A major report released by the Lancet International Commission on Dementia Prevention and Care in 2017 concluded that up to 35 percent of dementia cases can be delayed or even avoided altogether.

“The main message is that there are modifiable risk factors that can reduce your risk,” says Maria C. Carrillo, PhD, the chief science officer for the Alzheimer’s Association.

While you can’t change the genes you inherited, there are many probable risk factors that you do have some say over.

Living with or supporting someone with dementia is not easy. Laughter and love will get you through.

Researchers say that when they look at brains during autopsies, they often see signs of damage (either plaque associated with Alzheimer’s disease or trouble with blood supply) even when the patient did not suffer from dementia.

Because of that, they theorize that these people have “cognitive reserve”—meaning their brains have enough extra capacity to stay sharp despite physical damage.

The Lancet Commission report emphasizes the association between lack of formal schooling and dementia, which suggests that what happens to us early in life can build this reserve: People with higher socioeconomic status during early childhood are less likely to develop dementia, and people who go to school at least through the secondary level are also better off.

“This points to the fact that brain health and, really, overall health is a lifelong commitment—it’s even something we should be thinking about with prenatal care,” Carrillo says.

But, she adds, that doesn’t mean you can’t continue protecting your cognitive health once you’ve grown up.

“There’s not anything you can do about your childhood education, but there is something you can do about making sure that you’re staying mentally active, that you challenge your brain, that you find ways to stay socially active.”

Although there isn’t proof that hearing loss causes cognitive decline, studies show that those who suffer from it (and there are lots of us—it’s a problem in more than 30 percent of people over age 55) will have higher rates of dementia eventually, according to the Lancet Commission report.

“We know that it’s important for people who are experiencing hearing loss to get that checked out and corrected whenever possible because it can contribute to cognitive decline as you age,” Carrillo says.

Plus, as baby boomers hit retirement age, hearing aids are improving rapidly—they’re smaller and work better than your grandfather’s did, according to a recent Scientific American article.

Do visitors casually mention that your TV is blaring? Do you keep asking people to repeat themselves? You’re not alone.

Sleeping less than five hours a night—or more than ten—seems to raise your risk of dementia and an early death, according to a 2018 report in the Journal of the American Geriatrics Society.

If you snore a lot or don’t feel rested after a full night’s sleep, you should get tested for sleep apnea, an airway condition in which you stop breathing briefly throughout the night.

Treatment can make a big difference in the quality of your sleep.

If you suffer from insomnia that lasts longer than a few days or weeks at a time, a sleep specialist might be able to help you figure out how to overcome it. If you just don’t get to bed early enough for a full night’s sleep before your early-morning workout, rethink your priorities for the sake of your brain health. 

Few things are as coveted as good sleep: studies show that it adds years to your life and, over time, increases happiness as much as winning the lottery. 

It’s old news that cardiovascular health is really important for brain health, but preliminary results of a study announced in the summer of 2018 give extra weight to the importance of managing hypertension.

Subjects whose blood pressure was kept low—below the systolic (top) number of 120 mmHG—were 15 percent less likely to be diagnosed with mild cognitive impairment, which is defined as difficulty with problems solving and memory.

“It’s the most definitive study seen to date that maintaining blood pressure at less than 120 for systolic is a positive thing, not only for your heart but also for brain health,” Carrillo says.

A 2017 study published in the journal Alzheimer’s & Dementia analyzed medical records of more than one million adults and determined that those with a larger body mass index in middle age were more likely to develop dementia decades later. Maintaining a healthy weight—especially starting in midlife—will help protect the brain. 

Obviously, smoking is incredibly unhealthy, but did you know that it also raises your risk of dementia?

Several studies over the past three decades have linked cigarette use and mental decline.

But there’s good news: When you quit smoking, your risk of dementia from all causes drops to the same level of people who never smoked.

“The association with cognitive impairment may be due to the link between smoking and cardiovascular pathology,” the Lancet Commission report states.

“But cigarette smoke also contains neurotoxins which heighten the risk.”

When you quit smoking and no longer inhale the 4,800 toxic substances found in cigarettes, you experience enormous positive changes in your health, fitness, and risks of heart disease and cancer.

The relationship between depression and dementia is a tricky one - depression can be a symptom of dementia, as well.

But studies suggest that there’s a link between the number of episodes of depression a person suffers and his or her dementia risk, the Lancet Commission finds, so you should always seek treatment no matter how old you are.

Even if depression only appears after a person is showing signs of dementia, the mood disorder should still be treated, according to the Alzheimer’s Association; it will improve the patient’s quality of life. 

