10 ways to help protect yourself from dementia, according to science

As a 54-year-old woman with a family history of Alzheimer’s disease (my grandmother had the condition for many years), I want to implement evidence-backed actions into my daily life now and continue as I age. But, unfortunately, so often, a new study is released every day that reports whether to do this or not eat that.

It can be so overwhelming that it is tempting to do nothing because the path is unclear. Yet more than 6 million Americans have Alzheimer’s, a degenerative disease of the brain that causes dementia, or the gradual loss of memory, judgment and ability to function. 

The Alzheimer’s Association projects that by 2050, this number will rise to nearly 13 million. Most people who develop the disease, known as late-onset Alzheimer’s dementia, are 65 or older. 

Alzheimer’s, like other common chronic diseases, is thought to grow due to multiple factors rather than a single cause (exceptions are rare cases of Alzheimer’s related to specific genetic mutations). 

The most significant risk factors for late-onset Alzheimer’s are older age, genetics — especially the e4 form of the apolipoprotein E (APOE) — and having a family history of the disease, according to the 2023 Alzheimer’s Disease Facts and Figures Special Report.

Today is a good time to start increasing your brain health, says Mary Wirtz, who has worked at the Mayo Clinic as a clinical registered dietitian and nutrition instructor. 

“I regularly encourage individuals to include brain-healthy foods as part of their meal planning and preparation routine, such as fresh or frozen fruits and vegetables; whole grains, including oats, barley and quinoa; beans and lentils; olive oil and nuts; and lean poultry,” she says. 

Wirtz adds, “Foods high in added sugars, such as sweets, candies and sodas; and trans fats like red and processed meats, fried foods, butter and lard should be limited as part of a brain-healthy diet.”

In addition to these nutrition tips, the following 10 evidence-based tactics can be added to daily life to help optimize your brain by increasing neuroplasticity and cognitive reserves. 

Neuroplasticity refers to maintaining, repairing, and creating new neural connections in the brain, while the cognitive reserve is the brain’s flexibility and capacity to use resources in novel ways.

“The MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet contains vitamin-rich foods and flavonoids that protect the brain by reducing oxidative stress and inflammation,” explains Wirtz. 

In one study examining the effects of the nutrition plan, researchers found a 53% lower rate of Alzheimer’s disease for those with the highest MIND scores. Even participants with moderate MIND scores showed a 35% lower rate than those with the lowest. 

“Fortunately, the MIND diet helps to reduce other chronic health conditions, including heart disease, depression and obesity,” Wirz adds.

A systematic review of 13 more recent studies has confirmed these findings, showing that adherence to the MIND diet was positively associated with improved cognitive function in older adults. Following a balanced eating pattern is vital, concurs Elizabeth Ward, co-author of “The Menopause Diet Plan, A Natural Guide to Managing Hormones, Health, and Happiness.”

Even with a family history of cognitive function problems, a diet that is low in saturated fat, sodium, and added sugar and rich in plant foods, along with regular exercise, helps protect brain function, according to an 8-year study published in JAMA that followed more than 196,000 people who were at least 60 years old. 

In the study, the likelihood of dementia was cut by about half among those at high genetic risk when they closely adhered to positive lifestyle habits, which included not smoking, regular physical activity, a healthy diet and moderate alcohol consumption.

Also see: Medicare unveils plan for coverage of new Alzheimer’s drugs

You don’t have to train for a triathlon to boost your brain power; add a joint low-intensity exercise to your daily activities. Low-intensity activity is tied to brain health, notes Ward. 

For example, a 2019 study demonstrated that every additional hour of low-intensity physical activity, such as walking, was linked to greater brain volume in midlife adults even when they did less than the suggested amount of exercise (the nationally recommended guidelines are 150 minutes of moderate to vigorous physical activity per week) which could mean physical activity has the potential to prevent dementia. 

Other studies signal physical exercise is linked to neuroplasticity, in which the human brain adapts to changing demands by altering its functional and structural properties to learn and acquire skills.

Katie Tomaschko Tout, a registered dietitian nutritionist, advises people over 50 to increase their intake of omega-3 fatty acids. “Omega-3s, in particular DHA, have been shown to help prevent/delay cognitive decline and the onset of diseases such as Alzheimer’s disease,” she says. 

“Foods highest in DHA are fatty fish (such as salmon, tuna and trout), whole eggs, flaxseed and chia seeds. Because many Americans don’t eat seafood consistently, I recommend most individuals to supplement with a rich fish oil supplement (of at least 1000 mg combined EPA and DHA),” she notes.

Numerous studies, including one published in Neurology, the medical journal of the American Academy of Neurology, in 2022, confirm that eating cold-water fish and other sources of omega-3 fatty acids may preserve brain health and enhance cognition in middle age. 

Faculty of The University of Texas Health Science Center at San Antonio and other investigators of the Framingham Heart Study, a long-term, multigenerational study to identify common factors contributing to cardiovascular disease, conducted the analysis. For this study, the volunteers’ average age was 46. 

