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People who exercise regularly are more likely keep their thinking and memory skills as they age. In general, exercise means aerobic activity that increases your heart rate and breathing – this might be brisk walking, cycling, swimming, or vigorous cleaning and gardening. You should aim for moderate aerobic exercise for 20 to 30 minutes a day for five days per week1. If you jog, fast swim or cycle up hill, 15 minutes per day for five days will give you the same benefit1.

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The findings of 15 studies show that exercise reduces the risk of poor brain health2, although there is no evidence yet that it improves brain health. It is likely that exercise helps prevent dementia by reducing the risks from obesity, high blood-pressure and heart disease 3 4 which are all linked to dementia.


In addition to aerobic exercise, it is important to build your strength – this might be digging in the garden or weight exercises, twice a week. The NHS has published some helpful national guidelines: https://www.nhs.uk/live-well/exercise. Always consider your level of health when planning your exercise routine – ask your GP if you have any concerns.

Heart disease in midlife can contribute to poor brain health in later life. Evidence from the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study5 shows that high blood pressure, smoking, high cholesterol and diabetes significantly increase the risk of heart disease and strokes, which are linked to vascular dementia and Alzheimer's disease.6 7 8. If you are affected by any of these conditions, your GP can help you make changes to your lifestyle or offer medication to improve your health.

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Again, regular exercise1 is important and a balanced diet, low in sugars and saturated fats, can help to maintain a healthy weight. Since obesity is associated with the risk of developing high blood pressure and type 2 diabetes, this can increase your risk of dementia later in life5.


Regular alcohol consumption is also linked to poor heart and brain health5. One recent study showed evidence that regularly drinking alcohol is linked to shrinkage of the hippocampus9  – an area of the brain affected by Alzheimer's disease10. There is no evidence that alcohol protects brain health and current NHS advise is that people should have no more than 14 units of alcohol a week, spread over at least three days11.


Smoking also has an impact on both heart and brain health5. Recently, researchers showed that people who smoke are at a higher risk of developing Alzheimer's dementia, but the good news is that if you stop smoking the level of dementia risk lowers to the level of non-smokers5.

Mental wellbeing describes how you feel and how you cope with your day-to-day life. Studies show a link between depression in mid-life and dementia5, however, it is not clear the extent to which depression is an early sign of dementia12, or por whether long-term depression causes changes in the brain that increase the risk of dementia13Nevertheless, anxiety and depression can have serious negative impacts on our quality of life5.

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Stress may also play a role in developing dementia5 in a number of ways. Firstly, it triggers the release of hormones such as cortisol. Persistent high levels of cortisol increase the risk of heart disease and depression14 15 and may directly affect the brain's structure.5 Secondly, stress is also associated with unhealthy behaviours like smoking, drinking and unhealthy eating16. Such behaviours, in turn, have been associated with heightened risk of developing dementia independently of genetic predispositionREF1.

 

Sleep is very important for mental wellbeing, as disrupted sleep or sleep deprivation, are linked to poor memory and thinking skills5. This may be because dementia disturbs the sleep-wake cycle, which would explain why people with dementia often experience sleeping difficulties17. On the other hand, sleep problems themselves might be a risk for poorer thinking and memory skills18 as research suggests that poor sleep might affect a protein in the brain, which plays a significant role in Alzheimer’s disease19.

 

There are many different ways to boost your mental wellbeing.

Be active – Exercise helps to lift your mood and self-esteem and self-control. See 'exercise regularly' for things you can do.

Keep learning – Learning new skills improves your sense of achievement and builds confidence. New challenges are good for your brain.

Be social  – Connecting with people is important for your mental wellbeing.

Look after yourself – Eat well, drink plenty of water, exercise, sleep and avoid tobacco and alcohol can improve your mental wellbeing.

Get enough sleep – If you have difficulties falling asleep try a regular bedtime routine. Wind down before bed, keep your bedroom dark, quiet, and cool (8oC - 24oC).

Manage stress – Stress is a natural part of life, so it is important to deal with it effectively. Work out what helps you relax – exercise, a walk in nature, music, friends, or your pet. Relaxation exercises or mindfulness can also help you to recharge.

Ask for help if you need it – If you find it difficult to cope on your own, don’t be afraid to ask for help. Your GP can tell you about services in your area to get you the support you need.

The NHS has published some actions you can take to improve your mental wellbeing and to reduce the likelihood of depression, anxiety and stress 

 

Staying active mentally and socially as you get older is crucial to maintaining brain health.

Being social stimulates the brain; requiring it to process complex information so that we are able to adapt to other people's behaviours and intentions. Missing out on this through social isolation increases the risk of developing dementia 29 and affects your physical and mental health (high blood pressure, heart disease, low mood). The mind and the body health are linked.


Fortunately, the relationship between being social isolation and brain health is two way. Even small changes in social interactions can improve your memory and thinking: one study shows that interacting with someone else for ten-minutes before taking memory and attention task improved their results30. Social interaction is good for healthy adults as well as those living with dementia, so volunteer, join a sports club or start a book club.


Exercising your brain will help keep it young. Playing games, such as crosswords and Sudoku puzzles, can help the blood flow in the brain24, improve the brain's structure 25 , and helps memory and thinking skills. This is particularly important in midlife, as those that regularly engage in intellectual, artistic, and manual activities during that part of their life see less brain health decline as they age26, 31, 32.


Reading and writing, visiting museums, painting, playing instruments, needlework, and gardening throughout midlife are associated with reduced risk of developing dementia. Those that do develop dementia, experience this at later age and the condition progresses more slowly32.


Why not combine all of these healthy-brain activities at once? Joining a dancing group is social and intellectually and physically active, which is why dementia specialists recommend it.