30 way of life tweaks advisable by specialists to assist forestall dementia

You might not think that flossing your teeth or singing in the shower could have a lasting impact on your brain. But according to experts, these are just two of the simple lifestyle tweaks proven to help prevent dementia and age-related memory loss.

Exciting trials are under way into a new generation of drugs to treat Alzheimer’s Disease, the commonest cause of dementia.

Last week pharmaceutical company Eli Lilly announced that its drug, donanemab, reduced progression by up to 35 per cent in people with mild cognitive impairment.

But increasingly, research is also focusing on ways to help prevent the brain from deteriorating in the first place. According to the charity Alzheimer’s Society, about 40 per cent of dementia cases may be preventable.

So here, in the first part of an exclusive series you will want to cut out and keep, are 50 simple things you can do to reduce your risk, as recommended by leading experts in the field.

1. Change your wine glasses

Using a smaller size wine glass (125ml) helps cut your alcohol intake which is key as even moderate alcohol consumption could be linked to cognitive decline.

A study, published last May in PLOS Medicine, involving 20,965 participants, found consumption of seven or more units of alcohol a week is associated with high iron levels in the brain, which has been linked to Alzheimer’s and Parkinson’s Diseases.

The average volunteer’s intake was 18 units per week (equivalent to six large glasses of wine).

‘Many middle-aged people who wouldn’t see themselves as problem drinkers regularly drink two large 250ml glasses of wine a night with dinner,’ says Gill Livingston, professor of psychiatry of older people at University College London. Using a smaller glass helps you drink less and Prof Livingston also recommends two or three days without drinking every week.

2. Expand your brain power

‘Try to carry on learning in some form — anything that requires reading, concentration and memorising is good. Make the effort to learn something unfamiliar,’ says U.S. neuroscientist Dr Rahul Jandial, author of Life Lessons From A Brain Surgeon.

Scientists now know the brain is constantly regenerating — a process known as neurogenesis. By encouraging the birth and survival of new neural connections, you can increase the size and strength of your brain, making it more resistant to memory decline.

The very act of learning is one way to expand your brain power but only if it takes effort.

3. Brush and floss without fail

Brushing and cleaning between your teeth every day can reduce your risk of dementia in later life says dentist James Goolnik, of Bow Lane Dental Group in London.

The more teeth we lose as we get older, the greater the risk of reduced cognitive function,’ he says

A 2021 study found participants who lost more teeth were nearly 1.5 times likelier to suffer cognitive impairment — with the risk increasing according to the numbers of teeth lost.

Studies reveal a connection between bacteria and inflammation caused by gum disease with the build-up of amyloid proteins, which is linked to Alzheimer’s.

Brush teeth for two minutes twice a day and use floss, interdental brushes or a water jet to clean between your teeth at least daily, says James.

4. Curl up with a comedy

Make time for laughter every day whether it’s watching a comedy show, sharing a joke or finding something funny on social media.

‘Research shows laughing regularly can help to reduce your risk of developing dementia,’ says Dr Tom MacLaren, consultant psychiatrist at London’s Chelsea and Westminster Hospital and at Re:Cognition Health, a specialist clinic.

The act of laughing triggers the release of ‘feelgood’ brain chemicals including dopamine and serotonin, counteracting low mood and even depression (both risk factors for dementia).

5. Sort out bad sleep habits

Aim for seven to eight hours sleep a night and cut naps during the day if it is making you less tired in the evening.

Research published in Nature Communications in April 2021 shows that those 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 when older.

‘During good-quality sleep, the body clears out toxins including the build-up of beta-amyloid proteins, linked to Alzheimer’s. When you are sleep deprived, this process is interrupted — research shows your beta-amyloid levels rise,’ says Guy Leschziner, a professor of neurology and sleep medicine at Guy’s and St Thomas’ Hospitals in London.

6. Consider statins for cholesterol

Get your cholesterol checked with a blood test from your GP. Higher levels, particularly in middle age, are associated with a higher risk of dementia, says Ian Maidment, professor of clinical pharmacy at Aston University in Birmingham.

‘Treatment for raised cholesterol includes medication, such as statins, and lifestyle changes, including diet, exercise, losing weight and cutting back on alcohol,’ he says.

7. Play a musical instrument

It’s never too late to learn an instrument. Research shows those who do are less likely to develop mild cognitive impairment.

‘This may be because the brain rewires itself when it learns a new skill, improving cell connections and making it more resilient,’ says Dr Tom MacLaren consultant psychiatrist at the Chelsea and Westminster Hospital.

8. Stub it out

Get support from the NHS to quit smoking.

