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Anthea Rowan

This is the 58th instalment in a series on dementia, including the research into its causes and treatment, advice for carers and stories of hope.
Two in every three health and care professionals mistakenly believe dementia is a normal part of ageing. Because of this, your doctor may not recommend steps to reduce your risk of developing the disease or may fail to pick up on signs of it and intervene to slow its progression.
A recent report in the journal Neurology highlighted issues doctors should discuss with patients. If yours does not raise them with you, you can flag them.
Here is a list of questions to ask and why they are important.

1. Do you get enough sleep?
Several studies have found a link between sleep – both too little and too much – and dementia.
Researchers at the University College London analysed 8,000 people in their fifties and sixties and found those who were getting six hours of sleep or less a night were 30 per cent more likely to be diagnosed with dementia than those who got seven hours.
2. Do you have concerns about anxiety or stress?
Poor mental health can cause dementia or increase your risk of developing it. Depression earlier in life can increase the risk of developing dementia even 20 or 30 years later.
There are many theories as to why. It could be that anxiety causes an overproduction of cortisol, an inflammatory agent – the brain does not deal well with inflammation.
It could be that illnesses like depression affect the brain’s architecture including the hypothalamus – the memory centre.

3. Are you eating enough healthy food?
Diet and brain health are closely linked. The Mediterranean, Mind and Dash diets have all been touted as good for your heart, which makes them good for your head.
Conversely, ultra-processed foods – UPFs – are really bad for heart and head. A recent study found a high intake of UPFs to be associated with increased risk of dementia.
4. Do you do enough exercise?
Countless studies show how important exercise is in protecting us from dementia. Even a little is better than none at all.
A recent study found those who did just 35 minutes of moderate to vigorous exercise a week had a 41 per cent lower risk of developing dementia than those who did no exercise over an average four-year follow-up period. Even among frail older adults, greater activity lowered risk.
Researchers also found dementia risk went down as exercise minutes went up: 60 per cent lower for those who did 35-to-69.9 minutes of physical activity per week; 63 per cent lower for those who did 70-to-139.9 minutes per week; and 69 per cent lower for those who did at least 140 minutes per week.

5. Do you have regular contact with friends or family?
An analysis of recent studies found close ties between loneliness and dementia.
Loneliness is associated with depression, a well-known risk factor for dementia. Less social interaction leaves people vulnerable to cognitive decline.


Loneliness can also negatively affect the brain’s physical structure.
A 2022 study found loneliness to be associated with faster ageing – the biggest risk factor for dementia – but also smaller hippocampal volumes. The hippocampi – two little seahorse-shaped structures in the brain – play a crucial role in memory and learning.
6. Do you wear seat belts and helmets, and use car seats for children?
Head injury earlier in life, particularly repetitive head injuries as one might sustain playing rugby and other contact sports, is linked to dementia risk.
The inflammation in the brain resulting from head injury is known to reactivate herpes simplex virus type 1, or HSV-1, infection, which is increasingly linked to dementia.
A head injury can increase dementia risk even 25 years after the fact.
7. Do you have high blood pressure?
Research shows people with high blood pressure in their early forties to early sixties are significantly more likely to develop dementia including Alzheimer’s disease.
High blood pressure damages blood vessels and causes blockages that reduce blood flow to the brain. This in turn diminishes the brain’s ability to get rid of harmful waste products.
8. Are you at risk from genetic and metabolic factors?
Do you have trouble controlling your blood sugar or cholesterol? Is there a neurological disease that runs in your family?
Be mindful of all the numbers associated with a visit to your family doctor – not just weight and blood pressure, but blood sugar and cholesterol levels.
Type 2 diabetes has an impact on the heart and by extension brain health, and hypoglycaemia, or low blood sugar, is known to damage the hippocampus. Dementia is sometimes called type 3 diabetes.

