After my mum died of dementia I knew I had to change my life to save my brain
Could a brain coach help? One two-year clinical trial found that it increased cognitive function by 74 per cent after two years.
Dementia prevention coach Susan Saunders, who trained with US neuroscientist Dr Dale Bredesen, runs a three-month long Better Brain Framework that promises improved memory, sharper cognition and to banish brain fog. When I approach her about doing the programme, she was very clear that it was all or nothing: I had to commit fully to her – a commitment that included six 40-minute Zoom coaching sessions, plus homework of six teaching videos. I was daunted but realised it had to be done. At the age of 59 I knew I had to change my life to save my brain.
At our first meeting, Saunders, who is also a trained habit coach, told me that although she could not prevent dementia, what she could do was 'build long-term habits scientifically shown to reduce dementia risk'. Like me, Saunders lost her mother to dementia – in her case, Alzheimer's, in mine, a form of Parkinson's dementia.
My mum, Anita, was the perfect storm. She had a mind like a steel trap and lived an intellectually stimulating life – she was an academic and a journalist, she had a PhD in English literature, she saw every Royal Shakespeare Company production, she read and wrote constantly. She was active and slim with a wide circle of friends and a happy marriage to her second husband who she met at 50.
However, she lived in London near a busy road and had suffered a head injury in her 50s, falling down some stairs while sleepwalking. Then, when she was 65, she became a carer to her husband following a serious stroke that left him wheelchair-bound. She no longer rode her bike to the British Library every day, or went to the theatre. There was no time for reading. She began to decline and after five years was diagnosed with Parkinson's. Soon afterwards, the severe physical symptoms of her condition were joined by Parkinson's dementia, which features disturbed sleep, delusions, depression and anxiety. She died 10 years later, aged 81.
Lifestyle may not have caused my mother's illness but it almost certainly hastened it. How we live matters. 'It's about building the life that puts your brain health first,' says Saunders. 'There's no magic pill coming any time soon to prevent dementia. The best hope we have is lifestyle changes.'
What's more, work done now will give better memory, cognition and mental health now. 'Create an identity for yourself as someone who puts their brain first, prioritising yourself and your brain even above families, bosses, co-workers,' says Saunders. Not easy, she concedes, but vital. Over the next three months, I give it a try.
Session one: nutrition for a better brain
In our first session, Saunders reminds me that 20 per cent of everything we consume goes straight to our brain. 'Feed it c--p – it's going to work like c--p!' she summarises, pithily.
Saunders's top tip on how to build a meal that's better for your brain is 'plan veg first'. This is because they 'give us a type of antioxidant, called polyphenols, which feed our brain. The first studies to focus on this found that people eating at least three portions of veg each day had slower rates of cognitive decline, and similar research showed green leafy veg also slowed cognitive decline. You're aiming for six to nine portions of veg a day.'
I start planning our dinner plates veg first, then protein, then carbs. It's a revelation. We're having four veg (corn, grated carrots, avocados, beans) as well as our daily dose of broccoli. Protein (chicken, beef, fish) takes a quarter of the plate and in my case there's barely room for carbs, though the children and my husband still have pasta or potatoes.
I replace my morning porridge with banana and yogurt, nuts and seeds for more protein, which Saunders also recommends. I succeed in 'crowding out' biscuits – snacking on nuts which provide healthy fats and in the afternoon I eat dried apricots or dates – yes, high in sugar but not processed, and full of fibre.
I have to think long and hard about alcohol. The truth is, although I rarely get drunk, I drink a glass or two of wine most nights of the week. I rely on alcohol to manage stress and also to give me a feeling of being rewarded for working hard.
Saunders' advice is to cut back. 'It's a neurotoxin. You know that feeling when you relax, then feel a bit woozy, then drunk. That's the impact on your brain.'
I tell Saunders that when I did Dry January I felt great and she asks: 'What else could provide a different punctuation point at the end of the day? Can you start to move towards embodying someone who puts their brain first, who understands that alcohol is a neurotoxin and who needs less of it in their lives?'
I stop buying wine at the supermarket on weeknights and start trying to limit wine to two evenings a week. I manage three. I am genuinely shocked at the difference it makes to the way I feel the next day. The less I drink, though, the worse I feel when I do drink – which also gives me pause for thought. Have I just got used to feeling under-par most of the time?
Session two: movement, the brain's silver bullet
'Of all of the strategies we can try to reduce our dementia risk, none has more supporting scientific evidence than exercise,' Saunders tells me in our next session. It makes me sit up and listen. She explains that we're actually growing our brains when we exercise and that research has linked regular exercise to a 35 per cent lower risk of dementia. And it's not just structured exercise that makes a difference: moving about, for example doing regular housework, also has significant benefits. I'm not keen to start doing more domestic chores but I do take note.
When it comes to exercise I am very faddy. One month I'm walking, the next week cycling, the next week doing weights. I've kept up swimming in cold water for 10 years now and although that's good, it's not enough.
So, I start running up a huge hill near my house which is a form of resistance exercise (running counts, sort of) and getting enormously out of breath. All of these are vital for the brain.