“Studies have looked at this association in older populations. The new contribution here is that, even at younger ages, if you have a diet that includes some omega-3 fatty acids, you are already protecting your brain for most of the indicators of brain aging that we see at middle age,” explains Claudia Satizabal, Ph.D., lead author of the study and assistant professor of population health sciences with the Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases at UT Health San Antonio.

In a productivity-conscious culture, sleep often gets deprioritized. In addition, more sleep disturbances are reported among older adults than any other age group, according to the National Sleep Foundation. 

However, a long-term Harvard University Medical School study of 2,800 individuals ages 65 and older found that individuals who slept fewer than 5 hours per night were twice as likely to develop dementia as those who slept six to eight hours per night. 

Another study of almost 8,000 participants demonstrated a 30% increase in dementia risk was associated with sleeping six hours or less at ages 50, 60 and 70, compared with an average sleep duration of seven hours. 

So, it is worth the extra effort to develop improved sleep habits, such as limiting caffeine, keeping the bedroom dark and cool, switching off electronics in the hours before bedtime and considering using a white noise machine or app to help you fall asleep.

Plus: Could too little sex lead to dementia? Maybe, a new study suggests.

Even if you are not planning a trip to another country, learning to speak a foreign language can help boost brain power. Smartphone apps offer a way to acquire skills in a second language, and the benefits compare with brain training apps designed to improve executive function in older individuals. 

A recent study included 76 adults aged 65 to 75 who were assigned to either 16 weeks of Spanish learning using the app Duolingo for 30 minutes a day, an equivalent amount of brain training using the app BrainHQ or a control condition. For two primary measures, the language app provided equal benefits as BrainHQ compared with a control group.

Like up your language skills, open yourself up to various new activities, such as brain games (like jigsaw puzzles and word or number games) or learning to sew, create pottery or play pickleball. 

The mental stimulation of mastering new-to-you activities helps build neuroplasticity and cognitive reserve to solve new challenges.

Further, doing a single known activity strengthens the same neural connections, while novel activities require problem-solving that can lead to new neural connections.

New studies are disproving the notion that moderate drinking is good for health. For example, a systematic review of 107 cohort studies involving more than 4.8 million participants found no significant reductions in risk of death (all-cause mortality) for drinkers who drank less than 25 grams of alcohol (about two drinks) a day a day. 

There was a significantly increased risk of death among female drinkers who drank 25 or more grams daily and male drinkers who drank 45 or more grams daily. Other research shows that heavy alcohol consumption is associated with changes in brain structures, cognitive impairment and an increased risk of dementia. 

“Excessive drinking may result in memory loss and shrinkage of the brain, and research suggests that women are more vulnerable. Damage also tends to appear with shorter periods of excessive drinking for women than for men,” notes Ward.

And be on the lookout for diabetes! Both type 1 and Type 2 diabetes are associated with reduced performance of cognitive function and with structural abnormalities in the brain. 

“Most people have Type 2 diabetes, which is linked to a 50% increased risk of dementia. One analysis of studies involving over 1.7 million people found the risk of Alzheimer’s disease is higher in people with diabetes. Regular physical exercise, achieving and maintaining a healthy weight and an eating plan with adequate protein and fiber reduce the risk for Type 2 diabetes,” Ward explains. 

A yearly physical with blood work can also help keep glucose in check.

One of the nine principles of the Blue Zones for longevity is social circles that support healthy behaviors. Social connection is vital as it stimulates the brain and aids healthy aging. 

However, a 2023 study in the Journal of the American Geriatrics Society concluded social isolation among older adults is associated with greater dementia risk. The study evaluated data from the National Health and Aging Trends Study that followed 5002 older adults, of which 1172 were socially isolated and 3850 were not. 

“Being socially isolated had a 1.28 higher hazard of incident dementia over nine years,” the researchers report.

Read: Am I lonesome? ‘I’m fine. I’m fine.’ How single men can prepare to age alone.

Also, results from a 28-year follow-up of the Whitehall II cohort study of more than 10,000 participants who shared social contact data suggest “a protective effect of social contact against dementia and that more frequent contact confers higher cognitive reserve, although the ability to maintain more social contact may be a marker of cognitive reserve.”

You might like: Great news for coffee lovers: It can be really good for you. Here’s how to boost the benefits of your beans.

You might think, “Meditation does not work for me,” or “I can’t sit still.” Yet, a regular brief, daily meditation practice has been found to decrease negative moods and enhanced attention, working memory and recognition memory, as well as reduced anxiety in 8 weeks. 

Previously, a study of 20-year meditators demonstrated they had more gray matter (which is linked to brain optimization) than the control or nonmediator group. 

Another study in the Journal of Alzheimer’s Disease concluded that meditation and other modalities such as dietary modification, physical exercise, mental stimulation and socialization might be beneficial as part of an AD prevention program.

Use a short, guided meditation app or video (many are free), or take a class to get started with conscious breathing. In a few sessions, this can help begin to reduce stress. Ward explains that cortisol is a stress hormone that can affect recall. 

“In a study of midlife women and men, researchers found that higher blood levels of cortisol were associated with a lower brain volume, which is important because brain volume is linked to memory. Moreover, there was a stronger association between cortisol levels and memory issues in women. Though the study does not prove that cortisol is responsible for cognitive decline, it does suggest a link,” she says.

