Lauren Miller Rogen knows that Alzheimer's disease runs in her family, but she's not assuming it's her fate. “I've heard a lot of smart people say that your genes may be the map, but they don't have to be your destination,” she says.
“You don't have control over your genes or your family history,” says Liana Apostolova, MS, MD, FAAN, endowed professor of Alzheimer's disease research at the Indiana University School of Medicine. “But many things may help reduce your risk of developing Alzheimer's disease.”
Research shows that Alzheimer's disease begins in the brain at least 15 years before the first symptoms of memory loss appear, which is why it's important to protect your brain from an early age. Recently, a new review and analysis of hundreds of major trials, published in the Journal of Neurology, Neurosurgery and Psychiatry, pinpointed several significant risk factors—and offered a list of habits people can adopt to possibly lower their risk for the disease.
Most of these recommendations revolve around five key areas that Lauren Miller Rogen and Seth Rogen's charity, HFC, focuses on in its public awareness campaigns: exercise, nutrition, mental fitness, sleep, and emotional well-being. Acting on them doesn't mean you're guaranteed not to develop dementia, but you can do your best to build what HFC calls a “more Alzheimer's-resistant brain.”
Exercise
Lots of studies have found that physical fitness can translate into mental fitness. The hippocampus—the part of the brain primarily responsible for memory and learning—is larger in people who are more physically fit, and exercise has even been shown to increase the size of the hippocampus in older adults, which improves memory function.
“We have clear evidence that physical activity helps maintain cognition, reduces levels of stress—which itself contributes to cognitive decline—and increases levels of proteins in the brain that help maintain its functioning,” says Sudha Seshadri, MD, founding director of the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases at the University of Texas at San Antonio.
Pick something you'll stick with and aim for 30 minutes at least five days a week.
Nutrition
“We know that a brain-healthy diet and a heart-healthy diet are essentially the same thing,” says Dr. Apostolova. Most experts recommend following the “Mediterranean diet”—plenty of fruits, vegetables, whole grains, beans, nuts and seeds, olive oil as a primary fat source, and moderate amounts of eggs, fish, poultry, and dairy. The diet is endorsed by the American Heart Association, and in several studies has been associated with a lower risk of cognitive decline.
Together, a healthy diet and exercise protect against high blood pressure and diabetes, both of which are significant risk factors for Alzheimer's disease. “And we know that it's not just your blood pressure or having diabetes in your sixties or seventies that puts you at risk for dementia, but your accumulated exposure over a lifetime,” says Dr. Seshadri. “Midlife hypertension and diabetes affect your brain, and the period we define as ‘midlife' seems to go back further and further as we get more sensitive ways of detecting brain injury.”
Don't waste your money on products advertised as “brain health supplements,” however.
“If you have a diagnosed deficiency in a certain nutrient, then supplementing to a normal range can be beneficial, but if you're eating a healthy diet and have a normal nutritional intake, there's no need for that,” says James Burke, MD, PhD, professor of neurology at the Duke University School of Medicine.
Mental Fitness
“I sometimes joke that Head Start is an antidementia program,” says Dr. Seshadri. That's because research has found that education, from early childhood through adulthood, helps prevent cognitive decline later in life.
“The more education people get, the more protection they have against cognitive decline in general,” says Dr. Apostolova. “There's also something we call ‘cognitive reserve': the brain's ability to compensate for damage with more efficient connections and processing. That's increased by education.”
That doesn't necessarily mean that if you never got a college degree, you're out of luck. “It seems that a wide range of mental and social activities, begun early and continued throughout life, is important,” says Dr. Seshadri.
Rather than focusing on touted “memory training” programs, exercise your brain with intellectual and social activities. “If you're doing something you enjoy, you're more likely to continue doing it, whether that's reading, doing puzzles or games, learning a language, or even dancing, which combines an intellectual and a physical component,” says Dr. Burke. “If you're musically minded, pick up the guitar or violin. Stretch your brain in ways that are meaningful to you.”
Sleep
You can protect your brain simply by going to bed. “Sleep is a period of recovery during which buildup of harmful amyloid and tau proteins can be removed from the brain, especially during periods of deep sleep,” says Dr. Seshadri.
Being chronically sleep deprived, studies suggest, may increase your long-term risk of developing Alzheimer's disease and dementia. Even one night of sleep deprivation has been found to raise levels of amyloid and tau in the brain.
Go to bed at the same time every night (even on weekends); avoid alcohol and caffeine in the evening; don't exercise right before bed; and keep your bedroom cool, comfortable, and free of distractions.
Emotional Well-Being
Depression and stress are contributing factors in the development of Alzheimer's disease and dementia, so caring for yourself emotionally is an important part of maintaining your brain health. Spend more time out in nature; pursue mind-body wellness activities like meditation, tai chi, or yoga; and set aside time to socialize, either in person or virtually. You can even view hanging out with your best friend after work or reconnecting with your college housemates on a group Zoom call as an important wellness activity!