The running feels awful at first but the improvements are quick and when I get home I feel amazing. Added to the reduced drinking I'm as sharp as a pin and, my husband reports, a lot less grumpy than I used to be.
Session three: A good night's sleep starts in the morning
Saunders says: 'Deep sleep becomes harder to achieve as we get older but it's in this phase of sleep where the magic happens in terms of brain health. One study found that a 1 per cent reduction in deep sleep in people over 60 could lead to an increased dementia risk of 27 per cent.' That sounds pretty scary.
Having been an insomniac in the past, however, I already have quite good sleep habits. I keep a regular bedtime and getting-up time and I pop a magnesium tablet (also recommended by Saunders) before bed. To this I now add 'morning light' with my uphill runs, which is good for the body's circadian rhythm. I am also keeping up the restraint around alcohol to see if this makes a difference.
After a few nights of tossing and turning without a drink to clunk me on the head and get me to sleep I have started to drop off quickly and sleep deeply, waking earlier and much more refreshed. I love wine, and I couldn't bear the thought of life without a single vice, but I realise I've got to cut back further. When, a month in to the programme, I tell Saunders about my increasing clarity – the less I drink the sharper I feel – she gets excited: 'That's it working!' she says. 'That's better brain health.' She is right.
Session four: stress is bad for the brain
Stress has been linked to an increased risk of Alzheimer's in multiple studies. Allow time in your schedule to care for yourself. And that doesn't mean bubble baths. When I feel I'm getting stressed, I stop and tell myself how bad it is for my brain. I try to work through the suggestions Saunders has made: I distance myself from my feelings. I ask myself why am I feeling like this and what can I do. Most of all I remain aware when it's ramping up. As a result I feel less stressed, more in control and clearer headed.
Session five: start dancing to boost cognitive engagement
I feel cognitively engaged – I work as a journalist talking to interesting people, I have a chatty husband and three children, all lively, entertaining young people, I read as much as I can before falling asleep. But there's always more you could be doing. For me, table tennis and padel are out, as I am simply atrocious at sports, but Saunders has another suggestion. She says: 'It's been suggested that the best way to recreate the complex interaction of physical movement, memory, decision-making and social interaction that our ancestors experienced on that savannah is to dance.' This makes a lot of sense – it requires the full spectrum of cognitive skills, complex motor, perceptual and conceptual skills. One study examined the leisure activities of a group of older people over several decades and found that dancing provided the greatest dementia risk reduction (76 per cent) of any activity studied, cognitive or physical.
I realise music is missing from my life, as I barely know how to listen to it any more – the tech is too complicated – and rely on occasional bursts from the radio in the car. I brace myself and log on to Spotify which leads to dancing in the kitchen until I am caught by a horrified teenager.
It makes me realise there's always more you can add and that the danger point will come when one starts to work less. Plus my husband and I will need a plan for retirement (if that time ever comes) as we plan to move to the country – we will need to find new hobbies and interests.
Session six: managing my environment
The news about environmental factors leaves me downhearted. There are several categories of 'dementogens' including heavy metals, chemicals such as pesticides and cleaning products, and biotoxins such as moulds. However it is the air pollution that concerns me. Like my mum before me I live in London, in zone two, and I can't really get away from it. Nevertheless I change my run to the park so I go through back streets instead of on the road. I try not to breathe too much through my mouth (easier said than done when you're running uphill). Elsewhere I stop microwaving in plastic and consider not storing food in plastic, although given my immense Tupperware collection this will be a stretch. In the fullness of time I plan to replace some cleaning products.
The other factor grouped together with this is loneliness, known to increase the risk of dementia. Research published in 2023 found that the risk of developing dementia over nine years was 27 per cent higher among socially isolated older adults, compared with older adults who were not socially isolated. Other research has found that those with a strong support system are 46 per cent less likely to develop dementia.
'The best workout we can give our brains is talking to a stranger,' says Saunders. 'The brain has to process so much at this precise moment – who is this person? What do they want from me? Am I safe? Talking to a stranger every day is a great way to flex cognitive engagement.'
I talk to strangers all the time anyway, much to the mortification of my husband and children. I'll keep it up.
The final result
After three months I am convinced that we could all benefit from following this programme. For me, the two most significant and dramatic changes have been cutting alcohol back to once a week and starting running again. The combination of these two things plus the better sleep I get as a result has given me better clarity than I had at the age of 30 when I was starting out in journalism, living the high life in London, drinking, staying up late, stressing out, keeping irregular sleep patterns – you name it, I was doing it, wrong. The exhaustion of being a working parent and later also a carer for my mother, and the stress-related drinking that went along with it, didn't help in the years that followed.
Most people following her programme have one such realisation says Saunders – whether it's exercising, better nutrition, self-care or simply taking time for themselves.
I'm delighted that the effects are instant. Most importantly, if I stay on this path I will reduce my risk in the future. If only my mum could have done the same – though events conspired against her. I urge anyone who has become a carer, or whose parent has become a carer, to bear this in mind.
I'm grateful to Saunders for opening my eyes and encouraging me with her three-month programme. Her advice is so simple and sane: 'It's so easy. Choose those things you can keep up. There's no magic pill to reduce dementia risk. It's about long term consistency. That's the closest thing we've got to a magic bullet.'
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