Evidence is growing that essential oils can help fight a variety of ailments - including depression.

Carrillo goes to the gym every day at 5 a.m.

“We don’t know what the heck is in store for us,” she says.

“The healthier your body and brain can be, the more you may be able to withstand or delay the symptoms of cognitive decline that could lead to mild cognitive impairment, and that could lead to a type of dementia, including Alzheimer’s.”

The Lancet Commission reports that high levels of exercise appear to be more protective than lower levels, but any amount is helpful.

Carrillo’s early-morning gym friends call themselves the “breakfast club.”

Aside from motivating one another to exercise, they’re also boosting their brain health by simply being together.

Isolation, like depression, often becomes a problem as older adults begin feeling the effects of cognitive decline; however, loneliness also appears to be a precursor to dementia.

The Lancet Commission findings suggest that social isolation is a risk factor for high blood pressure, depression, and coronary heart disease as well, and all are bad for your brain.

Diabetes can damage your blood vessels, according to the Mayo Clinic, increasing your risk for vascular dementia, triggered by reduced blood flow to the brain.

Researchers think there may be more to the connection between diabetes and dementia—the Lancet Commission report indicates that insulin resistance interferes with the brain’s ability to clear amyloid proteins, which clump together to form the plaques that can lead to dementia.

It’s important to keep eating healthy food and exercising to avoid getting diabetes in midlife.

If you’ve already been diagnosed with diabetes, work closely with your doctors to control your blood sugar and manage the disease.

If the goal is to control your weight, blood pressure, and blood sugar and reduce your risk of cardiovascular disease to protect your mind, then the Mediterranean diet is one of the best eating plans you can follow. It’s shown in studies to be one of the easiest healthy-eating diets for subjects to follow, according to the Mayo Clinic.

It includes lots of fruits and vegetables, whole grains, nuts, olive oil, fish, and even wine.

Here’s the good news: Your brain can recover from common types of trauma like a concussion, according to the Lancet Commission report.

However, repeated mild injuries (such as those experienced by some athletes and soldiers) can lead to chronic traumatic encephalopathy—a degenerative brain disease.

The benefits of head protection are huge when you’re riding a motorcycle, biking, skateboarding, or skiing; the only downside is a flattened hairstyle.

While you’re eating lots of vegetables and keeping an eye on your blood pressure, don’t forget that an important part of protecting your cognitive health is enjoying life and taxing your brain in pleasurable ways.

Mixing up routines, taking on new challenges, and stepping outside your comfort zone provide stimulation that might help your brain maintain its resilience and build your cognitive reserves. 

Did you know that eating grilled meat could increase your risk of being struck down by dementia?

Or that getting on the treadmill can help keep your brain sharp?

The dozens of choices you make over the course of an average day—ordering the curry vs. the samosas, reading the newspaper vs. watching the news—really can determine whether you’ll develop dementia years from now, as well as how quickly the disease will progress.

There are no drugs or procedures that can cure or even effectively treat dementia.

But you have the power to combat some of its major risk factors, including diabetes, high blood pressure, high cholesterol, stress, social isolation, and sleeplessness, according to Bowman.

Caffeine consumed too late in the day may disturb your sleep and ultimately harm your brain.

But coffee consumed in the morning and perhaps the early afternoon, depending on your personal caffeine sensitivity, may reduce risk.

Coffee contains a chemical called eicosanoyl-5-hydroxytryptamide (EHT), which, in studies done on rats, has been shown to protect against Alzheimer’s disease.

The caffeine itself may also be protective: Mice developed fewer tau tangles in their brains when their drinking water was infused with caffeine.

In humans, Johns Hopkins researchers have shown that 200 milligrams of caffeine—the amount in one strong cup of coffee—can help us consolidate memories and more easily memorize new information.

Foldit is a multiplayer game designed by computer scientists at the University of Washington, and it enables nonscientists to work with others to solve challenging prediction problems concerning protein folding.

One day this game may help us understand how tau proteins misfold in the brain. Another game, Nanocrafter, allows you to build everything from computer circuits to nanoscale machines using pieces of DNA.

Other interactive games—ranging from bridge to Chinese checkers to Pictionary to charades—cause us to exercise social smarts along with intellectual ones.

In addition to using our brains to strategize and, at times, to do math, such games force us to contemplate what other players are likely to do and likely to think.

When we’re seated next to a stranger on a bus, plane, or train, most of us clam up and keep to ourselves.