9. Do you take your medication regularly, and can you afford it?
Do you have trouble with the cost of your medicines and are you taking them regularly, especially those that help to control chronic conditions such as diabetes, high cholesterol and high blood pressure?
10. Are you up to date on vaccines?
A 2024 study found that some infections can predispose a person to dementia many years later. Influenza as well as viral, respiratory and skin infections were associated with greater long-term dementia risk. They were also associated with volume loss in the brain’s temporal lobes.
There has been some suggestion that people who have been immunised against tuberculosis with the BCG – Bacillus Calmette-Guérin – vaccine, which has been used for 100 years, may have some protection against dementia.
A recent University of Oxford study found at least a 17 per cent reduction in dementia diagnoses in the six years after participants received the shingles vaccination Shingrix.
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How to prevent dementia, and 10 things to ask a doctor to help safeguard your brain health

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Inside the Hong Kong Ballet’s new programme for seniors

Wellness

Doctors should be able to answer your questions about dementia. Photo: Shutterstock

Having regular social interaction is one of the ways to reduce the risk of dementia as we age. Photo: Shutterstock

Sleep and dementia are linked, research suggests. A University College London study of people in their fifties and sixties found that those who got less than seven hours a night were at greater risk. Photo: Shutterstock

Studies show poor mental health can increase the risk of dementia later – even decades later – in life. Photo: Shutterstock

There is a plethora of research that suggests regular exercise significantly reduces the risk of dementia, so it is recommended to stay active. Photo: Shutterstock

Talk to your doctor about medication, for example if you struggle to afford it or are not sure whether you are taking it as prescribed. Photo: Shutterstock

Don’t gain weight or biohack, do exercise, sleep and think young to age well, experts say

To live a long and happy life, several experts agree, do things you like with people you love, and think yourself younger. 
Photo: Shutterstock

Nicklas Brendborg, aged 29, is a Danish scientist and bestselling author. Photo: www.nicklasbrendborg.com

The cover of Brendborg’s book. Photo: Amazon

Quit drinking alcohol if you want to live longer, says Dr John Tregoning, a medical school professor at Imperial College London. Photo: Light Republic Photography

The cover of Tregoning’s book. Photo: Amazon

Valter Longo, professor of gerontology and director of the Longevity Institute at the University of Southern California – Leonard Davis School of Gerontology, has coined the term “juventology”: how to stay young and healthy for as long as possible. Photo: instagram.com/prof_valterlongo

The cover of Longo’s book, The Longevity Diet, which supports daily 12-hour periods of eating and fasting. Photo: Amazon

Professor Andrew Scott at the London Business School and director of economics at the Ellison Institute of Technology Oxford, in the UK, is interested in longevity and ageing. Photo: London Business School

The cover of the book on longevity co-written by Scott. Photo: Amazon

Can you slow down ageing? 4 women who believe they can share their top tips for turning back the clock

How can women in their 40s and beyond slow the ageing process? Three women who have share their tips. Photo: Getty Images

Julie Gibson Clark shows you do not have to invest lots of money to slow down ageing. Photo: Julie Gibson Clark

Longevity experts recommend weightlifting as a way to build and maintain muscles and strength and rid the body of those niggling aches and pains that come with age. Photo: Shutterstock

Fasting is good for us in so many different ways, says Mindy Pelz. Photo: Mindy Pelz

JJ Virgin says creatine is an important nutrient to take as a supplement. Photo: JJ Virgin

Put on your blue light filtering glasses in the evening to block out screen light, says Alka Patel. Photo: Alka Patel

How pets gave my dementia-afflicted mother affection, as well as a sense of purpose

Anthea Rowan’s late mother, Lala Stephen, cuddles the family pet Mr Purr. Research has shown owning or caring for a pet lowers the risk of developing dementia, improves the emotional state of adults who have the condition and may slow their rate of cognitive decline. Photo: Anthea Rowan

The writer’s late mother strokes the family cat Mr Puss. Among adults already diagnosed with Alzheimer’s disease, pet ownership was found to have a positive effect on daily living function, mood and mental health. Photo: Anthea Rowan 

Petting an animal comes with positive physiological effects. Photo: Shutterstock

A study found dog owners had as much as a 40 per cent lower risk of developing dementia than older adults who did not own dogs. Photo: Shutterstock

Owning a pet, apart from the company an animal offers, gives a person much more purpose to their day, especially if they live alone. Photo: Shutterstock

As language begins to fail and conversations become difficult in dementia, sufferers can feel increasingly isolated as they withdraw. Animals provide a conduit for remaining engaged. Photo: Anthea Rowan

Bruce Springsteen, 75, follows the Omad diet, but could you live on one meal a day?

