Live your life, live your brain

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.

What can I do?

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.

  • Hearing loss

    Intriguingly, how well we hear may be important, with studies increasingly linking hearing loss with higher risk of dementia. In fact, according to the Lancet Commission, hearing loss could be behind 8% of all cases of dementia.

    It’s possible that the social isolation that can accompany hearing loss helps fuel dementia. You can learn more about the importance of social activity in the Active Mind pillar.

    Studies show that a person’s risk of dementia rises as their hearing worsens. But, importantly, hearing aids seem to protect against memory loss. With this in mind, the Lancet Commission recommends we protect our ears from excessive noise and wear a hearing aid when necessary.

    Additionally, hearing aids are improving. Many people find the newest hearing aids with Bluetooth enhance their life, meaning they can listen to music, podcasts, radio or books as they clean – or walk (an added bonus).

  • Obesity

    Excess weight is linked to dementia, but the reverse is also true, with studies showing that weight loss brings with it gains in memory, at least in the short term.

    Even a couple of kilos can make a difference. A study found that memory and attention improved when overweight men and women lost 2kg or more

  • High blood pressure

    Keeping a lid on your blood pressure could help keep your brain healthy. One key study illustrated the value of lowering systolic blood pressure (the top number) to 120 mmHg – lower than usually recommended.

    Over-50s who got their blood pressure down were 20% less likely to develop dementia and mild cognitive impairment (the slight memory lapses that can be a precursor of dementia) five years later than those whose readings remained higher.

    Taking into account all the research, the Lancet Commission recommends that, from around the age of 40, we try to keep our systolic blood pressure at 130 mmHg or below.

    Encouragingly, it adds that blood pressure tablets are the ‘only known effective preventive medication for dementia’.

  • Diabetes

    Type 2 diabetes – the form that normally occurs in middle-age and is associated with obesity – is a ‘clear risk factor for the development of future dementia’, the Lancet Commission concluded.

    Research links type 2 diabetes with a 60% higher chance of dementia. Often if you take exercise and keep your weight in reasonable limits then this may ward off diabetes - a risk that increases the longer and more severe the diabetes.

  • Education

    Those with less than eight years of education are more than twice as likely to develop dementia as those with more education.

    And those who have been to college or university with education up until the age of 20 or beyond have even more protection against dementia.

    This is thought to be due to something called cognitive reserve. This is the idea that the things we experience throughout our lives, including our education, jobs and hobbies, rewire and reshape the brain.

    These constant changes to the brain are believed to make it more resilient to decline and disease. You can learn more about cognitive reserve, and how to stay mentally active, in the ‘Active Mind’ pillar.

  • Smoking

    Smokers are at higher risk of dementia than non-smokers – but quitting the habit is good for your brain, no matter what age you are.

    For example, a study of 50,000 men aged 60-plus found that those who gave up smoking for at least four years were 10% less likely to develop dementia in the next eight years than those who didn’t stop.

    And don’t forget other people’s smoke. Studies have linked passive smoking – the breathing in of second-hand smoke – with memory loss.

    In recent years, patches and other ways to stop smoking have made this easier.

  • Physical inactivity

    Those with less than eight years of education are more than twice as likely to develop dementia as those with more education.

    And those who have been to college or university with education up until the age of 20 or beyond have even more protection against dementia.

    This is thought to be due to something called cognitive reserve. This is the idea that the things we experience throughout our lives, including our education, jobs and hobbies, rewire and reshape the brain.

    These constant changes to the brain are believed to make it more resilient to decline and disease. You can learn more about cognitive reserve, and how to stay mentally active, in the ‘Active Mind’ pillar.

  • Lack of social contact

    Social isolation is thought to be responsible for 4% of all cases of dementia.

    If you find meeting people daunting, the GCBH advises starting small. Its tips include sharing a smile a day with someone or showing an interest in someone by asking how they are. Another good tip is to make a point of seeing your family and friends.

    For lots of information on the brain benefits of socialising, see our Active Mind pillar.


  • Depression

    One in 25 cases of dementia may be linked to depression. It’s possible that depression in some way damages the brain, making it more vulnerable to Alzheimer’s and other forms of dementia. It may also be that those who are depressed miss out on vital social contact.

    Researchers also think that, in some people, depression is one of the very earliest signs of dementia.

  • Air Pollution

    Traffic fumes, wood smoke and other types of air pollution may be responsible for 2% of cases of dementia. Animal studies suggest the pollutants speed up the degeneration of the brain and the accumulation of beta-amyloid, the sticky brain protein that is a hallmark of Alzheimer’s.

    While you can’t choose whether where you live is polluted, you can try not to add to pollution levels (eg driving petrol cars, using wood burning stoves). Even walking down streets that are back from a main road can reduce the level of pollutants enormously, so think about the routes you take.

  • Excess alcohol

    While small amounts of alcohol might be beneficial, drinking heavily has long been linked to cognitive impairment and dementia. Now we know that even more moderate drinking can cause harm. The Lancet Commission recommends we don’t have more than 21 units of alcohol a week. If you have two relatively small glasses of wine a day, this is more than this recommendation. Try to have some alcohol-free days every week.

    A unit contains 8g of pure alcohol – the amount found in a single measure of spirits. A standard (175ml) glass of wine contains 2.1 units, and a pint of beer has 2.3 units.

  • Traumatic Head Injuries

    People with traumatic head injuries, such as brain damage caused by sports, falls and road traffic accidents, are at higher risk of dementia, numerous studies have shown.

    There is also concern that regular heading of a football can cause dementia, with a 2019 study of former Scottish professional players concluding they were three and a half times more likely to die from Alzheimer’s disease than other men of a similar age and social status.

The benefits of a healthy lifestyle

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.

In the pillars on this site, we also examine the effects of nutrition, sleep and gut health.

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.

FINGER study

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.

What about my genes?

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.

Says who?

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.’

What was their secret?

  • Exercised regularly. For example, two and a half hours of brisk walking or an hour and a quarter of singles tennis a week (you can read more about exercise in our Exercise pillar)

  • Didn’t smoke

  • Drank alcohol in moderation (no more than one drink a day for women and two for men)

  • Ate at least four out of seven types of food linked to a healthier brain (you can find out about how to eat your way to a healthier brain in the Nutrition pillar)

What about other types of dementia?

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’.

Research Details

May 2021

Page Last Reviewed

May 2022

Next Review Date

We use cookies to ensure you get the best experience and analyze web traffic. For these reasons, we may share your usage data with our analytics partners. By continuing to this site, you consent to this policy.