When it comes to brain health, there are many factors that can make a real difference – including how much exercise you get, how much you socialise, and keeping your blood pressure in a healthy range.
Even something as seemingly simple – and enjoyable – as spending time with your friends and family could help keep your mind sharp.
For, while it is easy to think of dementia as an inevitable consequence of getting older, it is anything but.
Evidence is mounting that a healthy lifestyle can help keep dementia at bay.
While simple changes to our lifestyle won’t delay, prevent or cure all cases of dementia, even delaying its onset by five years could halve the number of people with the condition.
Crucially, it is never too late (or too early) to start looking after your brain health – and even small changes could make a big difference.
Experts from University College London (UCL), leading a worldwide commission of experts, estimate that 40% of dementia cases could be delayed or prevented by healthier habits or environment.
A pivotal paper in 2020 identified 12 factors, from obesity and high blood pressure to air pollution and hearing loss, which, together, may be responsible for 40% of cases of dementia.
In other words, nearly half of all cases could potentially be delayed or avoided.
The 28 world-leading dementia experts of the Lancet Commission said that while it can be hard for us to change our behaviour, the potential for each of us to lower our risk of dementia is ‘huge’.
In this section, we explore the dozen factors pinpointed by the UCL-led review of dementia research. We also highlight practical ways of reducing your risk of dementia.
There are many simple changes you can make to help keep your brain healthy on top of factors such as maintaining a healthy blood pressure and getting hearing aids if you experience hearing loss.
But what happens if you adopt more than one, or even several, healthy habits?
After all, in real life, things don’t happen in isolation. We may cut back on our drinking while trying to eat more healthily, for instance, or find we have more energy for exercise when our sleep improves.
An increasing number of studies are looking at just this – what happens when we make several lifestyle changes – with fascinating findings.
The first big study of its kind was the FINGER study (the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) in 2015.
This tracked the health of 1,200 people aged 60-plus with a high risk of dementia for two years.
Half had coaching on diet and exercise, were given regular advice on heart health, diabetes and other medical conditions that could affect their brain health, and did regular brain training sessions. This intensive programme of lifestyle changes involved more than 200 meetings with doctors, nurses and coaches over two years.
The second group, or control group, was simply given general health advice.
Two years on and both groups did better than before in cognitive tests but those who had all the coaching improved the most, doing 25% better than those in the control group.
Particular improvements were seen in ‘executive functioning’ (a number of abilities, including multi-tasking, good judgment and sensitivity to others) and speed of processing information.
Disappointingly, however, there was no significant effect on memory – and the overall effect was smaller than expected.
Despite this, the study did highlight the very real potential for lifestyle modification to decrease the risk of dementia. Interestingly people in the control group also adopted a healthier lifestyle which may account in part for the small effect.
The researchers pointed out, "if the beneficial effects on cognition observed in FINGER will lead to even a modest delay in onset of dementia and Alzheimer’s disease, it would have a huge effect on both individual and societal levels"
Further evidence of the benefits of a healthy lifestyle comes from a U.S. trial in which 174 volunteers were given ‘brain plans’ tailored to their health.
Each was prescribed an average of 21 recommended changes, from blood pressure tablets to advice on how to sleep, eat more healthily, and how to reduce stress.
The results, published in 2019, revealed that those who had no memory problems at the start of the study delayed the onset of cognitive decline by around three years.
Those who already had some memory problems or had early mild Alzheimer’s also benefited, with further decline put off for around two years.
Yes, your genes are important but probably not as important as you think.
While there are handful of genes that always trigger Alzheimer’s in those who have them, they only account for around 1% of cases.
Most people have lots of different genes that act together to raise or lower their risk of Alzheimer’s.
And landmark research from 2019 shows that a person’s lifestyle can make a real difference, with healthy habits reducing the chance of developing of dementia, even in those at high genetic risk.
In other words, Alzheimer’s isn’t always inevitable, even with a genetic predisposition.
Exeter University researchers crunched data on almost 200,000 adults aged 60-plus who were free of dementia.
Information about whether they smoked, how much they drank, what their diet was like and how much they exercised was used to work out how healthy their lifestyle was.
Data on their DNA was used to determine whether their genes put them at high risk of dementia.
Ten years later, 1,769 of the participants had developed dementia. A healthy lifestyle cut the odds of the disease, however, even in those at high genetic risk.
Strikingly, those who were genetically predisposed but had a healthy lifestyle were almost a third less likely to develop dementia than those with similar genes but an unhealthy lifestyle.
The researchers said the tantalising result ‘undermines the fatalistic view of dementia’ – meaning your lifestyle can make a real difference, whatever your genes.
Researchers added: ‘Some people believe it is inevitable they will develop dementia because of their genetics. However, it appears that you may be able to substantially reduce your dementia risk by living a healthy lifestyle.’
University of California San Francisco research from 2020 revealed that the brain benefits of a healthy lifestyle don’t just apply to Alzheimer’s disease.
It found that being mentally and physically active (for instance, reading, spending time with family and friends and jogging) slowed the onset and progression of frontotemporal dementia, the most common type of dementia in under-65s.
For those who were the least physically and mentally active, the ability to perform everyday tasks such as washing themselves and managing finances declined twice as quickly compared to those who were the most active.
The researchers cautioned that they weren’t able to prove that an active lifestyle was behind the ‘remarkable’ difference but added: ‘If this were a drug, we would be giving it to all of our patients’.
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