Part 1: How everyday work shapes long-term cognitive health

Lasting cognitive decline does not begin at retirement; it is shaped quietly across decades of working life by the environments, expectations, and practices people inhabit every day. Last year, joining the Dementia Compass Advisory Board has widened curiosity about cognitive health not only in later life, but across the working years.

One of the most striking convergences comes from the 2024 Lancet Commission on dementia prevention, intervention, and care and Ellen Langer’s The Mindful Body. Read together, they challenge three assumptions: that cognitive health is fixed, purely medical, and solely individual.

The science

The 2024 Lancet Commission estimates that nearly 45 percent of dementia cases worldwide could be prevented or delayed by addressing modifiable risk factors across the life course. Many of these are not abstract lifestyle choices but conditions intertwined with work: physical inactivity, social isolation, depression, hypertension, hearing and vision loss, and limited ongoing education.

The Commission argues for a life course approach: risk accumulates across early life, midlife, and later life, yet remains malleable throughout adulthood. Langer’s work adds that expectation, attention, and choice shape both cognitive and physical outcomes, reframing mindfulness as an environmental property: do people have opportunities to notice, distinguish, decide, and engage?

Seen through this lens, cognitive health becomes responsive to context, including workplace context.

Three workplace insights
When this science is viewed through a workplace lens, three insights stand out.

• Work is a cognitive environment. It shapes how people direct attention, move, interact, and learn on a daily basis, often more than any formal wellbeing intervention.
• Mid-career years matter. The years of highest workload, responsibility, and pressure are also the years when many cognitive risk factors are actively shaped, for better or worse.
• Culture alone is not enough. What organisations signal through values can be undermined or reinforced by what they formalise through policy and process.

These insights move the conversation from individual resilience to the structure of work itself.

Policy as a cognitive lever
Culture is often described as “the way we do things around here”, but culture is sustained through policy choices, not intentions. Policies silently encode what an organisation believes about attention, energy, and capability.​

Some examples:

• Job design and role scope
  Highly fragmented or overly standardised roles may optimise efficiency while reducing cognitive engagement. Policies that allow for role evolution, task variety, and problem-solving discretion support sustained cognitive activation.
  Micro-question: Where in your organisation have roles become more administratively dense than cognitively rich?
• Learning and development
  When learning is framed narrowly around compliance or mandatory completion, its cognitive benefit is limited. Policies that value lateral learning, mentoring, and stretch assignments support the protective effects of ongoing education highlighted by the Lancet.
  Micro-question: How much of your learning budget goes to renewal versus reinforcement?
• Hybrid and flexible working
  Flexibility can protect focus and autonomy, but without intentional social design, it can also increase isolation. Policies that address connection, not just location, matter for long-term cognitive health.
  Micro-question: Who is structurally more isolated when your flexible working patterns are mapped?
• Workload and performance management
  Chronic overload increases depression and hypertension risk, both recognised contributors to cognitive decline. Policies that reward sustainable performance, not just output volume, send a different cognitive signal.​
  Micro-question: What, concretely, do your promotion decisions reward over a three-year horizon?

Seen this way, cognitive health is not an add-on wellbeing topic; it is a long-term outcome of how work is structurally experienced.

A quote to reflect on
“When we are mindful, we are actively making new distinctions. When we are mindless, we rely on old categories.” Ellen Langer.

A question to reflect on
What aspects of your organisation’s work design quietly support cognitive engagement, and which may be eroding it over time?

Further reading

• Livingston et al. (2024). Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet Commissions.
• Langer, E. The Mindful Body.

Introduction

As a new year begins and organisations reset their priorities, we often focus on what needs to change: new goals, fresh strategies, renewed expectations. But we rarely pause to examine the thing that will ultimately determine whether any of it sticks - behaviour. By behaviour, I mean specific, observable actions people take day to day, what they say, do, and how they interact, not general traits or feelings.

I recently listened to a session on behaviour change in organisations by Prof. Rob Briner (I am a huge fan of his work), and it put language to things I’ve instinctively believed for years. Behaviour is not a “soft” add-on; it is the work. As Daniels and Bailey put it, “All organisational results are the product of human behaviour.”

As organisations reach for new OKRs and bold ambitions, it is worth remembering that without revisiting the people practices and systems that shape everyday behaviour, very little will change. January is a natural reset point. Before we ask people to deliver more, collaborate more, or “be more proactive,” it is worth asking a simpler question: do we even know which behaviours matter, and are our systems designed to support them?

The Science

Psychological research in social learning and behavioural economics shows that environments cue behaviours more reliably than attitudes or motivations alone. From the webinar, I learned the following:

• Specific, observable, measurable behaviours are what organisations should target, not vague categories like “be proactive,” “be collaborative,” or “show ownership.” These are pseudo-behaviours, you cannot change them because they are not behaviours.
• Behaviour change in workplaces rarely requires digging into “root causes” like childhood, personality, or motivation. Instead, the evidence shows that changing aspects of the immediate environment is what shifts behaviour.
• Changing attitudes does not reliably change behaviour. In fact, it’s often the reverse: changing behaviour can shift attitudes over time.
• The Organisational Behaviour Management (OBM) model shows that behaviour is shaped by antecedents (what happens before), behaviour (what is done), and consequences (what happens after). Tweaking antecedents or consequences is more effective than launching new engagement campaigns.

