We Asked Experts What Healthy Brain Aging Looks Like—And Which Changes to Watch For

If you’ve ever lost your train of thought (or a set of keys) and immediately worried that your cognitive health is at risk, you probably don’t need to panic—occasional lapses like these can be a normal part of aging.

Healthy cognitive aging is about more than just maintaining a perfect memory—it’s about how well you function in daily life, regulate your emotions, and engage with others. Here, experts help explain what healthy cognitive aging really looks like—and the warning signs that could point to decline.

What Healthy Cognitive Aging Actually Looks Like

Healthy cognitive aging involves maintaining your ability to think, learn, and remember, according to Sharon Brangman, MD, a geriatrician and trustee at the McKnight Brain Research Foundation.

It isn’t about having a perfect memory—it’s about preserving function. That means keeping up with daily tasks like managing finances, medications, appointments, and other life responsibilities, independently. It also involves staying socially engaged with friends and family, being curious, and challenging yourself to learn new things.

You Can Be Cognitively Healthy and Still Forget Things

Forgetting things occasionally doesn’t automatically signal disease, said Brangman—it just shows how the brain can change with age, becoming less efficient at shifting attention between demands.

“Processing speed tends to slow somewhat, meaning it may take a little longer to retrieve information or complete complex tasks,” David Perlmutter, MD, FACN, a board-certified neurologist and best-selling author, told HEALTH.

This may show up as occasionally having trouble recalling a word or someone’s name or experiencing that familiar “tip of the tongue” feeling, difficulty multitasking, or momentarily forgetting what you’re doing, added Perlmutter.

In some cases, certain aspects of cognition may actually improve with age. Vocabulary and pattern recognition often get better because the brain has accumulated knowledge to draw upon, said Perlmutter. People may even better understand their relationships, emotions, and “the bigger picture” of life, he added.

Knowing When Cognitive Changes Are a Sign of Decline

Forgetting a word or someone’s name once in a while isn’t necessarily cause for concern. More concerning changes include consistently struggling to recall familiar words, substituting incorrect words, losing the meaning of common words, or experiencing memory problems that are getting worse or interfering with everyday life.

“It’s the pattern and progression, not the occasional lapse, that deserves attention,” said Perlmutter. “Forgetting where your glasses are is normal; but forgetting what glasses are used for is not.”

According to experts, other common red flags of dementia include:

• Getting lost in familiar places
• Repeating the same questions over and over again
• Having difficulty managing routine tasks
• Experiencing significant personality or behavioral changes
• Exhibiting increasing confusion or poor judgment
• Having difficulty recognizing changes in your own thinking or memory

Cognitive changes also aren’t necessarily either normal aging or dementia. Some people develop mild cognitive impairment (MCI), which involves problems with memory or thinking that are greater than expected for age but don’t significantly interfere with a person’s ability to function independently. MCI doesn’t always progress to dementia.

Noticing any of these cognitive changes—or hearing from family or friends that they’ve noticed persistent changes—should prompt a visit to a doctor for a cognitive assessment. This evaluation includes a series of questions or tasks that can help a doctor determine if additional tests are needed, or if memory loss could be caused by other issues, including medications or mental health conditions.  Other potentially treatable contributors to cognitive symptoms can include sleep disorders, thyroid problems, vitamin deficiencies, and alcohol or substance use.

Taking Steps to Help Prevent Cognitive Decline

You can’t completely prevent cognitive decline, but following a healthy lifestyle can help lower the risk of cognitive decline and dementia for some people, said Perlmutter. And starting as soon as possible is key.

That’s because many of the biological changes and risk factors associated with dementia can develop years or even decades before symptoms appear, which is one reason midlife health matters, said Perlmutter.

High blood sugar and insulin resistance can alter the brain before problems are noticeable, and chronic inflammation, poor sleep, and a sedentary lifestyle can also negatively affect cognitive aging. “This is precisely why the choices we make in midlife matter so profoundly,” said Perlmutter.

Experts say the following healthy lifestyle choices can help reduce the risk of dementia:

• Eating a nutritious, balanced diet
• Exercising regularly
• Managing cardiovascular and metabolic risk factors, including high blood pressure, high cholesterol, and diabetes
• Getting at least seven hours of quality sleep each night
• Staying socially engaged
• Routinely challenging your brain
• Not smoking and limiting alcohol intake
• Managing stress

While no single habit guarantees dementia prevention, consistency and focusing on function, not perfection, may help support healthier brain aging, said Perlmutter.