One in three of us will develop dementia in our lifetime – a condition that slowly but surely devastates lives.
Science has made dramatic strides recently – with medications in several trials showing promise in slowing Alzheimer’s disease, the most common type of dementia.
But just as exciting is the growing body of new research focusing on ways to help prevent the brain from deteriorating in the first place.
The recent Lancet Commission Report found nearly half of dementia cases may in fact be preventable by taking simple, practical steps to improve the way you live your daily life. And it’s never too late to start.
Here, in the second and final part of our exclusive series, leading experts outline the four key lifestyle pillars that can help reduce your risk of developing dementia, keeping your brain fit and functional well into later life.
SLEEP
Consistently sleeping badly can play an important behind-the-scenes role in increasing your dementia risk.
Insomnia, poor quality sleep and sleep apnoea (a disorder linked to snoring) can make it likelier you will develop other serious health problems including type 2 diabetes, obesity, stroke and depression – all risk factors for dementia
Disruption to sleep patterns interferes with the brain’s ability to clear out toxins and the protein beta amyloid, linked to Alzheimer’s, as well as interfering with other processes that maintain brain health and memory, says Guy Leschziner, a professor of neurology and sleep medicine at Guys and St Thomas’s Hospitals in London and author of The Secret World Of Sleep. ‘But it’s complex – the precise mechanisms need more research,’ he says.
Research also shows that insomnia, poor quality sleep and sleep apnoea (a disorder linked to snoring) can make it likelier you will develop other serious health problems including type 2 diabetes, obesity, stroke and depression – all risk factors for dementia.
Time to tackle snoring
If your snoring regularly bothers your partner at night, you might have obstructive sleep apnoea, a sleep disorder linked to an increased dementia risk. It’s estimated to affect up to 10 million people in the UK, according to the Sleep Apnoea Trust.
Sleep apnoea, where the muscles in your throat and neck relax when you are asleep, causes the airway to collapse, temporarily reducing or halting airflow.
Meditation
Meditation has been shown to promote better sleep if practised regularly. As well as calming thoughts, it lowers blood pressure, improves immunity and is as effective as drugs in preventing new episodes of depression, anxiety and stress – which unchecked can all increase dementia risk. The Oxford Mindfulness Foundation offers free weekday sessions. For details, go to oxford mindfulness.org.
‘Intermittent oxygen starvation stresses the brain, damaging blood vessels in the brain and may contribute to cognitive damage,’ explains Dr Dipesh Mistry, a consultant psychiatrist specialising in sleep disorders based in London.
‘Fragmented sleep also interferes with the functioning of the glymphatic system, the brain’s waste disposal system, preventing it from effectively clearing toxins and the amyloid proteins associated with Alzheimer’s,’ he adds.
A 2022 study by Korean scientists who tracked 1,110 volunteers for four years, found those with persistent sleep apnoea had a decline in memory, concentration and processing skills.
‘If you consistently wake up feeling tired get your GP to refer you for diagnostic tests or consult a sleep specialist,’ says Dr Mistry.
Effective treatments include losing weight and wearing a continuous positive airway pressure (CPAP) device that uses mild air pressure to keep your airways open while you sleep.
Get help for insomnia
Do you toss and turn all night? If this lasts for more than a month, you could have insomnia, defined as having difficulty falling or staying asleep. Chronic insomnia, (lasting more than three months) has severe potential long-term implications including raised blood pressure, heart problems, obesity, lowered immunity and depression – all risk factors for dementia. ‘Research also shows lack of sleep can lead to a build-up of beta-amyloid proteins linked to Alzheimer’s Disease,’ says Professor Leschziner.
Chronic insomnia can be successfully treated by CBTi courses, available online or via the NHS, after referral from your GP.
Review your sleeping pills
Although sleeping pills – including benzodiazepines and ‘Z’ drugs such as zolpidem – are often prescribed for treating insomnia, there is growing evidence that long-term use is linked to cognitive decline and a risk of dementia – as shown by 2018 research published by Korean scientists in the journal Plus One.
‘It’s thought they may affect chemicals in the brain important for memory and learning,’ says Professor Leschziner.
Ask your sleep specialist or GP to review your prescription and consider other options.
