Doing daily crossword puzzles and sudoku, along with playing board games, may protect against cognitive decline. Photo / 123rf
What can we do to reduce the risk? These strategies can help anti-age your memory in midlife
As we head into midlife, memory issues can become more frequent.
We “lose” words and misplace keys, but tend to shrug this off as normal.
But now a new study, conducted by neuroscientists at Trinity College Dublin’s School of Psychology, has found for the first time that self-assessing your own memory as poor (known as subjective memory problems) correlates more strongly with dementia risk factors (such as hypertension or loneliness) than performance on objective cognitive tests.
The study, which gathered data from 3327 participants aged 18-84 through the smartphone app Neureka, developed by the scientists at Trinity, asked members of the public to participate in neuroscience research at home by playing games and tracking their mood and behaviour over time.
The new research adds to our understanding of very early changes to brain health in otherwise healthy adults. It enabled scientists to confirm the role physical health factors have in the ageing of our brain, including heart health, hearing and vision loss and high cholesterol, says Claire Gillan, a professor at the School of Psychology and Global Brain Health Institute, Trinity, who oversaw the research. But it also helped the scientists to understand the activities that people can do to improve their memory.
“People think a lot about physical longevity, and it’s time to think about the longevity of our brains. Not just in terms of dementia, but our ability to think quickly and confidently. There’s a lot we can do practically to make sure we stay sharp for longer.”
The evidence suggests more than 40% of dementia is preventable. So what steps can we take to de-age our memory and reduce dementia risk?
Loneliness is associated with more than double the risk of developing late-life dementia. In contrast, having well-established supportive social networks contributes to “cognitive reserve” (how resistant the mind is to brain damage or deterioration), says Prof Kieran Clarke, 73, emeritus professor of physiological biochemistry at the University of Oxford, whose research interests include physical and cognitive function.
“We need to keep laughing. It releases endorphins, hormones that are good for us like dopamine and serotonin. It helps to protect your brain. Humans are social animals and need other humans to stay happy and content – daily social contact is best.
“Reading groups and bridge clubs are great because they encourage you to think (and you are more likely to go to a regular meeting). However, it doesn’t really matter what you do so long as it’s with someone you like.”
As we age it is particularly important to preserve our brain cells. “They can only come back a certain number of times, and each time the telomeres get shorter. And after you’ve lost a certain number of cells, they stop regenerating altogether. If you look at people with dementia, especially Alzheimer’s, much of their brain is dead.” Which is why the Trinity research is so important. “We know some people develop cognitive problems decades before they develop full-blown dementia,” says Anna M Rosická, who led the study. “So they could, for example, tell us: ‘Oh, I think that my memory might be getting worse’ before any objective test could pick it up.”
A harmonious relationship is essential to happiness and health, says Prof James Goodwin, the director of science at the Brain Health Network and the author of Supercharge Your Brain. “There’s nothing more destructive to brain health in the long term than having a negative or poor relationship with someone.
“It activates stress-related hormones and adverse biochemistry in the brain pathways. These changes accelerate brain ageing and work against natural anti-ageing processes in the brain.
“For example, the formation of new brain cells (neurogenesis) is slowed down or inhibited. Most people know a bad relationship is stressful and probably bad for long-term health, but what is not known is that it can physically damage the brain and worsen age-related changes, such as impaired working memory (eg I can’t remember her name).
“Studies have shown that you increase levels of the happy hormone, serotonin, when you pat your dog,” says Prof Clarke. In addition, pet owners experience less decline in verbal memory and verbal fluency than people without a pet because they are talking to it all the time.
In a study of nearly 8000 older adults, published in JAMA Network Open in January, researchers found that among those living alone, having a pet was associated with a slower rate of cognitive decline (specifically composite verbal cognition, verbal memory and verbal fluency). Though arguably dog owners are more likely to have a regular exercise habit as a result of walking their pet, which may also help to create connections and reduce loneliness. Also, looking after a dog engenders a sense of responsibility and care for another being who, in turn, loves you unreservedly.
Doing daily crossword puzzles and sudoku, along with playing board games, may protect against cognitive decline. Ditto learning another language where the brain is forced to focus and recall the correct words. This process – called cognitive inhibition – is linked to better executive functioning. By improving these types of processes, the brain becomes more resilient to the impairments caused by diseases such as dementia.
“Puzzles keep the connections up and the electrics going,” says Prof Clarke. “You’re concentrating all the time and the synaptic connections between neurones are functioning properly.
“When you’re passively sitting in front of the television, not much is going on in there. You can tell when you’re really concentrating because you don’t notice things, like the time or somebody knocking on the door.”
She also recommends we make shopping or to-do lists. “Concentrating is really good for your brain.”
