Lifestyle & Alzheimer’s Risk Reduction
Based on the work of Heather Sandison, a naturopathic doctor and Alzheimer’s researcher
Dr. Heather Sandison focuses on lifestyle and metabolic approaches to cognitive decline. Influenced by Dale Bredesen's work, she views Alzheimer's as a complex condition that may be influenced by multiple factors, including metabolic health, inflammation, sleep, exercise, nutrition, stress, and environmental exposures.
Her approach attempts to identify and address potentially modifiable factors that may contribute to cognitive decline, rather than relying on a single intervention.
Sandison has also conducted clinical research on this approach. A small 2023 study produced encouraging results, although important limitations make it impossible to conclude that the program can reverse Alzheimer's disease.
A Personalized Approach
Sandison emphasizes that cognitive decline can have many contributing factors. Her approach attempts to identify potentially modifiable problems in each individual rather than treating every patient the same way.
Areas commonly addressed include insulin resistance and metabolic health, nutrition, physical activity, sleep, stress, nutrient deficiencies, inflammation, social connection, and cognitive stimulation.
Her approach draws substantially on the work of Dr. Dale Bredesen and his personalized program for cognitive decline.
Diet and Metabolic Health
Metabolic health is an important part of Sandison’s program. She often recommends a low-glycemic or ketogenic diet intended to improve insulin sensitivity and provide ketones as an alternative fuel for the brain.
This reflects growing interest in the relationship between insulin resistance, impaired brain glucose metabolism, and Alzheimer’s disease.
Exercise, Sleep and Brain Stimulation
Sandison considers exercise one of the most important interventions for maintaining brain health. Her program combines aerobic activity, strength training, balance, and activities that challenge the brain and body simultaneously.
Sleep is another priority. Poor sleep is associated with cognitive decline, while adequate sleep supports memory, metabolic health, and normal brain function.
Mental stimulation, social engagement, and stress reduction are also important parts of her program.
What Her Research Shows
In a study published in the Journal of Alzheimer’s Disease in 2023, Sandison and colleagues evaluated a personalized lifestyle intervention in people with mild cognitive impairment or early dementia.
Thirty-four people enrolled in the study, and 23 were included in the six-month cognitive analysis. The intervention addressed diet, exercise, sleep, stress, supplements, brain stimulation, and other individualized health factors.
Participants who completed the program showed statistically significant improvements on several measures of cognition.
The study provides promising preliminary evidence that an intensive lifestyle program may improve cognitive function in some people with early cognitive decline. However, it was small, uncontrolled and non-randomized, and 32% of those enrolled did not complete the study. It therefore did not establish that the program can slow, stop, or reverse Alzheimer’s disease.
Prevention
Many of the lifestyle practices Sandison recommends are also consistent with the growing mainstream research on dementia prevention:
Regular physical activity
Good metabolic and cardiovascular health
A nutritious, minimally processed diet
Adequate sleep
Maintaining social connections
Staying mentally active
Addressing hearing loss and other modifiable risk factors
A 2026 JAMA article highlighted research suggesting that as many as 45% of dementia cases may be associated with potentially modifiable risk factors. This is a population-level estimate and does not mean that an individual can reduce their personal risk by 45%.
These measures cannot guarantee that someone will avoid Alzheimer’s, but they provide increasing evidence that brain health is something we may be able to influence as we age.
Learn More
Book
Reversing Alzheimer’s: The New Toolkit to Improve Cognition and Protect Brain Health
Dr. Heather Sandison presents a practical, lifestyle-based approach to improving cognitive health, including nutrition, exercise, sleep, stress reduction, metabolic health, and other potentially modifiable factors associated with dementia risk.
Research
A 2023 study in the Journal of Alzheimer’s Disease led by Dr. Heather Sandison found improvements in several measures of cognition among participants who completed a six-month personalized lifestyle intervention. The study was small and uncontrolled, so the findings should be considered preliminary.
Nearly Half of Dementia Cases May Be Preventable—Here’s What the Research Says So Far — JAMA (2026)
A useful overview of the growing evidence that potentially modifiable factors—including cardiovascular and metabolic health, exercise, hearing loss, sleep, and social connection—may influence dementia risk. It also discusses major lifestyle-intervention trials including FINGER and US POINTER.
Videos
Dr. Sandison discusses research on her personalized lifestyle approach to Alzheimer’s and the encouraging cognitive improvements reported in her clinical trial.
Dr. Sandison and Dr. Bredesen discuss the ideas in Reversing Alzheimer’s and their shared approach to identifying and addressing multiple factors that may contribute to cognitive decline.
Dr. Sandison describes her clinical approach to Alzheimer’s and explains how diet, exercise, sleep, metabolic health, and other lifestyle factors are incorporated into individualized treatment programs.
Care Facility
A San Diego residential memory-care program founded by Dr. Heather Sandison that incorporates nutrition, exercise, sleep, social engagement, and other lifestyle approaches into care for people with cognitive decline.