Brain Health Can Improve Into Your 90s, Landmark Three-Year Study Finds

A three-year longitudinal study from the Center for BrainHealth (search)Search term (CBH) at The University of Texas at Dallas (search)Search term has upended long-held assumptions about cognitive aging, demonstrating that brain health can be proactively cultivated well into one's 80s and beyond. The findings, published in Scientific Reports, a Nature research journal, draw on data from The BrainHealth Project (BHP), an initiative launched in 2020 to understand how brain health can be strengthened and optimized across the lifespan.

Researchers tracked 3,966 adults ranging in age from 19 to 94, representing roughly one-fifth of all BHP participants. Over the three-year period, participants completed brief training activities requiring only five to 15 minutes per day.

"Every brain is as unique as a fingerprint and has potential for growth," said Lori Cook MS'02, PhD'09, CBH director of clinical research and corresponding author of the study. "This study challenges the prevailing narrative of inevitable cognitive decline (search)Search disease, suggesting instead that brain health can be proactively cultivated at any age."

Measuring Brain Health with the BrainHealth Index

To evaluate changes in brain health and performance, the research team employed the BrainHealth Index (BHI), a patent-pending assessment tool developed by CBH researchers and first introduced in a 2021 pilot study. The BHI is designed to detect both improvements and declines, measuring three primary domains: clarity, emotional balance, and connectedness to people and purpose.

"The BrainHealth Index brings together about 20 metrics, including validated gold-standard measures like the Pittsburgh Sleep Quality Index and the Oxford Happiness Questionnaire, as well as tasks designed at the Center for BrainHealth (search)Search term to focus on more complex thinking skills," Cook explained. "This battery of assessments produces insights into individual brain health and change over time. Progress is measured by comparing results with participants' own earlier scores."

Lowest Baseline, Largest Gains

One of the study's most notable findings involved participants who started with the lowest BHI scores. This group experienced the largest improvements over time, suggesting that those with the greatest preexisting concerns may have the most opportunity for growth.

"Those who are starting at the lowest level appear to have the most opportunity for growth and may be coming in with more preexisting concerns," Cook said. "As such, they may be more motivated to invest the time needed to see more growth potential. But it is noteworthy that we saw measurable growth even in those entering as high performers."

Positive changes were observed even among participants in their 80s, indicating that efforts to improve brain health can be beneficial long before symptoms or disease appear and can remain effective later in life.

Engagement Outweighs Demographics

The researchers found that engagement was the strongest predictor of improvement. Factors such as age, gender, and education level did not determine whether participants experienced positive change. However, Cook acknowledged that the study population was not fully representative of the broader public, with most participants being white, female, and college educated.

"We have room to grow when it comes to representation for different demographic groups," she said. "We're working hard to increase representation, so we can be even more confident in how this generalizes to the population at large, especially communities typically underrepresented in research."

Reframing the Aging Narrative

Sandra Bond Chapman PhD'86, senior author of the study and CBH chief director, emphasized the paradigm shift these findings represent. "For too long, we've operated under the outdated notion that we need to wait until something bad happens to our brains before we do anything for them," Chapman said. "This study reminds us that our brain is not defined by age — it is defined by possibility."

Cook, who has worked with Chapman for more than 25 years, stressed the importance of translating these findings into public awareness. "One piece that is so near and dear to my heart is helping people link neuroplasticity with self-agency," she said. "Brain health isn't just something we strive to maintain; we can actively shape it over time. Research like ours, which provides an objective measure of brain health that people can track over time, can only further boost public awareness."

Ongoing Neuroimaging Research

The BrainHealth Project continues to collect long-term data through additional studies. Approximately 400 participants from the Dallas area have undergone more than 1,200 brain scans at the Sammons BrainHealth Imaging Center, providing a unique dataset to explore neural mechanisms associated with changes in brain health over time.

"This unique imaging dataset provides an opportunity to look at neural metrics associated with the BHI and gives us the capacity to use periodic brain imaging to explore potential brain mechanisms associated with changes in brain health over time," Cook said.

Additional authors currently affiliated with CBH include medical science research director Dr. Jane Wigginton, who also serves as co-director of the Clinical and Translational Research Center and chief medical officer of the Texas Biomedical Device Center; Dr. Jeffrey Spence, director of biostatistics; Aaron Tate MA'18, director of emerging technology; Erin Venza MS'13, PhD'25, head of clinical operations; and Zhengsi Chang PhD'22, research scientist. The study also included contributors from the Trinity College Institute of Neuroscience in Dublin, the University of California, Berkeley, and the Johns Hopkins University School of Medicine. The BrainHealth Project receives support in part through private philanthropy, including funding from Sammons Enterprises Inc.