More than 7 million have Alzheimer's. Can your brain health improve?

A total of 7.4 million Americans age 65 and older are living with Alzheimer's disease in 2026, an increase of about 200,000 from a year ago, according to a report released on April 21.

The growing ranks of people living with the memory-robbing disease have also strained families who care for loved ones.

Nearly 13 million caregivers, family, or other volunteers provided more than 19 billion hours of unpaid care, according to the Alzheimer's Association's annual facts and figures report. The estimated value of that care is nearly $450 billion, the report said.

Alzheimer's, the most common type of dementia, afflicts about 1 in 9 adults age 65 and older.

The number of Americans with the disease is projected to increase as people live longer. As Baby Boomers age and Generation X approaches retirement age, the number of Americans age 65 and older is expected to swell to 82 million by 2050, up from 65 million in 2026, the report said.

The combination of more people being diagnosed with Alzheimer's disease, Americans living longer and health care costs rising points to the importance of taking action earlier in life, experts said.

"One of the findings we had is midlife is the time to act, not later," said Chris Weber, the Alzheimer's Association's senior director of global scientific initiatives. "That's when a lot of conditions that can potentially affect our brain health start to appear."

Take steps now to protect your brain health

Americans want to maintain brain health as they age. More than 9 in 10 adults age 40 and older who were surveyed for the report said maintaining brain health is as important as physical health, according to a survey of more than 3,800 U.S. adults. The survey defined brain health as how well individuals think, learn and remember.

But just about 1 in 10 people said they knew a lot about how to maintain brain health. People have no control over known risk factors such as age, genes and family history. But the report listed "modifiable risk factors" that can shape brain health over one's lifetime. Some examples include diet, exercise, getting adequate sleep and managing blood pressure.

The report said studies differ on how risk factors influence a person's likelihood to develop memory and thinking problems later in life. The Lancet Commission identified 14 factors that could lower the risk of dementia if eliminated. Those factors include: lower education, vision loss, high cholesterol, head injury, physical inactivity, smoking, excess alcohol consumption, high blood pressure, obesity, diabetes, hearing loss, depression, infrequent social contact and air pollution.

A U.S. study of 375,000 people estimated more than one-third of dementia cases were mainly linked to factors such as midlife obesity, physical inactivity and low educational attainment. Other lesser risk factors include depression, smoking, diabetes, hearing loss and high blood pressure.

"The good news is people are motivated − they want to take action," Weber said. "But they're looking for clear, trustworthy guidance, especially from doctors and other health care providers."

'Doing something for my brain health makes me feel so good'

More than three decades ago, Patty Kelly first learned her mother was struggling with memory and thinking problems.

The disease progressed to the point where her mom didn't even recognize Kelly or her grandsons. When her mom died in 2000, Kelly made a vow to herself.

"I don't want my sons to experience this," Kelly said.

Kelly couldn't shake the fear she might eventually develop the same cognitive problems her mom experienced. In 2021, when Kelly received an invitation from Rush University Medical Center to participate in a study tracking whether lifestyle factors could influence brain health, she jumped at the chance.

She tracked her diet, exercise, blood pressure and social interactions. The study urged participants to limit red and processed meats, butter, cheese, fried foods and sweets. Kelly went a step further, discontinuing cheese, butter and sugary sweets. By making those dietary changes, she dramatically improved her study score on a measure of healthy eating habits.

She also walks vigorously enough to elevate her heart rate, and she goes to a gym to participate in aerobics classes and other exercises. She regularly visits friends and her two sons − one in Chicago, the other in Washington, DC.

She also regularly completes a brain-training game called Brain HQ. The computerized game addresses memory, attention, brain speed, people skills, decision-making and navigation.

She completed the two-year study in 2024, but she chose to continue for another four years.

As part of the study, she also underwent brain MRIs and PET scans, which can measure brain changes. She wasn't told any results from the brain scans, but study organizers had permission to forward any concerning results to her doctor.

"Every time I went and had the MRI and PET scans, I held my breath for about a month," Kelly said. "I never heard from my doctor, so I thought I must be OK."

In all, the study signed up more than 2,100 adults to measure whether lifestyle changes could protect cognitive functions. Participants were randomly assigned to structured group or self-guided groups. The structured group participated in regular peer team meetings and were prescribed goals for exercise, diet and social activities. The self-guided group was encouraged to make lifestyle changes.

The structured group showed greater improvement in cognitive scores over the two-year study.

Kelly said she feels energized and notices other changes, such as improved driving skills and overall health.

"Just knowing I'm doing something for my brain health makes me feel so good," Kelly said.