It’s the silent thief that gradually steals our memory, sense of self and, ultimately, our dignity. So is it any wonder many of us fear dementia, which affects around one million Britons, more than any other condition?
Science has made dramatic strides recently – with medications in several trials showing promising developments 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.
Nearly half of dementia cases, 45 per cent, could be avoided by adopting a healthier lifestyle, according to the recent, highly regarded Lancet Commission Report which highlighted 14 controllable risk factors – including high cholesterol, untreated hearing problems and air pollution.
Research is increasingly showing that looking after your brain involves keeping your whole body healthy
‘There is no magic bullet, but research shows that by making a combination of lifestyle changes you could dramatically improve your odds,’ says the report’s lead author Gill Livingston, a professor of psychiatry of older people at University College London.
‘It’s never too late to start. You can still make a real difference to your risk, even if you make changes in middle age and later in life.’
But where to begin? Research is increasingly showing that looking after your brain involves keeping your whole body healthy.
So today, in the first part of an exclusive series you will want to tear out and keep, is the ultimate head-to-toe guide to helping to prevent dementia, as recommended by experts in the field.
Head: Protect your brain from bumps
Knocks to the head, however minor, can lead to dementia later in life. So always wear a helmet when cycling, skateboarding, scootering or skiing – and encourage children to do the same.
‘Any kind of knock can cause an injury which may cause the brain to make amyloid plaques around the injury site as well as causing direct damage – the build-up of these deposits can help to cause Alzheimer’s in later life,’ explains Professor Gill Livingston.
Those who play contact sports can protect themselves by wearing a Rezon Halos headband, which is CE-approved and clinically tested.
Particularly dangerous are ‘rotational blows from angle hits – such as rugby tackles’, says Dr Emer MacSweeney, a consultant neuroradiologist and CEO at Re:Cognition Health.
This is because they shake the brain, leading to ‘tears in delicate blood vessels in the brain – and, ultimately, to the creation of abnormal tau protein, similar to that found in Alzheimer’s’, she explains.
Knocks to the head, however minor, can lead to dementia later in life, so always wear a helmet when cycling, skateboarding, scootering or skiing
Mind: Get help for depression
Studies show that depression doubles the risk of developing dementia. But seeking help and getting treatment substantially reduces that risk.
One major UK study found middle-aged sufferers who took antidepressants or had therapy were around a quarter less likely to develop dementia than those who didn’t treat it.
Those who had both antidepressants and therapy saw a 38 per cent reduction in risk.
The same areas of the brain are affected by both depression and Alzheimer’s – showing a reduction in certain brain chemicals that send messages between brain cells. Some anti-depressants restore the levels of these chemicals.
But studies have also shown that mindfulness, or mindfulness-based cognitive behavioural therapy (also available on the NHS) can be just as successful in preventing new episodes of stress and anxiety – both of which increase dementia risk.
Eyes: Get your cataracts treated
Research has found that those who fail to correct their vision in later mid-life increase their risk of dementia by 47 per cent.
Not only is it important to get the right prescription for your glasses, but the optician will be able to spot the early signs of cataracts.
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Studies have shown that those who have their cataracts removed – a simple operation to replace the cloudy lens of the eye with an artificial one – had a significantly reduced risk of dementia compared with those who did not.
‘When tested and treated, people not only tackle the excess risk of dementia but they also improve the quality of their life. The world is clearer and brighter,’ says Professor Livingston.
Nose: Do not be tempted to pick it!!
It’s widely reviled as a habit but now new research, published in the American Journal of Medical Sciences, suggests that picking your nose could also increase your risk of developing Alzheimer’s Disease.
Studies suggest that germs transferred from the fingers to the nose may travel to the brain, causing inflammation, which could in time damage brain cells, potentially contributing to Alzheimer’s disease.
The report also suggested that nose-picking could damage the lining of the nose, making it easier for harmful organisms to enter the bloodstream, causing further inflammation and increasing the risk of dementia.
Ears: Test for a hearing aid
People who struggle with their hearing are more than 40 per cent likelier to develop dementia than those with good hearing.
For every ten decibels lost, the dementia risk increases by up to 24 per cent. ‘Loss of hearing brings a massive loss of stimulation and particularly damages parts of the brain connected with memory,’ explains Professor Livingston.
But now research suggests that using hearing aids cuts the risk of dementia by 17 per cent.
Your GP can refer you for a hearing test; many High Street opticians and pharmacies also offer free tests.
Mouth: Ditch the mouthwash for floss
Make sure you clean between your teeth properly every day to reduce your risk of dementia in later life, says dentist James Goolnik, of Optimal Dental Health in London.
Good oral hygiene helps prevent decay and studies have shown that ‘the more teeth we lose as we age, the greater the risk of reduced cognitive function,’ he says.
Several studies have also shown a link between bacteria and inflammation caused by gum disease and the build-up of amyloid proteins linked to Alzheimer’s.
James advises brushing your teeth for two minutes twice-a-day and using floss or interdental brushes to clean between them.
But he advises against mouthwash as this can destroy the variety of bugs needed to maintain a healthy oral microbiome to effectively fight against infection and inflammation.
Lungs: Don’t light up and avoid main roads
Cigarette smoking is a major dementia risk factor. The Lancet researchers found it increased your chances of developing dementia by nearly a third (30 per cent).
Not only do reduced levels of oxygen increase your risk of heart attacks and strokes (dementia risk factors) but chemicals in cigarettes contain neurotoxins which can penetrate the blood-brain barrier designed to protect the brain, causing inflammation and damage to brain cells, linked to the development of Alzheimer’s.
Ask your GP, health visitor or pharmacist about the NHS’s free Stop Smoking Service.