‘Even if you’ve been smoking for decades, within two years of stopping you will reduce your dementia risk to being the same as someone who has never smoked,’ says Professor Gill Livingston.

Smoking is a major dementia risk factor — a 2020 report in The Lancet found that smoking resulted in a 60 per cent increase in the chances of developing it.

Not only do reduced levels of oxygen increase your risk of heart attacks and strokes (themselves risk factors for dementia) but chemicals in cigarettes contain neurotoxins which can penetrate the blood-brain barrier (designed to keep toxins and disease out of the brain). This causes inflammation and damage to brain cells, linked to Alzheimer’s, says Professor Livingston.

9. Sing to lift your spirits

A good sing-song in the bath or shower lifts the spirits and increases the flow of oxygenated blood to the brain even when warbling alone.

The benefits are even greater if you sing with others. So group singing has become an established part of dementia care as it also triggers the release of ‘feelgood’ brain chemicals such as serotonin and dopamine.

And as it requires intense focus on different things at once, it has been shown to help with mental alertness and memory recall.

Alzheimer’s Society (alzheimers.org.uk) runs Singing for the Brain groups or contact Making Music (makingmusic.org.uk) to find choirs near you.

10. Always wear a cycle helmet

It’s not just children who should always wear a helmet when cycling. Older people who suffer a head injury may be nearly four times more likely to develop Alzheimer’s according to research by Columbia University in the U.S.

Those with the ApoE4 Alzheimer’s gene have a particularly high risk of dementia after brain injury.

‘The injury may cause the brain to make amyloid plaques around the injury site as well as causing direct damage — a build-up of these deposits can help to cause Alzheimer’s in later life,’ says Professor Gill Livingston.

11. Curb that sweet tooth

Try to make sugary foods and drinks occasional rather than regular treats. Research shows that people with the highest consumption of sugar are also increasing their risk of developing Alzheimer’s. And all types of sugar — from fruit juice to confectionery — have the same impact.

Check the label for the sugar content of shop-bought food. The NHS recommends that sugars of all kinds should make up only 5 per cent of your daily diet. This includes sugars added to food and those naturally found in honey and unsweetened fruit juices.

Adults should eat no more than 30g of added sugars each day (equivalent to seven sugar cubes).

12. Don’t be a couch potato

Whether it’s brisk walking or dancing, any activity that increases your heart rate without leaving you out of breath is good for your brain. ‘Aerobic exercise increases blood flow to the brain, which among other things, stimulates the growth of healthy blood vessels,’ says Stephen Harridge, professor of human and applied physiology at King’s College London.

It also reduces your chances of having high blood pressure, obesity and insulin resistance — all dementia risks.

Professor Harridge recommends five 30-minute bursts of aerobic activity each week. Set a goal to encourage regular exercise by signing up for a charity challenge such as an Alzheimer’s Society memory walk memorywalk.org.uk.

13. Keep a wide circle of friends

The more friends you have the lower your dementia risk, numerous studies have found.

‘It’s estimated that older people with many friendships and relationships could be between 25 and 50 per cent less likely to develop dementia than those with few friends or family contacts,’ says neuroscientist Dr Rahul Jandial.

Join local clubs and societies, plus try volunteering to expand your social circle.

14. Tuck in to fish

Scientists at Tufts University in the U.S. found eating oily fish such as salmon and tuna twice a week slashed Alzheimer’s odds by 41 per cent. Eating lean fish made no difference, however.

‘It’s thought that this is due to the fact that these types of fish are high in DHA, docosahexaenoic acid, a type of omega 3 fatty acid,’ says Duane Mellor, senior lecturer in nutrition at Aston Medical School, Birmingham.

He recommends eating a variety of fatty fish — including mackerel, tuna, sardines and pilchards — at least twice a week. Frozen, tinned and canned are cheaper and just as beneficial as fresh.

15. Get out in the sun

Now spring is here, make sure you get outdoors. Research by Professor Lesley Rhodes at Manchester University, funded by Cancer Research UK, suggests nine minutes of midday sun a day is enough to top up vitamin D levels.

In a 2019 study, those who were deficient in the vitamin were more than 30 per cent more likely to have dementia than those who had enough in their blood.

‘Vitamin D — known as the ‘sunshine’ vitamin because our bodies need sunlight to create it — helps clear amyloid plaques from the brain,’ says Duane Mellor. A build-up is linked to Alzheimer’s.

16. Drink more water

Make sure you drink 1.5 to 2 litres of water a day as dehydration can cause poorer concentration and affects memory. The effects are particularly pronounced in people with mild cognitive impairment due to Alzheimer’s, who find it hard to remember to drink.

