After decades studying the aging brain and memory disorders, Los Angeles-based neuroscientist and psychiatrist Dr. Gary Small says everyday routines can support reducing Alzheimer’s risk. While he notes age is the strongest predictor of the disease, he adds that lifestyle choices in midlife, especially those tied to weight and inflammation, can influence cognitive health later on.
Small, a professor of psychiatry at UCLA who treats patients with memory loss and directs behavioral health breakthrough therapies at Hackensack Meridian Health, shared the habits he relies on as he grows older.
Reducing Alzheimer’s risk through movement and balance
Small aims to be active daily. He says regular exercise boosts overall health and mood through endorphins, and research indicates it may raise levels of brain-derived neurotrophic factor, a protein that supports neuron growth and survival. At home he does cardio on a stationary bike and simple strength work with resistance bands and dumbbells.
He also builds in extra walking. In New Jersey he took the stairs and parked farther away from destinations. In Santa Monica, he and his wife appreciate being able to walk to restaurants and errands.
Balance is another priority. He warns that falls in older age can lead to injuries that affect brain health. To help, he strengthens the glutes and practices moves such as lunges and standing on one foot with eyes closed.
Protein-forward meals and sharing portions
Small says there is no one-size-fits-all diet, but he keeps meals straightforward. He looks to pair a healthy protein with a healthy carbohydrate to stay satisfied, and he favors whole foods over ultra-processed items, which have been linked to faster cognitive decline.
His typical day might include a fried egg with cheddar and sourdough toast for breakfast, a turkey sandwich, chicken salad, or soup for lunch, and salmon or an occasional steak with a side salad for dinner, plus fruit for snacks. For carbohydrates, he prefers sprouted whole-grain and whole-grain breads for complex carbs and fiber, or sourdough for its lower glycemic index and improved nutrient absorption.
He tries not to overeat at night and often splits entrees with his wife, a simple way to reduce calories and potentially limit inflammation. Chronic brain inflammation is a risk factor for Alzheimer’s, he notes. Still, he avoids rigid rules and allows the occasional dessert or cheeseburger.
Sleep strategies: audiobooks and box breathing
Consistent sleep is another pillar for reducing Alzheimer’s risk by curbing inflammation. Small calls a good night’s rest critical for the aging brain, including for the clearance of amyloid proteins that are associated with memory loss and cognitive decline.
He says lighter sleep is common with age. When he wakes during the night, he practices box breathing, slow deliberate breaths that stimulate the vagus nerve and promote calm. He also sometimes plays an audiobook, often literary or historical fiction or comedians’ memoirs, to gently distract his mind and drift back to sleep.
The role of mindset in healthy aging
Small believes a positive outlook helps people adapt to health setbacks. During his time leading the UCLA Longevity Center, he observed that older adults with an optimistic mindset recovered function more readily after injuries such as a sprained ankle.
He describes himself as generally a glass-half-full person, though he acknowledges negative thoughts can creep in. When that happens, he makes a point to redirect his focus.
Above all, he tries not to fixate on arbitrary targets like exactly seven hours of sleep or 10,000 steps, since needs vary and factors such as genetics and age remain beyond personal control. He aims to take reasonable responsibility without turning healthy habits into a burden.
“I want to live longer,” he says, “I just don’t want to feel like life is longer.”
For many older adults, financial stress such as home insurance rates can also shape their sense of security and well-being as they age.