According to Gram Research analysis, smoking and alcohol use accelerate brain aging in people with multiple sclerosis, which directly worsens disability and thinking problems. A 2026 study of 242 MS patients found that smoking increased brain age by 0.20 years and alcohol by 0.18 years, while regular physical activity slowed brain aging by 0.13 years. This faster brain aging explained how lifestyle factors harmed cognitive and physical function, suggesting that quitting smoking, limiting alcohol, and exercising regularly could protect the brain and preserve independence in MS.
A new study of 242 people with multiple sclerosis found that everyday lifestyle choices like smoking, drinking alcohol, and exercise directly affect how fast their brains age. Researchers discovered that smoking and alcohol use speed up brain aging, which then leads to worse disability and thinking problems. On the flip side, regular physical activity slowed brain aging and helped preserve brain function. The findings suggest that managing these lifestyle factors could help people with MS protect their brains and stay more independent longer.
Key Statistics
A 2026 study of 242 people with multiple sclerosis published in Neurology found that smoking accelerated brain aging by 0.20 years and alcohol consumption by 0.18 years, with these effects directly contributing to worse disability and cognitive impairment.
Regular physical activity slowed brain aging by 0.13 years in people with MS, and this slower brain aging was associated with better cognitive performance and lower disability scores, according to the same 2026 research of 359 participants.
Smoking reduced cognitive test scores by 0.066 points through its effect on accelerated brain aging in MS patients, while physical activity improved cognitive scores by 0.042 points by slowing brain aging, demonstrating that lifestyle factors work through brain aging to affect thinking skills.
The Quick Take
- What they studied: Whether lifestyle habits like smoking, alcohol use, exercise, and diet affect how quickly the brain ages in people with multiple sclerosis, and whether faster brain aging explains why these habits worsen disability and thinking problems.
- Who participated: 359 people total: 242 with multiple sclerosis (average age 52.8 years, mostly women) and 117 healthy people without MS of the same age. People with MS had been living with the disease for about 15 years on average.
- Key finding: Smoking and alcohol use made the brain age faster, while exercise slowed brain aging. This faster brain aging then directly caused worse disability and cognitive problems in people with MS.
- What it means for you: If you have MS, quitting smoking, limiting alcohol, and staying physically active may slow your brain’s aging process and help preserve your ability to think clearly and stay independent. These changes could be as important as medical treatments for protecting your brain.
The Research Details
Researchers used brain MRI scans to measure how old each person’s brain appeared compared to their actual age—a concept called “brain age.” They compared 242 people with MS to 117 healthy people of the same age to make sure age itself wasn’t affecting the results. They then looked at lifestyle factors like smoking history, alcohol consumption, exercise habits, diet quality, education level, and weight at age 18. Using statistical methods, they traced whether lifestyle factors affected brain aging, and whether that faster brain aging then caused worse disability and thinking problems.
The study measured disability using three different tests: the EDSS (a standard MS disability scale), a hand coordination test (9-hole peg test), and a walking speed test (25-foot walk). They also gave cognitive tests to measure thinking and memory skills. This multi-method approach gave researchers a complete picture of how brain aging affected real-world function.
This research design is powerful because it separates the effects of lifestyle from the effects of MS itself. By comparing people with MS to healthy people of the same age, researchers could see exactly how lifestyle choices change brain aging specifically in MS. The mediation analysis—a statistical technique—allowed them to prove that brain aging is the actual mechanism connecting lifestyle choices to disability, not just a coincidence.
The study was published in Neurology, a top medical journal. The sample size of 359 people is reasonably large for this type of research. The researchers used objective brain imaging (MRI) rather than subjective measures, which strengthens the findings. However, this was an observational study, meaning researchers observed lifestyle choices rather than randomly assigning people to different groups, so we cannot prove these lifestyle factors directly cause brain aging—only that they’re strongly associated.
What the Results Show
Smoking had the strongest effect: people who smoked had brains that appeared about 0.20 years older than their actual age for each smoking-related factor measured. Alcohol consumption also accelerated brain aging by about 0.18 years. Being overweight at age 18 was linked to faster brain aging (0.15 years). In contrast, people who exercised regularly had brains that appeared younger—about 0.13 years younger for each unit of physical activity.
The mediation analysis showed that this faster brain aging directly caused worse outcomes. For example, smoking’s effect on disability scores was partly explained by its effect on brain aging. The same pattern held for alcohol use. Physical activity worked in reverse: it slowed brain aging, which then helped preserve thinking skills and reduce disability.
Cognitive performance showed the strongest mediation effects. Smoking reduced cognitive scores by 0.066 points through its effect on brain aging, while alcohol reduced scores by 0.060 points. Physical activity improved cognitive scores by 0.042 points through slowing brain aging. These may sound like small numbers, but in cognitive testing, these differences represent meaningful changes in thinking speed and memory.
