Why managing early memory loss should actually start with your heart

San Francisco Chronicle​

13-07-2025

Yesterday, we published a story about the importance of getting a medical evaluation if you're experiencing any symptoms of cognitive decline. Today, we focus on how you can live with cognitive decline if you're among the roughly one-third of U.S. adults 65 and older experiencing some form of cognitive impairment.
We spoke to Sharon Lukert, a former longtime Bay Area nurse and chaplain who in 2021 was diagnosed with mild cognitive impairment due to Alzheimer's disease. Lukert, who now lives in Wisconsin, recently wrote a book documenting her experience, 'Until My Memory Fails Me,' which offers guidance on meditation and spiritual practices that have helped her on her journey. (Disclosure: Lukert's son previously worked as a reporter at the Chronicle.)
We also interviewed neurologists and geriatricians about how to best take care of yourself in the early stages of impairment. They offer advice on everything from diagnosis to tips for lifestyle modifications to help slow cognitive decline — including focusing on heart health, which has a particularly strong connection to your brain health.
Consider lifestyle adjustments, with a focus on heart health
The same diet and exercise recommendations that help preserve brain health in general may also be able to slow down the progression of cognitive decline, so doctors recommend the following:
Exercise a minimum of 30 minutes a day, five days a week, with moderate-intensity aerobic exercise
Eat a Mediterranean diet
Get social engagement
Get good, consistent sleep
Do things that challenge and rechallenge your cognition. Even if you can't complete them perfectly (say, a crossword puzzle), the attempt is good for the brain.
There's ample evidence that taking care of your heart health in particular is important for your brain health. That includes managing hypertension, diabetes, obesity, cholesterol and not smoking. Those 'have a very important role in brain health — not just vascular dementia, but Alzheimer's and other forms of dementia,' said Dr. Kristine Yaffe, a professor of psychiatry, neurology and epidemiology at UCSF.
'When people are in midlife, that's a very important time to be working on this stuff,' Yaffe said. 'But it's never too late. If I had MCI, I'd want to make sure my blood pressure was well-controlled, my diabetes was well-controlled, I stopped smoking and I tried to take care of my heart health as much as possible.'
For Lukert, this means finding exercise and diet habits that are not just good for her, but also enjoyable so she can sustain them.
'It's hard to do those things unless you find a way to enjoy them,' she said.
To that effect, Lukert, who used to be a dancer, took up a cardio dance class, which is much more fun to her than working out on machines at the gym. Similarly, she loves blueberries, and started adding them into her oatmeal or yogurt in the morning.
And she can attest personally to the importance of finding activities that bring joy. She encourages others with MCI to think about what those things are early on, because continuing those activities later will help support you as you progress. Lukert, for instance, is a Buddhist chaplain and has recorded herself saying Buddhist prayers. In case she may one day not be able to say them herself, her family can play the recordings for her.
For Lukert's mother, who has dementia, music therapy has helped. She played several instruments and sang in choral groups for much of her life.
'I found a music therapist who visits her once a week,' Lukert said. 'She just loves it. She lights up during that time.'
'For someone else, it might be prayer. If you know what those things are, it's likely to be the same as you go through dementia,' Lukert said. 'Those things can be very supportive on an emotional and spiritual level. Emotional memory lasts longer than cognitive memories.'
Seek social support
After she was diagnosed with MCI, Lukert joined a support group of people living with cognitive change, which she found through the Alzheimer's Association in Wisconsin. The group as a whole meets once a month, and Lukert also talks regularly with people she met through the group about their similar experiences.
For example, Lukert had to give up driving two years ago because of problems with depth perception, and sometimes has issues with depth perception as a passenger. Another member of the group recently brought up the same issue, and the two talked about ways to cope. For Lukert, looking off into the distance instead of the road ahead helps. For her friend, putting on headphones helps because it distracts her.
'It makes such a difference to talk to other people who are going through similar experiences,' Lukert said.
Get your affairs in order
'I recommend patients get power of attorney in place, assign a medical decision-maker and someone to manage their finances,' said Dr. Irina Skylar Scott, a Stanford neurologist who specializes in memory disorders. 'They can decide whether to implement the power of attorney documentation right away, or at a certain time should they be unable to make decisions.'
Skylar-Scott also recommends people have a living will and a POLST (physician orders for life-sustaining treatment). A POLST form will get on the record what your wishes are when it comes to medical decisions, such as whether you want CPR if your heart stops or whether you want mechanical ventilation if you can no longer breathe on your own.