While no one knows what the future may hold, incorporating some or all of these lifestyle tactics in daily life as much as possible may help people over age 50, such as myself, be proactive and feel empowered about Alzheimer’s disease.

Lisa B. Samalonis is a writer and editor based in New Jersey. She writes about health, parenting, books, and personal finance. 

This article is reprinted by permission from NextAvenue.org, ©2023 Twin Cities Public Television, Inc. All rights reserved.

More from Next Avenue:

Health Professions and Medical Sciences

RIT’s Combined Accelerated Pathways are dual degrees that enable you to earn a bachelor’s and a master’s degree in approximately five years of study. They’re designed for exceptional undergraduate students with outstanding academic records. They accelerate your learning and position you for success. You’ll earn two degrees in less time and with a cost savings while still taking advantage of cooperative education experiences, internships, research, study abroad, and more.

Two is always greater than one, especially when it comes to investing in your education.

One simple fix for the primary care shortage: assistant physicians

A recent study by the Association of American Medical Colleges projects a shortage of between 17,800 and 48,000 primary care physicians by 2034. A December 2021 survey found that one in three physicians and advanced practice registered nurses intends to reduce their work hours, and one in five physicians plans to retire.

By sheer number, the shortage is projected to be the worst in California, Texas, and Florida. Making matters worse, graduates of U.S. and Canadian medical schools must complete at least one year of residency after graduation and pass Step 3 of the standardized U.S. Medical Licensing Exam to get a license to practice as a nonspecialist general practitioner, yet the number of medical school graduates exceeds the number of residency positions. Many graduates are stuck in limbo: They can neither apply the knowledge they acquired in school, nor hone and develop those skills in a residency program.

Some states are implementing innovative ways to help address the shortage. Missouri, a state with a large, medically underserved rural population, is the first state to launch a new licensure category of assistant physician (AP), not to be confused with physician assistant (PA). Assistant physicians are, in short, apprentice physicians, a common way to train physicians before the modern era of residency programs.

Missouri’s law permits assistant physicians to practice primary care in rural and underserved areas of the state with limited supervision by a licensed physician, with whom they must have signed a collaborative practice agreement. The Missouri Board of Registration for the Healing Arts began accepting assistant physician applications in January 2017. Applicants must submit letters of recommendation, proof that they graduated from an accredited medical school, and their exam scores from Step 1 and Step 2 of the three-step U.S. Medical Licensing Exam — the same requirements for admission into residency programs.

The law has already started lessening the primary care shortage. Missouri had 10,060 fully licensed primary care physicians engaged in direct patient care as of January 2023. As of mid-February 2023, the Missouri Division of Professional Registration listed 292 licensed APs, suggesting that assistant physicians increased the number of primary care physicians in Missouri by nearly 3 percent.

In a recently released Cato Institute briefing paper, Spencer Pratt and I provide an overview of how states are adopting this innovative approach to improving access to primary health care services.

Six other states have since passed laws similar to Missouri’s: Arkansas, Kansas, Utah, Arizona, Louisiana, and Idaho. And as this was written, Tennessee lawmakers sent an assistant physicians bill to the governor’s desk. Arkansas law refers to assistant physicians as “graduate registered physicians,” and Utah calls them “associate physicians.” Louisiana and Idaho use the term “bridge physicians” because their laws aim to help graduates bridge the waiting gap from graduation until they get another chance to apply for a residency position. Tennessee lawmakers call them “graduate physicians.”

Whatever name they go by, states typically require assistant physicians to sign an agreement with a fully licensed physician who can bill third-party payers for their services. All states require third-party payers to pay for assistant physician services at the same rate as physician assistants.

Supervising physicians need not be present when assistant physicians are providing services. Assistant physicians in Missouri can renew their licenses indefinitely. The other states limit the number of years assistant physicians may serve patients, after which they are expected to have obtained a position in an accredited residency program.

If doctors don’t land a residency slot within a designated period, those states will block them from further practicing as assistant physicians. For example, Idaho’s bridge physician license is not renewable, while Louisiana allows bridge physicians to renew for two additional years.

The state of Washington recently enacted an assistant physician program, but only for international medical graduates who emigrate from other countries and want to care for patients — not for graduates of U.S. or Canadian medical schools. There is no good reason why states shouldn’t enable both international and domestic graduates to become assistant physicians.

In our briefing paper, we propose that states can innovate even further by enabling medical school graduates, including international medical graduates, to use their experience as assistant physicians as an alternative pathway to unrestricted licensure as general practitioners. If one or two years of residency plus passing Step 3 of the U.S. Medical Licensing Exam qualifies physicians in most states to practice medicine as general practitioners, then three or more years of experience as an AP and passing the same exam should suffice.

If states lift constraints and allow domestic and international medical school graduates to become assistant physicians and use their experience as an independent pathway to general medical practice, they can increase the number and variety of primary care providers and improve access to primary care while reducing cost.

Jeffrey A. Singer, M.D., practices general surgery in Phoenix, Arizona, and is a senior fellow at the Cato Institute.