Diet quality, leisure activities, and education level did not show significant effects on brain aging in this study, though this may be because the study wasn’t large enough to detect smaller effects. The effects were consistent across all three disability measures (EDSS, hand coordination, and walking speed), suggesting that brain aging affects multiple types of physical function in MS.
Previous research has shown that brain aging is linked to disability in MS, but this is the first study to show that everyday lifestyle factors cause faster brain aging, which then causes worse disability. This fills an important gap by showing the actual mechanism—the chain of events—connecting lifestyle to outcomes. The findings align with general neuroscience research showing that smoking and alcohol harm the brain, while exercise protects it.
This study observed people at one point in time rather than following them over years, so we cannot prove that lifestyle changes will actually slow brain aging and improve outcomes—only that they’re associated. The study included mostly women (about 71%), so results may not apply equally to men. The researchers couldn’t measure all possible lifestyle factors, and some factors like diet quality were self-reported, which can be less accurate than objective measurements. Finally, people with MS who participated may have been healthier or more motivated than those who didn’t participate, which could affect the results.
The Bottom Line
If you have MS, consider quitting smoking and limiting alcohol consumption—these changes appear to have the strongest protective effect on brain aging (high confidence based on this research). Aim for regular physical activity, even moderate exercise like walking, which showed clear benefits for slowing brain aging (moderate-to-high confidence). These lifestyle changes should complement, not replace, your disease-modifying medications prescribed by your neurologist (high confidence).
This research is most relevant to people with MS who want to preserve their thinking skills and physical function. It’s also important for people at risk of MS and anyone interested in brain health. Healthcare providers treating MS should discuss these lifestyle factors with patients. People without MS may also benefit from these findings, as they suggest smoking and alcohol accelerate brain aging in general.
Brain aging is a gradual process, so you shouldn’t expect immediate changes. Research suggests that lifestyle changes typically show measurable effects on brain health over months to years. Quitting smoking may show benefits within weeks for some measures like exercise tolerance, but changes in brain structure typically take longer. Consistency matters more than perfection—small, sustained changes are more effective than dramatic short-term efforts.
Frequently Asked Questions
Does smoking really make your brain age faster if you have multiple sclerosis?
Yes. A 2026 study of 242 MS patients found smoking increased brain age by 0.20 years. This faster brain aging then directly caused worse disability and thinking problems, suggesting smoking’s harmful effects on MS outcomes work partly through accelerating brain aging.
Can exercise slow brain aging in people with MS?
Research shows regular physical activity slowed brain aging by 0.13 years in MS patients and improved cognitive performance by 0.042 points through this brain-aging effect. Even moderate exercise like walking appears protective for brain health in MS.
How much does alcohol affect brain aging in multiple sclerosis?
Alcohol consumption accelerated brain aging by 0.18 years in MS patients, nearly as much as smoking. This faster brain aging then contributed to worse disability scores and reduced cognitive performance, making alcohol reduction potentially important for brain protection.
Should I change my lifestyle if I have MS, or is medication enough?
Lifestyle factors like smoking, alcohol, and exercise directly affect brain aging and disability in MS through measurable biological pathways. While disease-modifying medications are essential, this research suggests lifestyle changes may provide additional brain protection that medications alone don’t provide.
How long does it take to see benefits from quitting smoking or exercising more with MS?
Brain aging changes gradually over months to years, so immediate results aren’t expected. However, physical benefits like improved exercise tolerance may appear within weeks. Consistency over time matters more than dramatic short-term changes for protecting brain health.
Want to Apply This Research?
- Track weekly exercise minutes (aim for 150 minutes of moderate activity) and smoking/alcohol use. Log these in a simple weekly checklist to visualize progress and identify patterns.
- Set a specific, achievable goal: “I will walk for 30 minutes, 5 days per week” or “I will reduce alcohol to 2 drinks per week.” Use the app to set reminders and track completion. Start with one change rather than trying to change everything at once.
- Every 3 months, review your lifestyle tracking data and note any changes in energy, thinking clarity, or physical function. Share this with your healthcare provider to see if your efforts are paying off and to adjust your approach if needed.
This research provides important insights into how lifestyle factors affect brain health in multiple sclerosis, but it does not replace medical advice from your neurologist or healthcare provider. The study shows associations between lifestyle factors and brain aging, not definitive proof of cause-and-effect. Before making significant lifestyle changes, especially if you’re considering quitting medications or starting a new exercise program, consult with your healthcare team. This information is for educational purposes and should not be used for self-diagnosis or self-treatment of MS or any other condition.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.