When Sarah Chester retired from a frantically busy teaching career, she asked herself two questions: “What am I going to do with the rest of my life? And how am I going to live it?”
Having been a keen cyclist all her life, she knew she wanted to devote some of her free time to being more active. But that was not just for reasons of general good health. Chester’s mother had first started showing symptoms of dementia 15 years ago, and she found herself thinking: “If I don’t really get my act together now, will I have the same trajectory?”
Now 63, Chester has certainly taken the lesson to heart. She weight-trains at least once a week with an instructor near her home in Wiltshire, and takes at least one long walk and does three Hiit (high-intensity interval training) sessions a week. She does puzzles and verbal tests daily, tries to limit outside stresses and sleep well, “and I know that social interaction with a variety of friends is vital”.
When you see dementia up close, she says, “you think, gosh, if there are ways that, through lifestyle choices you can mitigate your own risk of dementia, then it’s absolutely a no-brainer. You’ve got to do it.”
She is far from the only person to be concerned about her future brain health. The broadcaster Jeremy Vine this week said he now listens only to music that he doesn’t like, after a friend revealed he had started training himself to write with his left hand – all in an effort to keep stimulating the brain, and fend off future memory loss.
We asked Guardian readers what lifestyle changes they have made in the hope of keeping dementia at bay; the responses showed this is a subject that concerns many.
Anthony Ray, 74, a former financial adviser from Huddersfield, says he was not particularly healthy pre-retirement, but now walks 10,000-15,000 a steps a day, and regularly trains with weights at the gym. He volunteers with an organisation for blind people in Huddersfield, is involved in his local Catholic church, and reads the New Statesman from cover to cover “which I find very stimulating”.
It was a diagnosis of peripheral heart disease, and a conversation with his wife in which he briefly couldn’t remember her name, that sparked his lifestyle overhaul. “I thought, that’s not right, I’ve got to do something about this. So I did.”
Many readers spoke of trying to improve their fitness and health, through better nutrition and more exercise. Weight and resistance training (“which bores me rigid!”) was surprisingly popular; others spoke of cutting out processed foods and cutting down on alcohol. Brain-stimulating activities, such as puzzles and crosswords, were common.
“I refuse to get old!” said one reader, who sent a glorious picture of herself skydiving at almost 80, but preferred to stay anonymous.
Yvonne Martin, a 62-year-old retired primary school teacher from Gloucestershire, is now a keen gym member and says learning to lift weights and follow choreographed fitness routines “gives my brain and body the challenge it needs – never mind looking foolish on occasions, I’m just happy to move and give it a go”.
She is learning the piano, working on “The Novel” (a project over many years, she says) and is hoping to give painting a try, perhaps even learn pottery. “Whatever you do, I think you need to push yourself out of your usual comfort zone to prevent stagnation.”
‘Anything is better than nothing’
This advice is backed by the Alzheimer’s Society, whose head of knowledge, Dr Tim Beanland, stresses that while “the biggest risk factor for dementia is getting old, which we can’t do much about, the good news is that you can significantly reduce your risk. If you look after your general health and you stimulate your mind, then you are helping to stack the odds in your favour a bit more.”
Up to 40% of dementia cases could be prevented due to lifestyle changes, the organisation says, and crucially, those who do develop the diseases behind it can slow the rate at which it impedes them.
Beanland advises certain key lifestyle changes, starting with exercise, and particularly cardio and strength activities. “If you were only going to do one thing to reduce your dementia risk, it would be regular physical activity,” he says. The aim should be at least 150 minutes a week of moderate intensity (“it should make you a little bit breathless”).
That includes people with limited mobility, he says. “Anything’s better than nothing. And the benefits of exercise are actually greatest [when you] go from nought to a little.”
Eating healthily is also strongly recommended, as some conditions such as high blood pressure and diabetes have close links with dementia, he says.
Building up your “cognitive reserve” – your brain’s resilience to memory loss – is extremely important. That can involve doing crosswords, puzzles (of which Beanland has compiled a new book for the society), learning a language, trying to master the guitar – whatever you are interested in. The important thing is to challenge your brain, says Beanland. And if you’ve done Wordle or the Guardian crossword so often you now find it straightforward, “find a new puzzle, find a harder crossword”.
One reader from Michigan in the US, whose husband was diagnosed with an early-onset form of the disease in his 60s, was keen to stress that not all forms of dementia can be avoided by lifestyle choices. “Because of the attention being paid to lists like ‘Do these 12 things to stave off dementia!’, will people wonder whether he was too lazy to prevent it from happening? That’s the last reaction we need as we grapple with the looming catastrophe of dementia.”
One “avid” Guardian reader with a closer interest than most in the subject is David Smith, now retired and living in Sweden but formerly a professor of pharmacology who founded and directed the Oxford project to investigate memory and ageing (Optima).
When it was launched in 1988, says Smith, “the word ‘prevention’ wasn’t in vogue at all in relation to dementia. People saw it as a dreadful disease and nothing could be done about it.” Today, he says, “prevention is the way forward”.
The large leap forward in what we know about preventability has informed his own retirement lifestyle: he walks for half an hour a day, spends at least 15 minutes on an exercise bike, drinks alcohol sparingly, and follows a Mediterranean diet.
Having led a clinical trial into the benefits of B vitamins in people with mild cognitive impairment – a memory-loss condition that increases the chance of those who have it developing dementia – Smith takes 0.5mg of vitamin B12 daily and fish oil with Omega 3. Nutrition, he believes, is not given enough prominence when we talk about prevention.
Alzheimer’s Research UK does not recommend any supplements in particular, but says “there is no harm in people taking a supplement to reduce the risk of deficiency”.
For brain stimulation, Smith opts for “challenging” books – currently a 1929 Japanese biography of Botticelli. “Next month I am 85, but mentally, I don’t feel it at all. Physically I am starting to get a few problems, but otherwise – I’m fit.”
For Lateral G (she prefers not to share her real name), formerly the head of English at a West Yorkshire secondary school, challenging herself later in life has taken a bold form. Forced to retire in her 40s due to illness and subsequent disability, she started writing poems, but then noticed her memory faltering.
“I thought: is this the beginning of dementia? So I started learning my poems as a means of checking my memory loss. And I discovered that I could learn my poems – and once I’d learned them, and we came out of the pandemic, then I started going out and doing open mics.”
Now 53, she calls herself a “travelling performance poet” who appears at pubs and poetry events; she hopes the challenge of learning her work, and keeping her mind active and creative, will help keep further memory issues at bay.
“My partner always says, if you do get dementia, the poems will be the last things to go.”