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.
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.
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 dementia13. Nevertheless, anxiety and depression can have serious negative impacts on our quality of life5.
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