Eight ways to support brain health for rural older adults

An older adult couple are jogging on a rural path surrounded by sunflowers.


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By Juanita Bacsu, PhD, Post-Doctoral Fellow, Faculty of Kinesiology and Health Studies, University of Regina and Shanthi Johnson, PhD, Dean and Professor, School of Public Health, University of Alberta.


Age is the greatest risk factor for developing dementia, and the number of rural older adults is rising in Canada. As the rural population ages, there is an increasing need for knowledge on brain health and cognitive health promotion within a rural context.

This WellSpring issue takes a look at ways to support brain health from the perspective of rural older adults.


Brain health is a growing concern among older adults. Globally, approximately 50 million people live with dementia and this number is projected to increase.1 Age is the most important risk factor for developing dementia,2 and the number of rural older adults is rising in Canada.3 While most studies focus on prescription drugs and medical interventions, little is known about the ways older adults support their brain health, especially in rural communities.

Brain health and rural aging

Compared to urban seniors, rural seniors often experience unique barriers to dementia care and services related to limited access to medical specialists (e.g., geriatricians, neurologists, psychiatrists), finances, public transportation, education, and health and support services.4 Since the majority of dementia services exist in urban centres, this means that rural seniors must either travel to access services or forego them.5 Consequently, access to dementia services is a significant challenge for residents living in rural communities.6

Studies show that dementia and cognitive impairment are more prevalent among rural seniors than urban seniors.7 However, most of the work in this area remains urban-centric with little focus on brain health or cognitive health promotion in rural communities.8 As the rural population ages, there is an increasing need for knowledge on cognitive health promotion within a rural context.

Methods: what we did

Our team interviewed older adults in rural Saskatchewan to learn about what activities they thought supported their brain health.9 Using community-based research and an ethnographic methodology, two waves of semi-structured interviews were conducted with 42 adults (ages 60+ years) in rural Saskatchewan.

Participant observation was conducted by spending time with 5 older adults to observe day-to-day activities related to supporting their memory and brain health. Guided by theories of culture, thematic analysis was used to identify key patterns and relationships within the data.9

An older adult man is examining wheat from his field.

8 ways to support brain health

Our findings revealed a more holistic and multidimensional view of brain health than previously cited in the literature.10 Drawing on our study’s findings, here are eight ways used by rural seniors to support their brain health.

1) Think positive. Having a positive attitude and feeling happy is good for our brains and helps us to overcome stressful situations. Some ways to support positive thinking include listening to music, going to the hair salon, smiling, reading funny jokes, doing exercises, and getting dressed-up.

2) Learn something new. It is good to get out of our comfort zones and learn something different. Try a new recipe, read about bird species, tell new jokes, learn about star constellations, or play a new game.

3) Keep active. Maintaining an active lifestyle supports our brain health and stimulates our minds. Go on a walk, work in the garden, go swimming, make a scrapbook, join a bowling league, play pickleball, sing in a choir, visit a seniors’ centre, or volunteer in the community.

4) Challenge your brain. Challenging our minds helps to support our memory and boosts our mental sharpness. Do a jigsaw puzzle, take music lessons, do needle work, make a quilt, try a crossword or word search, play different card games, or do a sudoku puzzle.

5) Eat healthy. Eating nutritious foods supports our brain’s ability to function and our overall health. Eat green leafy vegetables, berries, fish and fruits.

An older adult Asian woman is tying vegetable vines to supportive branches.

6) Chat with a friend. Mingling and spending time with friends helps to improve our mood and reduces feelings of loneliness. Send an email, chat on the telephone, visit with a neighbour, play with a pet, grab a coffee, or use social media to stay connected with friends and family members.

7) Relax. Relaxation can help us to reduce stress and improve our sense of well-being. Meditate, spend time outdoors, write in a journal, paint a picture, drive in the countryside, listen to calming music, practice yoga or do tai chi.

8) Sleep tight. Getting a good night’s sleep helps to support our mental capacity and our brain’s ability to function. Limit caffeine, avoid naps close to bedtime, establish a nightly routine, and avoid rigorous physical activity or exercise before bed.

