Beyond a number: At Yale, a new hub for understanding aging and cognitive health

First, by expanding the FINGER study model and analyzing the data from various countries and settings, we can develop more individualized and effective models to increase your brain and general health. 

The second thing we want to focus on is implementation of research findings. There is a huge implementation gap, and it normally takes 15 to 17 years to start to use the research in clinical settings. That’s too long a time to wait, and that’s really something we can accelerate with the center.

We can also use the Center for Aging Well as a kind of testing hub — an experimental innovation lab where students, researchers, clinicians, caregivers, and industry partners can test, experiment with, and co-create the technologies and interventions shaping the future of brain health. 

We also plan to develop a Yale Brain Health Clinic, a prevention-first, patient-facing facility. We need to make it easy for people to come to us when they feel that they want to know the status of their brain health. 

What does it mean to age well today? What does that look like?

Kivipelto: In many societies, aging is almost taboo, and there is a lot of focus on staying young. The Center for Aging Well aims to redefine the concept of aging because aging happens throughout our whole life. We also know that 80 is the new 60 in some countries, meaning that some people who are 80 are like those who were 60 years old before — they are healthier and more vital, which is very positive. 

We need to have a more holistic perspective for the aging [process]. It’s not only the number of years or number of diseases. It’s about how you feel and function and also your lived experiences and social context. We aim to expand the span of wellness which is very important in our aging societies.

You’re known globally for your research into dementia specifically. Why is it so difficult to find a cure for Alzheimer’s and other neurodegenerative diseases? 

Kivipelto: First, Alzheimer’s disease and many other neurocognitive disorders are very complex and multifactorial. There is not just one cause, but many mechanisms and interactions between various risk factors and processes. For a long time, researchers hoped that there could be a single pill or medicine for curing the whole complex disease.  I don’t think this is the case, and most researchers now agree that we need to have a combination of different interventions, similar to cancer care. I believe that combinations of therapies and precision prevention are the future, allowing us to provide the right intervention to the right individuals at the right time. 

Second, we need to start early. When the brain damage is too advanced, it’s very difficult to repair that. It’s easier to prevent or reduce the risk if we start early — that’s why prevention is so important. The process that leads to Alzheimer’s dementia may begin 15 to 20 years before diagnosis. That is why I often say it is never too early to start preventive actions. At the same time, it is never too late. We can always do something for better brain health. 

While there isn’t a cure for dementia, there are ways to reduce the risk. What can people do to delay, and even prevent, cognitive decline?

Kivipelto: We know now that around 45% of all dementia [cases] are linked to potentially modifiable lifestyle and health-related and environmental factors. There are many things we can do today, including the FINGER model [which showed that lifestyle measures in five key areas can help prevent and delay the development of cognitive decline]. It’s easy to remember because it’s like one hand and a reminder to activate all your “five fingers” every day.