How to Help Keep Mild Cognitive Impairment from Progressing to Dementia

According to a 2025 report from the Alzheimer’s Association, studies assessing biomarkers for Alzheimer’s disease with PET scans have reported that about half of people with MCI have Alzheimer’s-related brain changes. Around 1 in 3 of them go on to develop Alzheimer’s within five years. MCI leading to other forms of dementia are linked to other factors; for instance, cardiovascular disease and diabetes are risk factors for vascular dementia.

Researchers have known for a while that people with dementia first pass through a stage of MCI (in the same way people with type 2 diabetes almost always have prediabetes first). What they’ve only recently been able to determine — thanks to biomarkers that show Alzheimer’s-related changes in the brain — is which cases of MCI are most likely to progress to Alzheimer’s.

Are there treatments for MCI?

There are no medications approved by the U.S. Food and Drug Administration specifically for MCI. Two therapies approved for early Alzheimer’s disease, however, are often prescribed for people with MCI, but only for those whose brain scans show a buildup of abnormal proteins called amyloid plaques and tau tangles — what’s known as “amyloid pathology,” a precursor to Alzheimer’s.

Lecanemab (Leqembi) and donanemab (Kisunla) are the two drugs that have shown promise in slowing the progression to Alzheimer’s. They work by removing amyloid from the brain, says Munro Cullum, a senior neuropsychologist at the UT Southwestern O’Donnell Brain Institute. “They may do nothing for you if your memory problem isn’t related to amyloid and its corresponding other pathogens.”

Lifestyle changes matter too

But medication isn’t the only way to improve the odds of regaining normal cognition or preventing MCI from progressing. The foundation of any MCI treatment — no matter the cause — is a familiar one: healthy lifestyle habits.

“Key principles in slowing the progression of MCI involve strategies for keeping the brain healthy, especially the arteries in the brain,” Yucus says.

AARP Brain Health Resource Center

Find in-depth journalism and explainers on diseases of the brain — dementia, stroke, Parkinson’s disease, mental-health topics. Learn about healthy habits that support memory and mental skills.

Learn, take action, build healthy habits

Take, for instance, exercise. The CDC recommends 150 minutes of moderate-intensity aerobic exercise spread out over a week. Then there’s the foods we eat.

“Diet plays a particularly important role in the vascular health of the brain — the Mediterranean diet and MIND diet have been shown to be helpful,” says Yucus. And “sleeping at least six hours per night helps reduce accumulation of the amyloid protein involved in Alzheimer’s disease,” he adds, echoing research published in 2023 in BMC Medicine.

He also suggests doing cognitively stimulating activities. That could mean learning a new language or an instrument, plus taking part in social activities to support brain health.

If all of the above sounds too pedestrian to be believed, never mind effective, research suggests otherwise.

In one large study published recently in JAMA, researchers set out to determine if lifestyle changes could improve or protect cognitive function in older adults at risk of cognitive decline and dementia. They enlisted more than 2,100 adults, average age 68, and divided them into two groups:

One group followed a structured program that included an exercise regimen focused on moderate- to high-intensity aerobic exercise, strength training and stretching; the MIND diet; cognitive challenges designed to improve memory, attention and brain speed; and cardiovascular health monitoring. The other group was asked to follow essentially the same program, but without supervision or structure.

At the end of two years, both groups showed improvement in cognition, but the structured group showed greater improvement than the unsupervised group.

“About 40 to 45 percent of dementia cases have been attributed to modifiable risk factors,” says Aurora. “The JAMA study gives new meaning to lifestyle modification.”

Charting a course

In the seven years since her MCI diagnosis, Rosenblatt has slowly implemented the blueprint prescribed by Yucus, her neurologist: “Exercise, proper sleep, eating mainly a Mediterranean diet, socializing, games, reading, writing things down, and the latest has been cutting out sugar,” she says. Although Yucus suggested she consider taking one of the anti-amyloid therapies, she ultimately decided against it. “I wanted to see what I could do without a medication intervention.”

Arguably the most profound aspect of her treatment, however, has to do with the way she went about satisfying Yucus’ prescription for more exercise. Not long after her MCI diagnosis, Rosenblatt took up noncontact boxing at a local gym, and what began as weekly sessions with a trainer has turned into three times a week.

In addition to the physical benefits, “the mental demands of boxing can be particularly stimulating, helping executive function and memory,” she says. “At first it was intimidating, but the repetitive motions of throwing a jab, a cross and an uppercut began to retrain my brain. My footwork became more deliberate, my balance improved.”

The most rewarding aspect arrived in the form of test results following her last annual checkup with Yucus: an improvement in memory. “I am convinced boxing has been a vital component to my mental and physical well-being,” she says.