Bruce Springsteen, 75, at an October 2024 rally for Democratic Party presidential candidate Kamala Harris in the US state of Georgia. Springsteen credits his fitness to following the Omad (one meal a day) diet. Photo: Reuters

Bruce Springsteen onstage in Las Vegas, looking very healthy at 75 years old. Photo: Getty Images

Eating “one meal a day is not a good idea”, says Brigham and Women’s Hospital obesity specialist Dr Caroline Apovian. Photo: Boston University

The Omad diet may not be suitable for some people, in which case the Mediterranean diet could be a better option. Photo: Shutterstock

Lifestyle

Health & Wellness

Health

Lists

Decoding dementia

How caring for a parent with dementia taught me about symptoms, prevention and why seeking out the latest research is so important

Author Anthea Rowan (right) with her mother.

Author Anthea Rowan (right) with her mother, who has Alzheimer’s disease, the most common type of dementia. Photo: Anthea Rowan

Anthea with her mother. Photo: Anthea Rowan

Studies suggest that regular exercise lowers the risk of cognitive decline by 35 per cent. Photo: Getty Images

Staying active can help prevent or delay the onset of dementia, studies suggest. Photo: Shutterstock

Why should you have a brain scan to test for dementia when there’s no cure? Knowing can help you delay its onset, neurologist says

It can be daunting to get a brain scan to test for signs of dementia, but a neurologist behind new research reveals the advantages of knowing early. Photo: Shutterstock

New research has found that dementia can be detected as early as nine years before symptoms manifest, and this could have significant implications for treatment. Photo: Shutterstock

Timothy Rittman, the neurologist who led the dementia research at Cambridge University. Photo: Cambridge University

A brain scan showing signs of dementia. Photo: Getty Images

Lizzie Perry, founder of This is Dementia, with her father, who was diagnosed with the disease at 58. Photo: This is Dementia

The approval in the US of a new drug that slows the onset of Alzheimer’s makes Rittman hopeful about the future of dementia treatment. Photo: Cambridge University

Why women are more likely to have dementia than men as they age, and how exercise and engagement can help lower your risk

Women may be at a greater risk of developing Alzheimer’s than men for a number of reasons: biological, societal or cultural. Experts suggest exercise and social engagement can help offset the risk. Photo: Getty Images

The spread of tau – the protein that clumps into the telltale tangles of dementia – may contribute to Alzheimer’s disease. Photo: Shutterstock

Female twins with a male co-twin were less likely to be diagnosed with dementia than female twins with a female co-twin. Photo: Shutterstock

Prenatal care and monitoring pregnant women’s health is key, as it may impact cognition and dementia risk in later life. Photo: Shutterstock

Taking regular exercise is key for women – and men – to reduce the risk of dementia. Photo: Shutterstock

How high or low blood pressure increases the risk of dementia, and why it’s never too late, or early, to adopt a healthy lifestyle to manage it

Having blood pressure that is too high or too low has been linked to a higher risk of dementia, but it’s never too late to start living a healthy lifestyle that will help maintain optimal blood pressure. Photo: Shutterstock


An optimal blood pressure reading, easily measured with a home device, is around 120/80. Photo: Shutterstock

Dr Ruth Peters was lead author of a study looking at the links between blood pressure and dementia. Photo: Dr Ruth Peters

It’s never too late, or too early, to start thinking about brain health and living a healthy lifestyle. Photo: Shutterstock

Problems with reasoning, planning, judgment, memory and other thought processes may result from damage caused by impaired blood flow to the brain – which may be brought on by high blood pressure. Photo: Shutterstock

6 dementia fighting tips from Dr Sanjay Gupta and Marc Milstein, experts on brain health – walk, talk, read, learn, relax, and eat and drink properly

We can protect ourselves against the risk of dementia with some simple lifestyle practices. Exercising (above), eating a good diet, drinking less alcohol, socialising, reading more and trying new things all help keep the brain sharp, say brain experts including Dr Sanjay Gupta. Photo: Shutterstock 

