Neurologist Says People Who Stay Sharp Well Into Old Age Almost Always Do These 5 Things

Written on Mar 20, 2026

Man who plans to stay sharp into old age smiling on a couchKampus Production | Pexels
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Most people believe that your brain is just your brain, that once you're an adult, it doesn't change unless somethign catastrophic happens. But Dr. Majid Fotuhi is a leading expert in memory and successful aging at Johns Hopkins University says decades of research shows you can change your brain to keep you sharp well into old age. 

Dr. Fotuhi He has over three decades of experience in neuroscience research and clinical practice. He told theGetting Open Podcast that the hippocampus and the cortex are important for cognitive abilities. So habits like poor diet, sedentary lifestyle, or stressing too much will "shrink those parts of your brain a lot, or if you do the opposite, these parts of your brain grow a lot."

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Dr. Fotuhi initially thought it would take nine months to see significant changes, but after 12 weeks, he found the hippocampus and cortex of his patients in the program had become larger, "so much larger we could see with the naked eye on a brain MRI." Want to get started? Here are a few top tips.

A neurologist says people who stay sharp well into old age almost always do these 5 things:

1. People who stay sharp well into old age exercise

Dr. Fotuhi has seen how physical exercise has direct effects on the brain. When you exercise, when you increase your hippocampus, you increase the number of neurons in the body. This is called neurogenesis.

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If you exercise intensely for 12 weeks, at the end of the 12-week period, you see noticeable changes in the brain. Exercise alone can improve brain functions and increase brain area capacity and size.

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2. They get optimal sleep

Dr. Fotuhi explains, "Sleep is an active process during which your brain goes through cleaning and rinsing mechanisms. Your brain literally gets cleaned during deep sleep. So when people don't have enough deep sleep, the waste products accumulate in the brain. One of those pieces of junk that needs to be removed is amyloid, which is the risk factor associated with Alzheimer's disease."

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Sleeping fewer than six hours a night doesn't remove enough of the amyloid buildup, so the hippocampus becomes inflamed and shrinks. Sleep is a critical factor for brain health.

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3. People who stay sharp well into old age eat well

Several studies have shown how high levels of trans fats, ultra-processed food, and food that spikes your sugar level cause inflammation in the brain and reduce brain size. "To me, food is like medicine," says Dr. Fotuhi. 

He recommends eating lots of fruits, vegetables, and legumes, drinking plenty of water, and avoiding junk food to reduce inflammation in your body. The same mechanisms will also reduce inflammation in your brain. So diet is a key.

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4. They reduce their stress 

Dr. Fotuhi says, "People stress all the time and have a tendency to think up the worst-case possibility." Unfortunately, all the chronic stress is shrinking the brain silently. But he emphasizes, "That kind of stress is within your control. You can complain all you want. Or you can say, you know what? I'm going to own this problem."

By changing your internal narrative, you can reduce how much you stress about the imaginary worst-case scenarios. Stress can also interrupt your optimal sleep, which is another reason less stress makes for a bigger brain.

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5. People who stay sharp well into old age train their brains

"Your brain's like a muscle. The more you use it, the stronger it gets. It's also you use it or lose it," advises Dr. Fotuhi. As we age, we often think we can't do certain things anymore and tell ourselves we are too old for that. So people stop using their brains. 

When we stop using our brains, our brains shrink more. This sets up a self-fulfilling prophecy where the more we believe we can't do things, the less our brain will be able to do. If you say, "I'm bad at math." Well, OK, that is totally true now that you said so.

If you are not being challenged enough, you can start doing something to get outside your comfort zone. Making mistakes until you can do something new involves the process of neuroplasticity. Dr. Fotuhi says, "You're rewiring your brain. So pick something you like and do it over and over again until you get good at it." There is one sure way to make your brain bigger, and that is to use it.

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Will Curtis is YourTango's expert editor. Will has over 14 years of experience as an editor covering relationships, spirituality, and human interest topics.

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