This is consistent with decades of behavioural science:

• Lewin’s field theory emphasised that behaviour is a function of the person and their environment.
• Kahneman and Tversky demonstrated that environments consistently shape decisions more than we like to admit.
• Duckworth and Gross (2020) highlight that despite numerous behaviour-change models, no single approach works everywhere - context is always king.

The challenge for organisations is twofold:

1. We often target things that are not behaviour.
2. We underestimate how much our systems shape what people actually do.

Key Findings
Drawing on the webinar, three insights stood out:

1. Many organisations are trying to change things that aren’t behaviour.
Examples: “be empathetic,” “be resilient,” “be more commercial.” These sound good but are not observable actions. You can’t influence what you can’t define.

2. Behaviour change requires clarity.
If we want better performance, we need to pinpoint the behaviours that drive it. For example, improving customer service in supermarkets wasn’t about “being helpful,” it was about three observable actions:

• make eye contact,
• smile,
• ask customers if they need help.

Simple, specific, measurable.

3. Systems support (or sabotage) behaviour.
Antecedents (e.g., goals, instructions, feedback, resources) and consequences (e.g., praise, recognition, loss of opportunity) determine whether behaviours show up consistently. A beautifully designed strategy rarely stands a chance if the system - metrics, processes, rituals, leadership habits, pulls people elsewhere.
This is behaviour science 101: we get the behaviours we reinforce, not the behaviours we request.

What Does This Mean for Organisations in this Year?
January is a natural moment to start again, but we miss an opportunity if we only rewrite objectives and not the behaviours that will bring them to life.

Here are four practical opportunities for organisations to revisit:
1. Get clear on the behaviours that actually drive your goals.
Take one strategic priority and ask:

• What behaviours would we see if we were successful?
• Can we observe them?
• Can we measure them?

If the answer is no, you’re not ready to implement the strategy.

2. Look at the environment, not the individual, first.
Instead of asking why people aren’t doing something, ask:

• Do they have clarity?
• Do they have cues?
• Do they have the resources?
• Are there blockers in the environment?
• Are the consequences aligned with what we want?

Most “performance issues” are system issues in disguise.

Across very different industries, a few examples stand out:

• Google (Tech): Introducing simple meeting norms such as equal speaking turns measurably improved team performance (Project Aristotle).
• Heathrow Airport (Public Infrastructure): Etching a small fly into urinals reduced spillage by 80 percent - a micro-cue that transformed hygiene behaviour.
• Call Centres (Service Industry): Synchronising break schedules increased collaboration and boosted productivity by around 20 percent (MIT Human Dynamics Lab).
• Hospitals (Healthcare): Installing real-time feedback screens at ward entrances lifted hand hygiene compliance from ~60 percent to over 90 percent and reduced infections.
• Microsoft Engineering (Technology): Introducing 15-minute daily paired code reviews reduced software defects by more than 60 percent.

Across sectors, the lesson is the same: change the system, and behaviour changes with it.

3. Reinforce progress, not perfection.
The behavioural model emphasises sub-goals and positive reinforcement.
People repeat behaviour that is acknowledged and rewarded, even in small ways.

4. Stop relying on attitudes or culture as the lever for change.
Engagement surveys are useful, but improving attitudes alone will not drive specific behaviours.
Culture, too, is not a cause of behaviour, it’s a description of behaviour. If you want to change culture, change behaviour first.

This aligns with the equity lens many organisations now explore. When people perceive inequity, in workload, recognition, pay, development, or opportunity, their behaviour shifts long before their words do. They withdraw, reduce effort, change their frame of comparison, or leave altogether (Adams, 1963).
Behaviour always tells the truth.

A Quote to Reflect On

“Behaviour change emphasises that it is changes in behaviour that cause changes in attitude rather than vice versa.”

A Question to Reflect On

If your organisation could only change three behaviours next year, which ones would make the biggest difference and what in your environment needs to shift to make them possible?
While focusing on behaviour is key, organisations must also address systemic barriers like workload, incentives, or leadership alignment, that affect people’s ability to act differently. Retention, performance, and culture ultimately come down to what people do every day. Design your systems so those behaviours are clear, supported, and consistently reinforced, and watch your organisation transform.
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Further Reading

• Corporate Research Forum. (2025). Behaviour Change in Organisations [Webinar].
  https://www.crforum.co.uk/research-and-resources/video-behaviour-change-in-organisations/
• Daniels, A. & Bailey, J. (2014). Performance Management: Changing Behaviour That Drives Organizational Performance.
• Duckworth, A. & Gross, J. (2020). Behaviour Change: An Integrative Review.
• Kahneman, D. (2011). Thinking, Fast and Slow.
• Adams, J. (1963). Equity Theory of Motivation.
• Michie et al. (2015). The Behaviour Change Technique Taxonomy.