The cover of one of Dr Sanjay Gupta’s book. Photo: Simon & Schuster

The cover of Marc Milstein’s book. Photo: Marc Milstein

Drink alcohol mindfully and ask yourself why you are having that drink. Photo: Shutterstock

Learning new things creates new brain cell connections and helps keep your mind sharp. Photo: Shutterstock

Reading is good for brain health. Try to read a wide range of book styles, and join a book club to discuss with others what you are reading. Photo: Shutterstock

During sleep, our brains are restored and repaired, so relaxing is important if we’re going to get those seven hours of quality sleep. Photo: Shutterstock

Relationships keep us engaged, interested and interesting, and may help prevent dementia. Photo: Shutterstock

‘Like a light switch’: how sundowning syndrome affects dementia sufferers – and their carers; what it is and tips for how to cope

A person with dementia may experience “sundowning” syndrome - towards the end of the day they become more agitated, confused, panicked, resistant to instruction and restless. This affects their carers, too. Photo: Shutterstock

A person in bed, unable to sleep. Conservative estimates suggest about 20 per cent of dementia patients experience sundowning at some point.

Trey Todd is a neuroscientist at the University of Wyoming. Photo: Trey Todd

Sundowning was coined in 1987 by Lois Evans of Penn Nursing at Pennsylvania University. Photo: University of Pennsylvania

The pineal gland in our brain produces melatonin, which is what helps prompt us to sleep and awaken. In a broken system it is disrupted. Melatonin supplements might help fight sundowning. Photo: Shutterstock

Taking a patient with sundowning syndrome for a walk at a consistent time each day, morning or evening, may alleviate symptoms. Photo: Shutterstock

Getting out into the daylight early in the day is good for our sleep patterns, whether we have dementia or not. Photo: Shutterstock

Healthy marriage, healthy mind? Dementia risk lower for people married a long time, studies show; expert suggests why

Research suggests that people who have stayed married for a long time have a lower risk for dementia because they feel less lonely, are more likely to eat well and exercise more, and are more cognitively engaged. Photo: Shutterstock

Vegard Skirbekk is a researcher at the Norwegian Institute of Public Health. Photo: Norwegian Institute of Public Health

Anthea Rowan’s parents on their wedding day. Photo: courtesy of Anthea Rowan

A long-time married partner represents a security that provides a buffer against stressors. Photo: Shutterstock

Anthea Rowan and her husband on their wedding day. Photo: courtesy of Anthea Rowan

If you live with a partner long term, you are more likely to develop healthy daily patterns, to eat well and exercise more. Photo: Shutterstock

‘Dementia village’ that’s the first of its kind helps residents live normal lives, has a restaurant, theatre and supermarket – and no one wears a white coat

Residents are free to live their lives as they like at the world’s first “dementia village”, The Hogeweyk in The Netherlands. Photo: The Hogeweyk

The Hogeweyk, a “dementia villlage” in the Netherlands, provides care and a familiar and safe environment in which people with dementia live while retaining their own identity and autonomy as much as possible. Photo: The Hogeweyk

Jannette Spiering is the senior managing adviser and co-founder at The Hogeweyk in the Netherlands, which offers “humanising care for people with dementia”. Photo: The Hogeweyk

Residents relax around the fountain in the theatre square at The Hogeweyk. Photo: The Hogeweyk 

Residents of The Hogeweyk respond positively to their increased autonomy. Photo: The Hogeweyk

Residents at the healthcare facility take part in a painting class. Photo: The Hogeweyk

Hearing loss dramatically raises the risk of dementia, so why are so many people in midlife doing nothing to prevent it? A test is easy to arrange

Hearing loss has been linked to a higher risk of dementia and cognitive decline,  say experts, who recommend testing for preventable hearing problems (above).  Photo: Getty Images

Alison Huang, a senior research associate at the Cochlear Centre at Johns Hopkins, in the US, says hearing loss makes the brain work harder to process sounds. Photo: Johns Hopkins

Jiang Fan from the School of Public Health at China’s Shandong University. Photo: Shandong University

Checking your hearing in midlife is crucial, and can help you stave off cognitive deterioration. Photo: Shutterstock

