Midlife hobbies like travel and music may offset genetic risk for Alzheimer’s disease

Engaging in stimulating hobbies during middle age tends to protect brain health better than minimizing medical risks alone, providing evidence of a strong defense against cognitive decline. Activities like playing the piano, traveling abroad, and socializing with friends emerged as powerful ways to reduce the risk of memory disorders, according to new research from Trinity College Dublin. The study was published in the journal Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring.

Alzheimer’s disease is a progressive brain condition that slowly destroys memory, thinking skills, and the ability to carry out simple tasks. It is the most common cause of dementia, a broader term for a decline in mental ability severe enough to interfere with daily life. The physical changes in the brain associated with this condition begin decades before any visible symptoms appear, making middle age an important window for potential prevention.

Dementia currently affects about 48 million people worldwide, including nearly 1 million people in the United Kingdom and 65,000 in Ireland. Globally, dementia cases are projected to reach 150 million by the year 2050, with associated costs expected to triple to 3 trillion euros. Because of this massive global impact, scientists want to find accessible and cost-effective lifestyle interventions to help adults strengthen their cognitive health early on.

One key concept the scientists focused on is cognitive reserve. Cognitive reserve is essentially the brain’s ability to improvise and find alternate ways of getting a job done. It acts as a mental shock absorber that helps the brain cope with damage or disease without showing immediate signs of decline. People with higher cognitive reserve tend to maintain normal memory and thinking skills even if their brains begin developing the physical markers of Alzheimer’s disease.

The researchers drew data from the PREVENT Dementia program, which is a large longitudinal study examining the early origins of memory disorders. The project evaluates healthy individuals over a ten-year period. Lorina Naci, a professor at the Trinity College Institute of Neuroscience and the Global Brain Health Institute, leads the study site at Trinity College Dublin. Her research team works closely with collaborating sites at the universities of Cambridge, Oxford, Edinburgh, and Imperial College London.

The authors analyzed a final sample size of 587 participants. Originally, the study recruited 700 individuals, but the scientists excluded people who had incomplete medical or cognitive testing data. The participants ranged in age from 40 to 59 years old and were all cognitively healthy at the time of their first clinical visit. About one-third of the participants carried a genetic risk for developing Alzheimer’s disease later in life.

To measure cognitive performance, the participants completed thirteen different brain tests. These assessments evaluated multiple mental domains, including attention, language, and working memory. Working memory is the ability to hold and manipulate information in the mind over short periods. The participants also took visual memory tests where they had to remember complex shapes and color combinations.

The scientists gathered data on ten modifiable risk factors, which are elements of a person’s life or health that can be changed or managed. The modifiable factors included high blood pressure, high cholesterol, obesity, diabetes, hearing impairment, depressive symptoms, smoking, alcohol use, traumatic brain injury, and poor sleep quality.

Alongside these, the authors recorded non-modifiable risk factors, such as age, biological sex, family history of dementia, and genetic makeup. Specifically, the researchers tested the participants’ blood for a specific gene variant known as Apolipoprotein E epsilon 4, a well-known risk factor for late-onset Alzheimer’s disease.

Finally, the scientists measured protective factors that contribute to cognitive reserve. These included total years of formal education and occupational attainment, which looks at the complexity of a person’s job. The researchers also used a questionnaire to measure engagement in stimulating activities. These activities included socializing with family or friends, practicing a musical instrument, engaging in an artistic pastime, exercising, reading, practicing a second language, and traveling.

To make sense of all these variables, the researchers used an advanced statistical technique to find the strongest mathematical relationships between the risk factors, the protective factors, and the cognitive test scores. They found that engaging in physically, socially, and intellectually stimulating activities in middle age is one of the most powerful ways to boost cognition. This positive association held true even for people with an increased genetic or familial risk of developing Alzheimer’s disease. In fact, stimulating activities played a greater role in shaping mental health than the strongest common genetic risk factor, the Apolipoprotein E epsilon 4 gene.

Simply put, the positive mental benefits found for these lifestyle activities were stronger than the negative impacts of carrying the high-risk gene. Naci noted that the research team did not anticipate such a strong effect so early in life. “We have known for some time that lifestyle activities, such as exercise, can stave off cognitive decline in older adults,” Naci said. “We were surprised to see that stimulating everyday activities significantly boost cognition in mid-life, decades before age-related cognitive decline sets in.”

The scientists also found that participating in a wide variety of these activities seemed to create a cumulative protective effect. Doing multiple different hobbies boosted cognitive performance more than any single medical risk factor pulled it down. “Crucially, we saw that bigger benefits came from a mix of different activities, rather than one single one,” Naci said. “Our results suggest that variety is key and that a combination of physical, social, and mental stimulation is most effective for boosting brain health.”

On the negative side, depressive symptoms and traumatic brain injury emerged as the most harmful modifiable risk factors for mental performance. Participants who reported higher levels of depression or previous head injuries scored significantly lower on the memory and attention tests. Other medical conditions, such as diabetes, high blood pressure, poor sleep, and hearing impairment, also showed negative associations with cognitive performance.

The study highlighted that men generally performed slightly worse on the cognitive tests than women. Older participants within the 40 to 59 age bracket also showed weaker mental performance. Surprisingly, participants who carried the high-risk gene variant actually performed better on many of the memory tasks during middle age. While this gene increases the risk of Alzheimer’s disease in old age, the scientists noted that it might provide a slight mental advantage during early and middle adulthood.

Naci indicated that these findings shift dementia prevention from a distant medical concern to an immediate, actionable opportunity for younger adults. “This research is empowering: it shows that engaging in a diverse range of stimulating activities, such as socializing, learning new skills, staying physically active, and nurturing mental health, can actively strengthen cognitive resilience decades before any symptoms appear, even for those with genetic risk and family history of dementia,” Naci said.

There are a few potential misinterpretations and limitations to keep in mind. Because the research took a snapshot of people at their first clinical visit, it cannot definitively prove cause and effect. It is possible that people who naturally possess stronger cognitive skills are simply more likely to seek out engaging hobbies.

Additionally, the scientists relied on self-reported questionnaires for information about lifestyle activities and sleep quality. People sometimes misremember or overestimate their healthy habits, which introduces a certain amount of bias into the data. Another limitation is the study’s demographic makeup. Approximately ninety-five percent of the participants were white, which means the findings might not fully apply to people of other racial or ethnic backgrounds.

Future research will follow this group of participants over the entire ten-year study period to determine how this positive association evolves over time. By tracking them as they age, scientists will be able to see exactly how their midlife habits influence the actual development of memory disorders. The authors hope that these upcoming studies will guide medical professionals in designing better prevention programs.

“This reframes brain health as something people can shape through attainable lifestyle choices, encouraging earlier and sustained engagement in enjoyable activities,” Naci said. “It also shows that governments who are serious about reducing the future burden of dementia need to prioritize lifestyle mid-life interventions, including mental health support, cardiovascular risk management, brain injury prevention, and access to lifelong learning and community engagement programs.”

The study, “The relative contribution of modifiable and non-modifiable factors for determining cognition in mid-life individuals at risk for late-life Alzheimer’s disease,” was authored by Bolin Cao, Qing Qi, Siobhan Hutchinson, Damien Ferguson, Paresh Malhotra, Ivan Koychev, John T. O’Brien, Katie Bridgeman, Craig W. Ritchie, Brian Lawlor, and Lorina Naci.