Sort out bad sleep habits
People who have consistently short sleep – defined as less than six hours a night – when they are middle aged are 30 per cent more likely to go on and develop dementia in older age, research published in Nature Communications in April 2021 shows.
If you are sleep deprived (you go to sleep quickly but aren’t sleeping enough) as opposed to having insomnia (difficulty falling and staying asleep), you can address this by adopting good patterns of sleep hygiene.
Professor Leschziner advises the following:
- Sleep in a dark room – a recent study by Australian and American researchers involving 84,000 people found that those whose sleep was interrupted by light exposure between 12.30am and 6am were one and a half times likelier to develop type 2 diabetes, a major risk factor for dementia.
- No weekend lie-ins. Regular bedtimes and wake-up times are important to maintain a consistent circadian rhythm, he says – ‘so you shouldn’t lie in for more than an extra hour at most’.
Sleep in a dark room – a recent study by Australian and American researchers found that those whose sleep was interrupted by light exposure between 12.30am and 6am were one and a half times likelier to develop type 2 diabetes, a major risk factor for dementia
- Resist a stiff nightcap – alcohol disrupts sleep quality and there’s plenty of evidence that even moderate drinking could be linked to cognitive decline.
- Don’t scroll on your phone in the evenings. ‘Not only does blue light interrupt the body’s circadian rhythm but being constantly engaged on your phone or iPad means your brain will still be activated just before bedtime,’ says Professor Leschziner.
HOBBIES
What you choose to do in your spare time can have a huge impact on how well your brain functions. There are plenty of ways you can engage your brain and strengthen neural connections – but pick hobbies you really enjoy.
‘Try to see improving your brain health as something fun rather than something you ‘ought’ to do. You’ll get much more out of it and you’re more likely to adopt the habit,’ says Dr Thomas MacLaren, a consultant psychiatrist at London’s Chelsea and Westminster Hospital and Re:Cognition Health. Here are some suggestions, backed by science.
Get out in the garden
A groundbreaking study this year found gardeners may receive protection against dementia and lead longer lives.
The University of Edinburgh research, which tracked hundreds of people and their lifestyles over nearly a century, found that those who spent time gardening had
better brain function in later life.
‘Engaging in gardening projects, learning about plants and general garden upkeep, involve complex cognitive processes such as memory and executive function,’ says Dr Janie Corley, lead author of the study. ‘Consistent with the ‘use it or lose it’ framework of cognitive function, more engagement in gardening may be directly associated with a lower risk of cognitive decline.’
Gardening is also great exercise, which can help to reduce blood pressure and keep obesity and type 2 diabetes in check, all risk factors for vascular dementia.
Walk in the woods
Forest bathing – the ancient Japanese practice of simply spending quiet time in woodland – has been shown by numerous studies to calm persistent anxiety and stress, both dementia risk factors.
Trees and plants also emit ‘phytoncides’ which have antibacterial and antifungal properties. We breathe these in when we spend time in a forest and they have been shown to enhance the activity of our body’s natural killer cells, helping the body to fight disease more effectively.
Forestry England (forestryengland.uk) has advice on where to find a calming location near you, including tips for beginners and where to find a guided forest bathing session.
Have a good sing-song
Numerous studies show singing increases the flow of oxygenated blood to the brain. This triggers the release of ‘feel good’ brain chemicals such as serotonin and dopamine, linked with warding off depression, a dementia risk factor.
Singing increases the flow of oxygenated blood to the brain. This triggers the release of ‘feel good’ brain chemicals such as serotonin and dopamine, linked with warding off depression, a dementia risk factor
A good sing-song also boosts oxytocin, aiding feelings of social bonding and reduces levels of the stress hormone cortisol. As it needs you to focus intensely on several things at once, it helps with mental alertness and memory, too.
Alzheimer’s Society runs numerous Singing for the Brain groups (alzheimers.org.uk) or contact Making Music (makingmusic.org.uk) for other choirs near you.
Turn on a sitcom
Research shows that laughing regularly can reduce your dementia risk so actively look for something to make you laugh every day, advises Dr MacLaren.
Whether that’s watching a comedy show or finding something funny on social media, the act of laughing triggers the release of ‘feel good’ brain chemicals including dopamine and serotonin.