A protein breakfast (eggs, cheese, a protein shake) keeps our blood sugar and energy levels constant. Research published in May 2023 in the journal JCI Insight found elevated blood glucose and increased sugar intake over time can lead to the proliferation of amyloid plaques in the brain.
“Alzheimer’s is not called Type 3 diabetes without a reason,” says Prof Clarke, who recommends we aim for a BMI of under 23. She never eats potatoes, pasta, bread or rice.
“If you’ve got diabetes, or even if you’re obese, you’ve got three times the chance of developing dementia, and it’s a metabolic thing.”
“If you look at people who have dementia, they often have abnormally low vitamin D levels,” Prof Clarke says.
A study published last year in the Journal of Alzheimer’s and Dementia assessed the effects of vitamin D incidence on 12,388 participants with Alzheimer’s and found that vitamin D exposure was associated with a 40% lower incidence of dementia compared to those with no exposure.
“Only worry about things you can do something about. Don’t worry about anything you can’t do anything about,” counsels Prof Clarke.
“I also avoid social media because of the high stress it can cause.”
Dealing with stress is essential for preventing cognitive decline. Having high levels of adrenalin starves the brain of glucose. Catecholamines are a group of stress hormones that play an essential part in our “fight or flight” responses and they include dopamine and adrenaline. Chronically high levels affect sleep, blood pressure and many other functions essential for brain health.
Prof Clarke reads a book instead of looking at her phone before bed. She also advocates listening to the radio.
“It helps the cells regenerate, it keeps you stimulated. It’s like exercising the brain. Studies have shown you can’t take in the same amount of information when you’re reading on a Kindle, or online. I watch films but I don’t watch television.”
Watching four or more hours of TV daily may increase your risk of developing brain-based disorders such as dementia, depression and Parkinson’s disease.
“Reading the obituaries of famous people, you may have noticed they’re often really quite old because they had an intense interest,” says Prof Clarke.
“Frank Auerbach, for example, has just died, aged 93, and he was obsessed with painting, and that focus is why he lived so long. It doesn’t matter whether people go back to do a maths degree at university, or they’re a photographer – you need something you want to be doing all the time.
“It comes back to the right formula of hormone levels in the brain. As soon as you get out of bed, your catecholamine levels go up, you’ve slept well, and now you’re going to do something you really enjoy.”
Part of it is an issue of tailoring to people’s interests and passions, rather than prescribing the same intervention to everybody, stresses Prof Gillan.
“A loneliness intervention or a group support might not be everybody’s thing. So it’s important to find those passions.”
A good night’s sleep is important for brain health in helping prevent toxins accumulating in the brain – clearing problematic debris and flushing away many of the proteins and metabolites thought to be involved in the development of Alzheimer’s, says Prof Clarke.
It also helps us maintain a healthy weight and blood pressure, essential to prevent cognitive decline.
“Your body doesn’t heal during the day when you’re running around because the catecholamine levels are too high. It heals at night when you rest because injured cells recover when the catecholamine levels are lower.”
She recommends keeping your feet warm if you want to go to sleep as soon as your head hits the pillow.
“Cold feet keep you awake because you haven’t been able to relax enough for your brain to turn off.
“Which is why you shouldn’t do emails, or look at your phone or computer several hours before you go to bed. You also want to eat early in the evening: you won’t sleep well on a full stomach.”
A physical activity such as tidying can clear brain toxins, while acting as a “fertiliser” that stimulates new neurones and connections. A house with too much clutter can be overstimulating and make it hard to locate a desired item, focus on an activity or remember a sequence of tasks. Mess can also increase confusion because the person isn’t sure exactly what to pay attention to, says Prof Clarke.
“Organising is actually a way of thinking. People hoard because they don’t stop and say: ‘Alright, I’m going to concentrate on sorting out my wardrobe or the kitchen cupboard.’
“When you hoard you’re just throwing everything on the pile, and hoping that when you die somebody will come and throw it in the bin.”
Six minutes of high-intensity exercise boosts the blood level of a protein involved in learning and memory formation, according to a 2023 study by the University of Otago.
Brain boosting BDNF (brain-derived neurotrophic factor), also known as “Miracle-Gro for the brain,” increases blood flow to the brain, promotes growth of new neurones and enhances connections between brain cells. Plus, exercise can help combat depression. But don’t stress if you hate burpees.
“A lot of the work the Global Brain Health Institute does is trying to explore alternative interventions for people, like learning to play a musical instrument or sing in a choir,” says Prof Gillan. “There’s work on dance interventions and interventions to help people find other ways to get exercise that might be more appealing than the treadmill.”
Earlier this year, a study by The University of Edinburgh found those who spent time gardening had better brain function in later life. “You’re building up cognitive reserve in your brain by building better connections and stronger synapses, and that tends to offset the symptoms of cognitive ageing or dementia,” says Prof Clarke, a passionate gardener.
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