Infographic of 8 ways to support brain health


Brain health is an important and a vital part of healthy aging. Our study identified a range of activities used by rural seniors to support their brain health. Ask questions and talk to your healthcare provider about other ways to support your brain health.


Practitioners: download and share this infographic of "8 Ways to Support Brain Health" with your clients as a quick reminder of things that they can do.

About the Authors

Juanita Bacsu, PhD, is a Post-Doctoral Fellow in the Faculty of Kinesiology and Health Studies at the University of Regina and the Saskatchewan Population Health and Evaluation Research Unit at the University of Saskatchewan. Her work is funded by the Alzheimer’s Society of Canada and the Saskatchewan Centre for Patient-Oriented Research. She has been a board member of the Canadian Rural Health Research Society since 2011. Click here to like Healthy Aging in Place on Facebook.

Juanita Bacsu

Shanthi Johnson, PhD, is the Dean and Professor at the School of Public Health at the University of Alberta. She is a former Associate Dean of (research and graduate studies) in the Faculty of Kinesiology and Health Studies at the University of Regina, Canada.

Shanthi Johnson


  1. World Health Organization. Dementia: Key facts. World Health Organization. Published September 19, 2019. http://www.who.int/news-room/fact-sheets/detail/dementia. Accessed May 1, 2020.

  2. Alzheimer’s Disease International. World Alzheimer Report 2019: Attitudes to dementia. London: Alzheimer’s Disease International. September 2019. https://www.alz.co.uk/research/WorldAlzheimerReport2019.pdf Accessed April 30, 2020.

  3. Statistics Canada. Canada’s rural population since 1851: census in brief. Catalogue No. 98-310-X2011003. Ottawa, ON: Statistics Canada, 2011. https://www12.statcan.gc.ca/census-recensement/2011/assa/98-310-x/98-310-x2011003_2-eng.cfm. Accessed April 15, 2020.

  4. Bacsu J, Abonyi S, Viger M, Morgan D, Johnson S, Jeffery B. Examining rural older adults’ perceptions of cognitive health. Canadian Journal on Aging. 2017; 36(3): 318-327. DOI: 10.1017/S0714980817000150

  5. Bacsu J, Novik N, Johnson S, Viger M, McIntosh T, Jeffery B, Muharjarine N, Hackett P. Recognizing the needs of rural and remote people in a national dementia strategy for Canada. Canadian Journal of Public Health. 2019;110(6):752-755. DOI: 10.17269/s41997-019-00241-0

  6. Standing Senate Committee on Social Affairs, Science and Technology. Dementia in Canada: a national strategy for dementia friendly communities. Ottawa, ON: Government of Canada, 2016. https://sencanada.ca/content/sen/committee/421/SOCI/Reports/SOCI_6thReport_DementiaInCanada-WEB_e.pdf. April 30, 2020.

  7. Weden M, Shih R, Kabeto M, Langa K. Secular trends in dementia and cognitive impairment of U.S. rural and urban older adults. American Journal of Preventive Medicine. 2018;54(2): 164-172. DOI: https://doi.org/10.1016/j.amepre.2017.10.021.

  8. Forbes D, Hawranik P. Looming dementia care crisis: Are Canadian rural and remote communities ready? In J. Kulig and A. Williams (Eds.), Health in rural Canada (pp. 447-461). Vancouver, BC. UBC Press, 2012.

  9. Bacsu J, Viger M, Johnson S, Novik N, Jeffery B. Rural older adults' perspectives of activities to support cognitive health. Activities, Adaptation and Aging. 2019. DOI: 10.1080/01924788.2019.1626203.

  10. Anderson L, Day K, Beard L, Reed P, Wu B. The public’s perceptions about cognitive health and Alzheimer’s disease among the U.S. population: A national review. The Gerontologist. 2009; 49(S1): S3–S11. DOI: https://doi.org/10.1093/geront/gnp088

June 2020, Volume 31, No. 06

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