This can make their symptoms deteriorate significantly, leading to confusion and even hospitalisation, according to Alzheimer’s Society.

Dr Emer MacSweeney, consultant neuroradiologist and CEO of Re: Cognition Health, a specialist brain clinic, recommends the Waterlogged app to record intake.

Alzheimer’s Society recommends Jelly Drops, which contain 95 per cent water and are sugar-free, to tempt older people to stay hydrated (jellydrops.com).

17. Take up Yoga 

Yoga has many benefits, from improving balance to combating stress — and it may also slow the rate of cognitive decline. 

The emphasis on breathing and mindfulness can help combat low mood and stress, risk factors for dementia. 

Meanwhile, changing positions and chanting engages different parts of the brain, encouraging it to form new neural connections, says Heather Mason, founder of the charity Yoga in Healthcare Alliance. 

The British Wheel of Yoga bwy.org.uk has details of classes near you. 

18. Spell words backwards

Dr Rahul Jandial recommends this simple exercise to boost your cognitive reserves. Choose a long word such as Dumbledore, parliamentarian, Elizabeth, antediluvian, commemoration, surveillance, turmoil, Shakespeare, establishment and intelligence. Look at each word, then close your eyes and spell it backwards in your head.

You’ll be surprised how hard it is. Spend five minutes a day thinking up other words and doing the same.

19. Pamper your microbiome

Switch to a mainly Mediterranean-style diet — one which is high in fibre, fruit, and vegetables — as it helps feed good gut bacteria.

A constant two-way communication exists between our brain and our gut microbiome, the colony of bacteria in our guts.

But if the delicate balance between good and bad bacteria is disturbed — and more bad bacteria allowed to flourish — research has shown this can lead to the development of numerous conditions, including Alzheimer’s.

20. Manage blood pressure

Get your blood pressure checked regularly at your GP surgery or at a community pharmacy.

High blood pressure can be symptomless but if it is persistently high in middle age, it increases dementia risk. Blood pressure readings consist of two numbers — the systolic (first number) indicates how much pressure your blood exerts against your artery walls when your heart beats. The second, diastolic reading, indicates resting pressure on artery walls in between beats. A healthy range is 120/80 mm HG or less.

Ian Maidment, Professor of Clinical Pharmacy at Aston University says: ‘High blood pressure can be treated with a combination of lifestyle changes and medication. Your GP will advise you what’s best.’

21. Pick up the Phone

The simple act of using the phone can reap brain benefits, says Dr Tom MacLaren, citing American research published in the Lancet last October (2022).

This examined phone calls as part of the relationship between cognitive decline and social connections.

‘Make time to call family and friends at least once a day — you can protect your brain health and memory from the comfort of your armchair and stay in touch,’ says Dr MacLaren.

22. Snack on nuts

A daily handful of almonds or walnuts could also help keep Alzheimer’s at bay.

High in antioxidants, there is research to show both could have brain-protective qualities in addition to other health benefits.

It’s thought that the antioxidants in walnuts may curb oxidative damage in brain cells, potentially leading to Alzheimer’s.

Nuts are included in the top ten ‘brain healthy’ foods by the charity Dementia UK.

23. Tackle snoring

If your snoring regularly keeps your partner awake you might have sleep apnoea, a sleep disorder linked to an increased dementia risk. Ask your GP to refer you for diagnostic tests.

Sleep apnoea is where the muscles in your throat and mouth relax when you are asleep, causing the airway to collapse, temporarily cutting off oxygen.

This means your breathing starts and stops.

‘In addition to the effects on sleep, intermittent oxygen starvation stresses the brain, damaging blood vessels in it and may contribute to cognitive damage,’ says sleep expert Professor Guy Leschziner, author of The Secret World Of Sleep.

But there are effective treatments to help stop this once diagnosed.

24. Investigate taking HRT

Research suggests oestrogen replacement may have a protective effect against dementia as well as helping to ease menopausal symptoms.

A 2021 study at the University of Arizona in the U.S., involving 400,000 women, showed taking oestrogen replacement within ten years of the menopause (ie before the age of 60) could reduce the dementia risk by up to 50 per cent.

‘Hormone replacement is the most effective treatment for improving menopausal symptoms. But more research is needed to support prescribing it solely for preventing dementia,’ says Dr Melanie Hacking, a GP and menopause specialist at Oxford Hormone Clinic.

Consult your GP or menopause specialist about whether HRT would be suitable for you.