These counteract low mood and even depression, both dementia risks. Sharing a joke with a friend is also a way of bonding which helps guard against feelings of isolation, another dementia risk.
Get a pet
Caring for a pet reduces feelings of loneliness and depression, both dementia risk factors
Caring for animals reduces feelings of loneliness and depression, both dementia risk factors.
A study published in Preventative Medicine in 2022 involving 11,000 people found that dog owners, for example, had a lower risk of dementia than those who didn’t have a dog.
Phone a friend
Protect your brain health and memory from the comfort of your own armchair by ringing up family and friends at least once a day.
American research published in The Lancet in 2022 found that frequent phone conversations can help limit cognitive decline by strengthening social connections.
Other studies have found that older people with a wide circle of friends and relationships could be 25 to 30 per cent less likely to develop dementia than those with few contacts.
Soak up some rays
Make the most of warm autumn days by sitting in the sunshine – just nine minutes of midday sun is enough to top up your vitamin D levels, according to research by Professor Lesley Rhodes at Manchester University.
People who are deficient in vitamin D are more than 30 per cent likelier to have dementia than those who have enough in their blood according to a 2019 study. Known as the ‘sunshine vitamin’, vitamin D may help to clear amyloid plaques in the brain.
The NHS recommends that both adults and children should consider taking a daily vitamin D supplement of 10 micrograms (mcg) during the winter months when we are all at risk of not getting enough from being outdoors.
EXERCISE
Any form of activity can slash your risk of dementia. A 2022 study which tracked half a million middle-aged Britons over 11 years, found that people who regularly worked out or played sport had a 35 per cent reduced chance of developing dementia. But even those who did lighter physical activities saw a benefit.
Work up a sweat
Aerobic exercise gets your heart pumping, delivering more nutrients to body and brain.
It also stimulates production of a protein called brain-derived neurotrophic factor (BDNF), often dubbed ‘brain fertiliser’ because it promotes the growth of new brain cells and supports the survival of existing ones, especially in the hippocampus, the area of the brain important for memory.
Just 30 minutes of aerobic exercise can increase blood levels of BDNF by 30 per cent – and the higher the intensity, the more BDNF appears to rise. Any form of activity that leaves you slightly breathless is good – dancing, cycling, jogging, tennis, swimming or even strenuous gardening.
Stephen Harridge, professor of human and applied physiology at King’s College, London, recommends combining regular aerobic exercise with resistance training, as building muscle also benefits the brain.
One study found that older women who participated in resistance training twice a week had fewer and smaller brain lesions (a marker of brain ageing associated with impaired cognitive performance) than those who trained only once a week.
Research shows exercise reduces your chances of having high blood pressure, obesity, insulin resistance and a stroke, too – all are dementia risks.
Walk and talk
Going for a brisk walk with a friend combines exercise with being sociable, a bonus say experts. So-called ‘dual task training’ gives body and brain a workout at the same time. Other examples include
listening to a foreign language podcast while riding a stationary bike.
‘Don’t think of physical and mental exercise as being separate. For top brain health you need to be doing both,’ says Tim Beanland of Alzheimer’s Society. Consider signing up with a pal this autumn at one of Alzheimer’s Society Memory Walks, (memorywalk.org.uk).
For a challenge, train for a Trek 26 walk, covering either 26 or 13 miles, at one of ten locations across the UK, in spring 2025, visit alzheimers.org.uk/Trek26.
Household chores count
Few of us enjoy housework – but apart from the satisfaction of a clean and tidy house there’s another major bonus.
The 2022 study which tracked the activity levels of more than half a million middle-aged Britons found that those who regularly did vigorous household chores had a 21 per cent lower risk of developing dementia.
The research echoes the findings of a 2021 study in BMJ Open, which found that older adults who reported doing a lot of housework had higher scores in memory and attention tests that those who did not.
Short bursts help
Personal trainer Lavina Mehta
You can reap benefits from just a few minutes of exercise at a time. For the best results, spread these throughout the day says personal trainer Lavina Mehta, an ambassador for Alzheimer’s Society.