Can HRT reduce dementia risk? New hormone replacement therapy studies say yes, upending 2002 reports

HRT use has been linked to better cognition, blood flow and brain size and a reduction in all neurodegenerative disease in recent studies. Photo: Shutterstock

HRT (hormone replacement therapy) use has been linked to better cognition, blood flow and brain size and a reduction in dementia and other neurodegenerative disease in recent studies. Photo: Shutterstock

If HRT is started after the age of 65, brain cells will have already been deprived of oestrogen for many years. This could mean there is a decline in neuronal connections – the brain’s messaging system. Photo: Shutterstock

HRT was found to be most effective when introduced early in menopause, says Anne Marie Minihane, director of the UK’s Norwich Institute of Healthy Ageing at the University of East Anglia. Photo: University of East Anglia

Dr Andrea Kwakowsky from at the University of Galway in Ireland believes the “critical period” for starting HRT is within five years of menopause. Photo: University of Galway

How can you prevent dementia? Free brain health online tool teaches the risks and gives essential tips on avoiding it

The new free “Think Brain Health Check-in” online tool from Alzheimer’s Research UK doesn’t test your memory but checks how well you’re looking after your brain and gives tips to help prevent dementia. Photo: Shutterstock

Dr Susan Mitchell is head of policy at Alzheimer’s Research UK. Photo: Dr Susan Mitchell

The Think Brain Health Check-in asks how often you challenge your brain - and then highlights why challenging your brain is key to staving off dementia. Photo: Shutterstock

Getting a good night’s sleep every night is one way to lower the risk of developing dementia. Photo: Shutterstock

Up to 40 per cent of dementia cases could be prevented if people were mindful of the risk factors for the illness and made lifestyle changes to prevent them. Photo: Shutterstock

Can lack of sleep raise dementia risk? Yes, studies say – but with one exception

Having only five hours of sleep a night can increase dementia risk by 30 per cent for adults over 50, one study says. Photo: Shutterstock

One tip to overcome insomnia is to avoid clock-watching. Photo: Shutterstock

Taking a warm shower or bath in the hour or so before bed may help you fall asleep – and stay asleep. Photo: Shutterstock

Professor Roger Wong of the department of public health and preventive medicine at the State University of New York’s Upstate Medical University. Photo: Roger Wong

Sleep aids can heighten dementia risk, Wong says. Photo: Shutterstock

Can’t sleep? Try getting up and engaging in cognitively stimulating activities, like reading or making jam. Photo: Shutterstock

Dementia and ACB scores: how common prescription and over-the-counter drugs raise the risk of memory loss and cognitive decline

Certain common drugs, including antihistamines, antacids, antidepressants and anti-anxiety medicines, can disrupt the neurotransmitter acetylcholine, dubbed the “memory molecule” increasing the risk of dementia. Photo: Shutterstock

The writer, Anthea Rowan, with her mother. Photo: Anthea Rowan

Taking medications that block the action of acetylcholine can lead to memory loss, problems with spatial awareness, and cognitive decline. Photo: Shutterstock

Studies have found that anticholinergic drugs carried “significant’ dementia risk” for the over-65s. Photo: Shutterstock

Doctors need to be mindful of the risks posed by anticholinergic drugs, especially to an already at-risk population: the over 65s. Photo: Shutterstock

How to safeguard your ageing brain: build ‘cognitive reserve’ with mental and physical exercise, and stay active and socially engaged

The phrase ‘use it or lose it’ is not just a hypothesis, it’s a basic biological fact that holds as true for our brains as our muscles or bones. Photo:
Shutterstock

Our brains, like our muscles need regular use to stay healthy and flexible, say experts, and keeping our brains active builds our ‘cognitive reserve’, helping us to stave off dementia. Photo: Shutterstock

Geriatric psychiatrist Dr David Merrill recommends the active pursuit of activities that keep the brain sharp to stave off dementia. Photo: Dr David Merrill

How to prevent dementia, and 10 things to ask a doctor to help safeguard your brain health

Dementia risk factors range from mental health to diet. Ask your doctor about them to help you slow down or prevent the onset of disease

1. Do you get enough sleep?