One daily routine, triple the protection

A person completing a puzzle.
​Daily cognitive activities such as puzzles, reading or learning something new have a protective effect against developing brain disease. (Photo: Getty Images)​

Every day, millions of people worry about losing their memory, having a stroke, or dealing with depression later in life. It’s no wonder as stroke, dementia and late-life depression are three of the most common and life-altering brain conditions affecting people as they age.

But what if it was possible to lower the risk for all three at the same time by changing just a few things in your daily routine?

A new study has found exactly that. It was led by Dr. Sanjula Singh of Brain Care Labs at Massachusetts General Hospital and co-authored by Dr. Aleksandra Pikula from UHN’s Jay and Sari Sonshine Centre for Stroke Prevention and Cerebrovascular Brain Health, part of the Krembil Brain Institute.

The research brings good news: these diseases, while serious, are not inevitable. In fact, a large portion of cases may be preventable by addressing everyday lifestyle habits.

The study looked at years of global research to find what stroke, dementia and late-life depression have in common. It found they often share the same underlying issues such as poor circulation in the brain and the same lifestyle risk factors.

The good news is that many of these risks can be reduced with small, manageable changes.

“Maintaining brain health is a complex challenge that requires a comprehensive approach,” says Dr. Pikula. “However, it’s reassuring to know that focusing on just one habit or risk factor can significantly reduce your risk of developing these three major brain conditions.”

Blood pressure monitor on an arm.
High blood pressure is the leading modifiable risk factor for developing brain disease. (Photo: Getty Images)

In total, the team identified 17 modifiable risk factors that appeared in at least two of the three conditions. Hypertension and chronic kidney disease contributed most to risk, while physical activity and social connection were the most protective.

Risk factors that increase the likelihood of developing dementia, stroke or late-life depression include:

  • High blood pressure
  • High body mass index
  • High blood sugar
  • High total cholesterol
  • Depressive symptoms
  • Diet high in red meat, sugar-sweetened drinks, sweets and sodium
  • Hearing loss
  • Kidney disease
  • Pain, particularly forms that interfere with activity
  • Sleep disturbances — insomnia, poor quality or for periods longer than eight hours
  • Smoking history
  • Loneliness or isolation
  • General stress or stressful life events

Factors that protect against developing dementia, stroke or late-life depression include:

  • Regular cognitive activity such as reading, doing puzzles
  • A large social circle
  • Diet high in vegetables, fruit, dairy, fish and nuts
  • Moderate or high levels of physical activity
  • A sense of purpose in life
  • Low to moderate alcohol intake

Notably, two factors — diet and social circle size — showed both protective and harmful associations depending on their quality. For example, a diet high in vegetables was protective, while one high in processed foods increased risk.

“This study puts agency into the hands of the population and patients,” says Dr. Pikula. “With the evidence now in hand, medical providers are also empowered to fully support patients as they work to make positive behavioral and lifestyle changes.”

A group jogging together on a path in the sun.
Moderate physical activity such as walking 30 minutes a day was linked to better outcomes for stroke, dementia and depression. (Photo: Getty Images)

What Can You Do?

With 17 risk factors, it can feel overwhelming to know where to start. But the study offers some helpful tips.

  • Get blood pressure under control: High blood pressure stood out as one of the strongest contributors to brain disease risk.

“Keeping your blood pressure in check is a powerful way to support brain health,” says Dr. Pikula. “Know your numbers. Simple steps like cutting back on salt, staying active and managing your weight with a healthy and sustainable diet based on whole, fresh foods can make a big difference.”

  • Move more: Even moderate physical activity such as walking 30 minutes a day was linked to better outcomes for all three conditions.
  • Challenge your brain: Whether it’s reading, puzzles, or learning a new language or skill, cognitive activities keep the brain young.

“Engaging your mind in cognitive activities can be an effective way to protect against dementia, potentially dramatically reducing the risk for stroke when combined with other health lifestyle habits,” says Dr. Pikula.

  • Don’t ignore sleep: Both too much and too little or poor-quality rest can raise the risk. Aim for seven to eight hours of solid rest each night.
  • Stay connected: Loneliness and low social engagement were linked to worse brain outcomes. Call a friend, join a group, or just chat with a neighbour.

Other improvements people can make include managing blood sugar, hearing health, stress levels, kidney health and keeping a sense of purpose in your daily life.

So, when is the best time to start?

While it’s never too late, Dr. Pikula says, research shows that the most effective time to take action is in midlife or earlier. Addressing risk factors early can help prevent or slow the progression of disease with age.

Just as importantly, it lays the foundation for a healthier, more sustainable lifestyle as we grow older, she says.

This research matters more than ever

These brain conditions aren’t just affecting a small segment of the population. According to global health data, stroke, dementia and late-life depression are three of the biggest contributors to disability and reduced quality of life around the world.

Treatments are improving, but they’re still not enough to meet the scale of the problem and likely never will be.

That’s where prevention comes in and why it’s so important. As this research shows, there’s now a roadmap, and it starts with everyday habits.

The team behind the study hopes their findings will lead to practical tools — such as the brain health tracking tool Brain Care Score — that help people understand their risk profile and take steps to reduce it. They’re developing a new version of the Brain Care Score based on the 17 modifiable risk factors identified in this study.

But even before further tools arrive, the message is clear: people don’t need a prescription to start protecting their brain. A proactive approach, even one starting with small changes — going for a walk, reducing salt intake or calling a friend — can make a meaningful difference.

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