 steps per day was linked to a 25 percent reduction in risk.
“This study is remarkable because it’s very precise, but it’s not surprising,” McDowell says. “The difference between patients who walk daily and those who don’t is easy to detect within the first few minutes of meeting them. Those who walk regularly are in better moods, report better sleep, have better pain tolerance, have better balance, lower fall risk and, most importantly, have better cognitive clarity.”
In the study, those who walked less declined faster on every metric compared with those who walked more. The reason the study is so important, McDowell emphasizes, is that it clearly states that 3,800 steps lowers the risk, rather than just establishing a correlation.
‘Sixth vital sign’
McDowell points out that there’s something you should pay attention to while you’re walking that can help detect cognitive changes significantly earlier than you would otherwise. “A slower gait can signal cognitive decline up to seven years before a clinical dementia diagnosis,” she says. “Walking gait deserves the same attention we give blood pressure and heart rate.”
When your gait slows down, she adds, it’s rarely because one system is failing in isolation — it typically reveals that your whole system isn’t functioning as well as it was.
“Checking your walking speed a couple of times a year is a responsible way to monitor your baseline data, just like you would have your blood pressure checked at a medical visit,” McDowell says. “Beyond your walking pace, pay attention to other symptoms such as increased falls, losing your balance, needing handrails or reaching for the wall when you didn’t do so before.”
If you’re starting to fall behind loved ones when walking with them, she says, or are unable to hold a conversation at a typical walking pace, these are also signs and symptoms to heed.
Not too late to start
No matter how old you are or how long you have been sedentary, McDowell emphasizes that your brain still wants to change and grow.
“Research studies demonstrate that even sedentary older adults, when they start a walking program, can retrain their brains, and their brain health can improve,” she says. “For those starting from zero, what’s important is adding a minimum to get them to 2,500 steps a day. If we can increase that to 3,000 steps, it drops your risk of dying by 7 percent, and if you can get to 3,500 steps, it cuts all-cause mortality risk by 15 percent.”
That’s an incredible return on a 10-minute-per-day investment. And once you commit to walking around 3,500 steps per day, try to do this at least six to seven days a week for at least a month.
“After that, you can add about 10 percent per week,” says McDowell, a physical therapist with more than 20 years of experience. “If you stack walking with other activities you enjoy, such as talking to a friend, walking on a golf course or taking your dog for a stroll, it will reward you even more for showing up.”
