By Colleen McCauley, PT, DPT, NCS, CBIS, and Matthew Keilty, MS, OTR/L, CBIS

You have the ability to change the structure of your brain. Let that sink in. You can change the structure of your brain.

Insights from decades of brain research reveal the mechanisms by which our behavior can shape our brains. These mechanisms amount to a blueprint for action to reduce the risk for dementia and other brain diseases.

Here’s what we know:

Your brain constantly changes in response to what it experiences. One of the most exciting insights is that you can change your neural network, down to the cellular level.

Your brain is a creature of habit. The more you think or do something, the stronger that neural pathway becomes. That’s why it’s difficult to replace an old, unhealthy habit with a new, healthy habit.

Your brain creates new neural connections by purposeful and repetitive activity. Similarly, the repetitive practice of specific tasks can rebuild connections around areas that have been damaged by stroke or other health event.

Initial changes are temporary. Bypassing a midnight snack on Tuesday doesn’t necessarily mean you’ll skip it Wednesday. Just as learning to play the piano takes practice over time, building new habits takes practice over time, too.

There is no magic pill to prevent future dementia or stroke, but you can take steps to reduce some risks to your brain.

In our work helping people regain function after stroke, brain injury and other neurological disorders, we witness the capacity of the human brain to build new pathways and reorganize itself every day. Neuroplasticity refers to the brain’s ability to change its structure, chemistry and function by creating new neural connections in response to internal and external stimuli. For example, targeted therapies and neurorehabilitation techniques prompt the brain to develop new connections to take over function for areas damaged by stroke. The same principles can be applied to fortify the brain as we age, to activate neuroplasticity to reduce the risk of disease.

Fundamentals of rewiring your brain

Effort matters. The harder you try, the longer you try, and the more motivated and intentional you are, the bigger the potential to change your brain. Note that doing nothing has consequences, too. Either way, your choice to be active or passive, to adopt healthy or unhealthy behaviors, is being registered in your brain and reinforced with time.

Challenge your brain to learn something new. The desire to avoid memory loss and brain illness has given rise to an entire industry of brain games that claim to improve memory and other cognitive skills. Doing Sudoku or crossword puzzles is good, stimulating activity. But if they’ve become routine, doing them will strengthen existing pathways, not develop new ones or improve overall cognition. Lifelong learning can be a delightful protective strategy. To stimulate neuroplasticity, try a novel task that engages multiple areas of your brain. Dance, tai chi, and learning a musical instrument are more immersive experiences that engage motor, perceptual, and cognitive regions of the brain.

Sleep matters. Sleep deficiency leads to a host of ills, including changes in hormones and metabolism that promote weight gain, increased risk of high blood pressure, heart disease and stroke, release of stress hormones that cause inflammation and weaken the body’s immune response, increased irritability, impatience, depression, fatigue, and trouble concentrating. Adults need at least eight hours of sleep daily. During sleep, our brains go through a cleanup phase. Cerebral spinal fluid circulates through the brain, clearing out toxins. New neural pathways are pruned. New learning and memories are consolidated. Evidence continues to mount that sleep plays a crucial role in optimizing brain performance.

Be social. Isolation is bad for us. Developing a strong social network and keeping up with social interactions stimulates the brain cognitively and generally decreases stress. Research shows that people with meaningful social activities feel happier and healthier, which reduces the risk for health problems, including Alzheimer’s.

Manage stress. Stress is fundamental to life. Not all stress is bad. Some stress, such as a deadline, can motivate a person to action. But chronic stress leads to the production of the stress hormone cortisol, which can cause fatigue, anxiety, irritability, fuzzy thinking, and loss of emotional control. Over time, chronic stress can halt production of new brain cells. There is a wealth of information about evidence-based stress reduction techniques. Practicing relaxation response, taking up meditation, tai chi or yoga, learning positive coping strategies, exercise, talk therapy, and spiritual practice can help reduce the impact of chronic stress on our bodies.

Exercise and diet. No surprises here. Study after study emphasizes that getting enough exercise and eating a healthy diet are the best preventive strategies to reduce lifestyle-related diseases. Many physicians consider them as medicines to treat these disorders. The rule of thumb is that if it’s good for your heart, it’s good for your brain. For example, a Mediterranean or plant-based diet rich in whole foods and healthy fats and low in red meat, processed foods and sugar can reduce inflammation, which is implicated in all these diseases.

Bottom line: your brain will respond to the demands that are placed on it. Just as muscles will atrophy with disuse but gain mass and strength with the right exercise and nutritional support, you can activate your brain’s amazing potential for positive change by the choices you make every day.

Colleen McCauley, physical therapist, and Matthew Keilty, occupational therapist, developed Spaulding Rehabilitation Hospital Cape Cod’s neurobics program to enhance recovery after stroke. They frequently lecture on the topic of brain health. Learn more at spaudingrehab.org/capecod.