‘Short bursts of activity count and they provide immediate benefits including reducing your risk of depression and chronic illnesses like dementia,’ says Lavina, who advocates ‘exercise snacking’ as an easy way to incorporate more activity into your day.
By this she means taking regular breaks to do something physical, even if only for a few minutes.
Try The Stair Snack: Three flights of stairs, three times a day. Start off small, step-by-step, if you’re new to exercising and build up to climbing three flights of stairs in the morning, at lunchtime and in the evening.
To progress, take two stairs at a time or add some shopping bags or a rucksack. Add more flights – or increase your pace – as you find it becomes easy.
Could revving up your love life help keep dementia at bay?
An active sex life well into your later years has been linked with having a healthier brain.
Those who had sex the most (at least once a week) frequently scored better on cognitive ability tests than those who had infrequent, or no, sexual relations, Coventry University researchers found.
The team, who looked at 73 men and women aged between 50 and 83, with no previous history of dementia, concluded: ‘The findings have important implications for the maintenance of intimate relations in later life.’
The menopause can play a major role in dwindling libido for many women, partly caused by declining hormone levels
Other studies have shown that regular sex can also help to lower blood pressure, ease stress and anxiety, improve sleep and boost immunity, which all have important roles in helping to prevent dementia.
Scientists at Johns Hopkins University in the US found that men who have sex at least twice a week and women who report having satisfying sex lives are less likely to have a heart attack, a known risk factor for vascular dementia.
How the Big O stimulates brain cells
Having an orgasm could boost your brain power, according to research.
More than 30 regions of the brain are stimulated when you climax – resulting in an explosion of activity that lasts for around ten seconds after the orgasm began, according to US research
At that point, your brain is flooded with ‘feel good’ chemicals including dopamine, serotonin and oxytocin, which boost mood and reduce anxiety.
It’s thought that these chemical messengers latch on to parts of the brain responsible for memory, complex thoughts and decision making – giving you a cognitive boost, albeit temporarily.
Separate studies suggest regular orgasms may have other long-term health benefits including boosting blood flow, blunting chronic pain and improving sleep. The benefits are similar for both men and women.
Pep up your libido
Middle age can be a time when sexual satisfaction flags for many – due to pressures of work, family commitments and other health and lifestyle issues.
The menopause can play a major role in dwindling libido for many women, partly caused by declining hormone levels.
Vaginal dryness, urinary tract infections (UTIs) and painful sex are also common post-menopause due to flagging oestrogen levels, which cause vaginal tissues to be thinner and drier. Dr Melanie Hacking, a GP and menopause specialist at Oxford Hormone Clinic, advises consulting your GP or a menopause specialist if these are troubling you to see if Hormone Replacement Therapy (HRT) can help.
Some research shows that oestrogen replacement may also have a protective effect against dementia.
A 2021 US study found that taking oestrogen replacement within ten years of the menopause (i.e. before 60) could reduce risk of dementia by up to 73 per cent.
Meanwhile, erectile dysfunction affects more than half of men aged between 40 and 70. ‘It’s important that men don’t ignore this as it may be a symptom of underlying health problems so discuss it with your GP,’ says Dr Hacking.
Treatments include over-the-counter medicine Viagra Connect and painless shockwave treatment to improve blood flow to the penis.
Poses that perk up the memory
Yoga may help to slow the rate of cognitive decline. As well as improving balance and reducing stress, changing positions and chanting engage different parts of the brain, encouraging it to form new neural connections.
A 2016 study looked at the effects of a 12-week yoga programme on older people (55 and above) with mild cognitive impairment, a risk factor for dementia. The volunteers saw improvements in mood and memory that lasted up to six month
In one 2016 study, scientists from the University of California studied the effects of a 12-week yoga programme on older people (55 and above) with mild cognitive impairment, a risk factor for dementia.
The volunteers saw improvements in mood and memory that lasted up to six months.
This was backed by MRI scans which identified increased activity in the areas of the brain involved in memory and complex decision making.
The British Wheel of Yoga (bwy.org.uk) has details of classes near you.
The Feel Good Fix, by Lavina Mehta, Penguin, £18.99. You can find free exercise tips on Lavina’s Instagram @feelgoodwithlavina and workouts on YouTube.
