As you get older, it’s natural to worry about developing dementia or Alzheimer’s disease. Or you may fear having to care for a partner or parent who has one of those debilitating neurological disorders.
The good news is that about a third of Alzheimer’s cases are preventable, according to a spate of recently published research. Rather than drugs, lifestyle changes offer the best hope of avoiding these illnesses, including some moves that may surprise you.
“There are a whole lot of things we can specifically address quite effectively through lifestyle changes and practice,” says James E. Galvin, the director of the Comprehensive Center for Brain Health at Florida Atlantic University and author of a 2017 paper in the Journal of the American Geriatrics Society on the science of Alzheimer’s prevention.
“It doesn’t necessarily require medications. There is nutrition, exercise, diabetes, cholesterol, sleep, mindfulness, and attitude.”
Know your numbers
There is no one-size-fits-all program to prevent Alzheimer’s or dementia. Rather, the first step is exploring with your doctor whether you have known risk factors, such as being overweight, having high blood sugar or cholesterol, getting too little exercise or sleep, or eating a poor diet.
Your genes can play a role in determining whether or not you will get Alzheimer’s, but even that risk factor many not produce an inevitable result.
For example, people with certain mutations on a gene known as APOE tend to be at higher risk for vascular diseases and Alzheimer’s. “But if they do everything right from a lifestyle perspective, those patients may even respond preferentially because it’s a cholesterol gene and we can improve cholesterol and metabolism,” says Richard Isaacson, the director of the Alzheimer’s Prevention Clinic at the Weill Cornell Memory Disorders Program in New York.
Hit the gym
Isaacson sees patients with a family history of Alzheimer’s and tailors the treatment plan to each individual. But he says that exercising regularly is probably the most important move you can make, followed by treating metabolic illnesses like hypertension or diabetes, and increasing the amount of high-quality sleep you get every night.
One surprising finding is that sarcopenia—the decline in muscle strength that often accompanies aging—can be a severe problem for mental clarity. “A number of papers demonstrate a very strong link between muscle health and brain health,” says Isaacson.
Isaacson recommends a mix of aerobic and anaerobic exercise, such as a combination of jogging and weight lifting (see this story for how to make lifting weights easier.) Tailor any exercise plan to your physical condition—don’t try running a long distance or lifting very heavy weights if you have not trained in a long time.
Improve your diet
Galvin recommends following the so-called MIND diet, an acronym for the Mediterranean-DASH Intervention for Neurodegenerative Delay, which combines two popular diets that both recommend eating more leafy greens, olive oil, berries, nuts, and fish and cutting down on butter, red meat, and cheese.
Plus, check your Vitamin D level, suggests Isaacson, as very low levels have recently been associated with increased risk of dementia. That includes a 2017 French study of 916 adults age 65 and older that concluded that sufficient Vitamin D could slow cognitive decline and delay the onset of dementia.
Get a good night’s sleep
With too little sleep a risk factor for dementia, tending to this aspect of your health is important too.
While you tend to sleep less as you get older, paying attention to sleep hygiene—keeping your bedroom cool and dark, not using electronics in the hour before bed, and avoiding caffeine late in the day—can help you rest for longer.
And issues that can cause a chronic lack of sleep and heighten your risk of Alzheimer’s, such as sleep apnea, a bed partner with snoring problems, or prostate problems in men, are treatable.
On the flip side, recent research has found that too much sleep is also linked to a higher risk of cognitive decline and early death. A team of researchers in Japan reported that in a 10-year study of adults 60 and over, those who slept 10 hours or more a day were more than twice as likely to develop dementia or die, vs. those who slept five to 6.9 hours.
Don’t pin your hopes on games
You’ve probably heard that doing crossword puzzles can help stave off dementia, but does the research back this up?
There’s some evidence that puzzles, computer use, arts and crafts, music, and continuing education may help protect against Alzheimer’s. Deeper social connections may also lower your risk of cognitive decline.
But this evidence is not as strong as the case for eating well and exercising, losing weight, treating your high blood pressure, and lowering your cholesterol.
As to whether mental games can help prevent further forgetfulness if your memory is slipping, Isaacson says: “A memory problem usually correlates with a metabolism problem. So I’ll look at their body composition and nine times out of 10, they’re going to have elevated amounts of body fat. Usually the bigger the belly, the smaller the memory center in the brain.”
Sweat it out
Finally, one pleasurable if sweaty habit might pay off.
In a 2016 research paper, Tanjanina Laukkanen of the Institute of Public Health and Nutrition at the University of Eastern Finland reported that sauna use is inversely associated with dementia and Alzheimer’s. In a study of 2,315 men, the study found that the more saunas taken per week, the lower the risk.
“I think the important explanation is that there are quite similar risk factors for memory diseases and cardiac diseases,” says Laukkanen. “It’s been shown that sauna use may decrease blood pressure and have a positive effect on vascular functions.”
Of course, saunas are a national pastime in Finland, so there may be other factors at play. And Laukkanen cautions that people with heart disease or low blood pressure should avoid saunas.
But it’s good to know that such an enjoyable pursuit might be another step to add to your lifestyle changes that help in reducing your risk of getting Alzheimer’s disease.