There are two important takeaways to close practice gaps in the lifestyle medicine management of cognitive aging and neurodegenerative disorders. First, the most measurable differences in outcomes occur in those who have the greatest risk or when the individual acknowledges a concern. This means that early modifications and interventions that are initiated at the first sign of a problem or at the earliest report of patient concern may have the biggest effect. The second takeaway is that the healthcare professional has an important role in creating motivation and persistence. Assuring that there is a shared commitment to common goals at each encounter is critical to continued adherence. Problem-solving around barriers to adherence can be one of the most useful aspects of clinical management.