Age Brightly Blog | Dementia Series, Part 5 of 5 Featuring Dr. Cheryl Johnson, Lead Geriatrician at Age Brightly
Dementia isn't inevitable. And even for those already experiencing cognitive change, there is plenty that can be done to slow the progression and protect what's there.
This final post in our series focuses on exactly that — the evidence-backed things that make a genuine difference to brain health, at any age, at any stage.
Dr. Johnson is emphatic on one point: these aren't just for people who are worried about their memory. They're good for everybody. "It doesn't matter how old you are, doesn't matter if you've already got dementia — they're good for everybody."
This comes up again and again in the research, and Dr. Johnson puts it first. Physical exercise has been shown to slow and stabilise memory loss in people who already have dementia, not just prevent it in those who don't.
The target is 30 minutes, five times a week. Walking counts. "You don't need a gym membership," she says. The mechanism is simple: getting oxygen and nutrients to the brain.
Brain-friendly eating doesn't have to be complicated. Dr. Johnson highlights:
Berries (blueberries, strawberries) — high in antioxidants
Walnuts — they even look like little brains
Turmeric — strong anti-inflammatory properties
Leafy green vegetables, broccoli, olive oil — the foundations of a Mediterranean diet
Water — straightforward and often underestimated
A little coffee — the evidence is encouraging
Restorative sleep matters for brain health, and it's often the first thing to go when someone is under stress or caring for another person. Exercise during the day supports better sleep at night — a useful compounding benefit.
Worth stating plainly: excess alcohol is a risk factor. It's also one of the more common coping mechanisms for carers under strain, which makes this worth paying attention to.
Not all stress is bad — some is necessary for motivation and function. But chronic, unmanaged stress is harmful. Exercise is one of the best stress relievers available. Beyond that, building in deliberate strategies to manage workload and pressure matters.
The evidence on brain games (sudoku, crosswords) is mixed. What does matter is doing things that genuinely challenge your thinking, require you to learn new skills, or give you a sense of meaning and engagement. "Doing things that have that element of challenge allows our brain to think and learn new skills."
Beyond behaviour, there are a number of medical risk factors that directly influence dementia risk. These come largely from a landmark 2020 article in The Lancet that mapped dementia risk across the lifespan.
In early life: Education. Achieving your highest level of education builds what clinicians call cognitive reserve — essentially, more brain capacity to draw on before symptoms emerge.
In midlife: This is where vascular health becomes critical.
High blood pressure — get it checked, treat it if needed
High cholesterol — same
Diabetes — managing blood sugar protects the brain
Obesity — weight management in midlife has long-term brain benefits
Hearing loss — this one surprises many people. Untreated hearing loss is a significant risk factor for dementia. Get a hearing check; wear hearing aids if recommended.
Head injury — repeated concussion (as seen in contact sports) is a recognised risk factor for neurodegenerative conditions.
In later life: Air pollution features in the research, though the picture is still being refined.
Bloods to keep an eye on: Vitamin B12 and thyroid function are worth checking regularly. Both can cause cognitive symptoms that mimic dementia — and both are straightforwardly treatable. This is something Age Brightly actively monitors for members, because catching a fixable problem early can look indistinguishable from catching early dementia.
One of Dr. Johnson's observations that stays with you: these factors stack. A person who isn't sleeping well, is drinking more than usual to cope, isn't exercising, and isn't getting their blood pressure checked — each of those alone is a risk. Together, they compound into something considerably harder to reverse.
The same logic works in the other direction. Walk for 30 minutes while listening to a podcast. Sleep better because you exercised. Manage your blood pressure because you're seeing your GP. These aren't separate interventions — they reinforce each other.
Dr. Johnson ends every conversation about dementia by pushing back against the idea that nothing can be done. "There is hope. It's about getting that early diagnosis, understanding the problem, putting in treatment if we can, and then keeping brain health where it is at that point into the future."
New treatments — particularly lecanemab for early Alzheimer's — are changing the landscape. The science of brain health is advancing fast. And the lifestyle factors above, applied consistently, have genuine evidence behind them.
You don't have to wait for a diagnosis to start protecting your brain. The best time to start is now.
This series was drawn from a conversation between Hannah McQueen, founder and CEO of Age Brightly, and Dr. Cheryl Johnson, Lead Geriatrician at Age Brightly. To learn more about proactive brain health and what Age Brightly offers, visit our website.