Even if you’ve been smoking for decades, within two years of stopping you will reduce your dementia risk to the same as someone who has never smoked.
Breathing in polluted air has also been shown to increase your dementia risk by 10 per cent. This is because it contains tiny PM2.5 particles, linked to lung conditions and heart disease, both dementia risk factors.
There is evidence these tiny particles can enter the brain. ‘Try to regularly walk on quieter side streets rather than busier, more polluted main roads. This can make a big difference to the amount you inhale,’ says Professor Livingston, who also advises not lighting woodburning stoves, responsible for 38 per cent of the UK’S PM2.5 particles.
Arms: Tone up any excess flab
Researchers recommend under-taking an exercise programme that includes upper body exercises to improve muscle tone
Carrying excess fat around your upper arms could mean you are at a greater risk of several serious conditions – including Alzheimer’s, according to new research published last month.
Chinese researchers at Sichuan University in Chengdu, who analysed data from more than 400,000 people over nine years, found those with flabby arms (measuring over 32cm/12.5in midway between their elbow and shoulder) were 18 per cent more at risk of developing Alzheimer’s or Parkinson’s. By contrast, those with muscly arms were 26 per cent less likely to develop either condition.
Researchers recommend under-taking an exercise programme that includes upper body exercises to improve muscle tone.
Hands: Strengthen your grip
Poor grip strength has been linked in several studies with an increased risk of developing dementia – meanwhile having a solid grip is associated with greater longevity.
This is because as you age, a strong grip becomes an important indicator of overall health including muscle strength, bone density and heart health. It’s also thought that losing muscle strength may result in reduced production of proteins including brain-derived neurotrophic factor (BDNF), sometimes dubbed ‘brain fertiliser’, which stimulates the brain to produce new brain cells and pathways.
Exercises such as lifting weights or kettle bells can help to strengthen muscles in your hands.
Another suggestion is to practise squeezing a tennis ball several times a day – this is a great way to engage your wrist and finger flexors and improve your grip. Simply hold a tennis ball in your hand, clenching as hard as you can for five seconds, then release. Repeat ten times.
Stomach: Tackle that spare tyre
Nearly two-thirds of adults in the UK are overweight or obese – this is linked to a 30 per cent increased risk of developing dementia later in life.
Extra weight around your middle is particularly linked to type 2 diabetes, another dementia risk factor. But research shows you can even reap brain benefits from modest weight loss; losing just 4lb (2kg) could be enough to see an improvement in cognitive function six months later.
Talk to your doctor about NHS weight-loss programmes. You may qualify for the weight-loss drug, Wegovy, which works by suppressing appetite and is also available privately.
Blood vessels: Do you need a statin?
Having high levels of ‘bad’ LDL cholesterol affects six in ten British adults, putting you at a 30 per cent greater risk of developing dementia.
High cholesterol causes fatty deposits to build up in the blood and arteries but often goes undiagnosed until it causes a stroke or heart attack, as it has no obvious symptoms. A healthy level of total cholesterol is 5mmol/L or below; for ‘bad’ cholesterol this is 4mmol/L and below.
‘Higher cholesterol levels in middle age are particularly associated with dementia,’ says Ian Maidment, professor of clinical pharmacy at Aston University, in Birmingham.
Although healthy diet and exercise can help some, Professor Livingston says that you may also need statins, prescribed by your GP.
Check blood pressure and cut down on wine o’clock
Pancreas: Control your diabetes
Type 2 diabetes may triple your chances of developing Alzheimer’s as high blood sugars lead to amyloid deposits in the brain. The earlier the condition takes hold, the greater the odds.
‘High blood sugar and insulin can also damage the brain’s blood vessels and disturb its control of its chemicals,’ says Dr Emer MacSweeney, consultant neuroradiologist at Re:Cognition Health.
More than a million people are thought to have elevated blood sugar levels, putting them at risk of type 2 diabetes – yet most are unaware.
Blood sugar readings under 42mmol is considered normal, 42-47 mmol is pre-diabetic and over 48 is classified as having diabetes.
The good news is that weight loss can reverse the condition.
Drinking more than two bottles of wine a week (21 units) is associated with almost a 20 per cent higher risk of cognitive decline
Heart: Lower blood pressure
High blood pressure, particularly in mid-life, increases your dementia risk by 20 per cent. Not only can it cause heart attacks and strokes, it can damage blood vessels supplying the brain. This can interrupt the flow of blood, depriving brain cells of the oxygen and nutrients needed to function correctly, leading to vascular dementia.
Keep vigilant by getting a free blood pressure reading at a local pharmacy (120/80mmHg or lower is healthy). Minimising your intake of alcohol and salt and exercising can all improve your blood pressure.
Liver: Ease back on nightly tipples
Drinking more than two bottles of wine a week (21 units) is associated with almost a 20 per cent higher risk of cognitive decline.
Even moderate consumption could raise your dementia risk. A study in PLOS Medicine found that people who drank more than seven units a week had higher levels of iron in their brains. This has been linked to Alzheimer’s and Parkinson’s. Swapping to smaller 125ml glasses is an easy way to cut intake which reverses the risk.
Legs: Work muscles to boost your brain
Intense exertion triggers increased production of proteins including brain-derived neurotrophic factor (BDNF) which help form new brain cells and pathways. A study in 2023 by New Zealand scientists suggested an intense, daily exercise routine lasting just six minutes could help stave off Alzheimer’s by boosting BDNF production.
Stephen Harridge, professor of human and applied physiology at King’s College London, suggests mixing gentler exercise with intense activity to stimulate BDNF. Try a HIIT class or a mix of walking and running.