25. Make Berry Ice Cream Cake

Berries are naturally rich in a powerful plant compounds, flavonoids. Older adults who consumed small amounts of flavonoid-rich foods were more likely to develop Alzheimer’s than those whose intake was higher, according to research carried out in 2020 in the U.S. 

American doctors Dean and Ayesha Sherzai, authors of The 30-day Alzheimer’s Solution, suggest using blueberries in this brain-boosting recipe: 

Berry Nice Cream 

Serves 12 Preparation time: 15 minutes plus overnight freezing. 

For the vanilla cake layer: 

•  2 cups of raw cashews, soaked in water for 4 hours
• 2 very ripe bananas, cut into 1in slices, arranged on a plate and frozen overnight 
• 10 pitted medjool dates 
• ½ tsp vanilla extract
• ¼ cup unsweetened soy milk

For the berry layer: 

• 2 cups blueberries, plus extra for serving 
• 1 cup soy milk l ½ cup dates 
• 1 cup raw walnuts Freeze banana slices overnight and soak cashews in water for 4 hours before starting.  

Blend the soaked cashews, frozen bananas, dates and vanilla until smooth, adding as little soy milk as possible. 

Spread into a medium pan or tin and freeze until set. Whizz blueberries, soy milk, dates and walnuts until smooth. 

Spread over the frozen vanilla cake layer. Return to freezer for 2 to 3 hours or until set. Dip a knife in hot water to cut the cake. Serve with fresh berries. 

• From The 30-Day Alzheimer’s Solution by Dean Sherzai and Ayesha Sherzai and reprinted with permission from HarperOne, an imprint of HarperCollins. © 2021.
• A set of measuring cups is available from Tesco, £5.50. 

26. Don’t light wood burners

Breathing polluted air which contains tiny PM2.5 particles increases the risk of lung conditions and heart disease, a risk factor for dementia.

It’s estimated that 38 per cent of the UK’s PM2.5 particles come from wood or coal-burning stoves.

Professor Gill Livingston, who heads the influential Lancet Commission on dementia prevention, intervention and cure, recommends not lighting wood burners or only using them occasionally to cut the air pollution in your immediate environment.

27. Build up a sweat

Short bursts of intense exercise stimulate increased production of a specialised protein called brain-derived neurotrophic factor (BDNF). This boosts the brain’s ability to form new brain cells and pathways, essential for learning and memory according to research published in January this year in the Journal of Physiology.

Professor Stephen Harridge of King’s College London, advises starting at a lower intensity, building up to more intense exercise for shorter times — like brisk walking uphill then progressing to walking interspersed with running.

28. Spend time on an allotment

There’s every reason to get gardening, says Dr Tom MacLaren, consultant psychiatrist.

Being physically active in the fresh air, whether digging, sweeping or planting, can lead to reduced agitation and improved sleep, he says.

And dexterity can be maintained with weeding, potting and pruning. ‘There are also cognitive advantages in terms of getting the person to help plan the garden and choose the plants, for instance’ he adds.

29. Be good to your heart

High blood pressure plus high levels of cholesterol and the protein homocysteine all ramp up your odds of both heart disease and dementia. Heart disease makes it harder for blood to circulate around the body. This is most strongly linked to vascular dementia, directly caused by problems with the blood supply to the brain.

But it can also increase your chances of developing Alzheimer’s. The brain needs an uninterrupted supply of blood to provide brain cells with the oxygen and nutrients they need to remain healthy.

Reduced blood flow to the brain means nerve cells are starved of the nutrients they need and don’t work properly.

Look after your heart by eating more healthily and monitoring your blood pressure and cholesterol levels.

30. Take care with contact sports

Former England rugby captain Steve Thompson has spoken movingly about the link between contact sport and the risk of chronic traumatic encephalopathy (CTE), a progressive brain disease which causes behavioural problems, memory loss and dementia.

‘Rather than one knock-out blow, CTE normally results from multiple minor ‘sub-concussive’ hits to the head where the brain is shaken but not sufficiently severely to cause actual concussion,’ explains Dr Emer MacSweeney, consultant neuroradiologist and CEO at Re:Cognition Health.

‘This causes inflammatory changes in the brain, but no symptoms. It’s dangerous as it goes unnoticed until it’s too late.’

CTE can affect people playing contact sports at all levels and ages. Particularly dangerous are rotational forces from angled hits, causing the brain to rotate inside the skull, tearing delicate blood vessels. If repeated often, this can ultimately lead to the creation of abnormal tau protein, similar to that in Alzheimer’s.

While helmets protect the skull, they do not protect against rotational forces that can damage the brain so Dr MacSweeney advises wearing a Rezon Halos Headband, CE-approved and clinically-tested, when playing a contact sport.