Yet research from the University of Chicago Booth School of Business has found that many of us overestimate the difficulty of connecting with strangers and underestimate the rewards of doing so.

Before engaging in the study, participants predicted that engaging with strangers would reduce their well-being.

But when they went ahead and struck up a conversation with the person seated next to them, the opposite happened.

They felt better than when they sat in solitude.

Our pets really are part of our social network.

They sleep in our beds, are pictured in our family portraits, and often earn a great deal of space in our holiday letters.

They also, in many cases, listen attentively to our problems.

Some surveys show that our pets are better listeners than our spouses.

Walk your pets together with your neighbors and you will feel less lonely, which helps ward off Alzheimer’s.

The pigments that lend bright colours to many fruits and vegetables are especially powerful sources of antioxidants.

Higher vegetable consumption was associated with slower rate of cognitive decline in 3,718 people ages 65 years and older who participated in the Chicago Health and Aging Project.

All of the study participants scored lower on cognitive tests at the end of the study than they did at the beginning, but those who consumed more than four daily servings of vegetables experienced a 40 percent slower decline in their abilities than people who consumed less than one daily serving.

One research review out of the University of Miami and Duke University concluded that massage helped to lower levels of the stress hormone cortisol while boosting levels of brain chemicals thought to be associated with positive emotions.

Potatoes contain an amino acid called asparagine, which, when exposed to high heat, changes into acrylamide, a neurotoxin.

Acrylamide binds to the ends of our axons, making it tougher for brain cells to communicate with one another.

Water protects asparagine, so soaking potatoes for 15 to 30 minutes before cooking them can stop it from transforming into acrylamide.

Drain the potatoes and blot them dry before cooking. 

It’s no joke. Laughter clubs exist. They’re run by “certified laughter leaders”—often psychologists, therapists, and psychiatrists—who are trained in the healing benefits of laughter.

These workshops can help you connect with others as you get in a good laugh.

Look at World Laughter Tour to find out if there’s a club near you.

A good belly laugh produces a chemical reaction that elevates your mood; reduces pain, stress, and blood pressure; and boosts immunity.

Humour therapy may be as effective as some prescription drugs at reducing agitation in people with Alzheimer’s disease and other forms of dementia.

Nursing home patients who were entertained by clowns for two hours once a week were significantly less aggressive and agitated.

Even two weeks after the nursing home stopped bringing in the clowns, the patients remained less agitated.

Researchers at the Laboratory of Human Chronobiology at Weill Cornell Medical College in White Plains, New York, studied how 22 men and women reacted to varying napping regimens, finding that naps of all lengths enhanced cognitive performance during the day. 

Black and green tea are rich sources of antioxidants called catechins that may fend off oxidative damage throughout the body, including the brain.

Green tea is also a rich source of epigallocatechin-3-gallate, which has been shown to reduce beta-amyloid plaque and tau tangles in mice.

Tea has also been shown to drop blood pressure and cholesterol levels.

But commercially available bottled teas have been shown to contain few, if any, of these protective substances.

Rather than exercise in one long 30-minute session, consider breaking up your exercise into shorter seven- to ten-minute bursts, repeated several times a day.

This kind of training may be ideal for people who have diabetes, a risk factor for Alzheimer’s, especially if you do these bursts about a half hour before each meal.

Study participants with insulin resistance (a precursor to diabetes) were instructed to do six minutes of vigorous exercise (such as walking uphill on a treadmill or vigorous calisthenics) interspersed with six minutes of recovery exercise (such as slow walking) about a half hour before breakfast, lunch, and dinner.

Other study participants just walked for 30 minutes before dinner.

Those who did the six-minute vigorous intervals experienced better post-meal blood sugar levels than study participants who did the once-daily, moderate session.

That way you’ll get to know the teller at the bank, the checkout person at the grocery store, and the clerk at the post office.

Whenever possible, actually walk into such establishments and conduct business in person instead of using the drive-through.

In addition to providing you with a moment of face-to-face interaction, this gives you a short burst of movement, which is also good for your brain.

Microwave popcorn contains many different potential health hazards.

For one, most bags of microwave popcorn are lined with perfluorooctanoic acid, a chemical thought to raise risk for cancer (though the jury is still out). Many microwave varieties with a “buttery taste” contain partially hydrogenated soybean oil, or trans fat.

Research has linked a high consumption of trans fats to Alzheimer’s and heart disease, and the evidence is so strong that the FDA is considering banning the fat. In some brands of popcorn, the buttery flavoring also comes from diacetyl, a chemical that has been linked to lung disease.

Instead, make your own popcorn. Place popcorn kernels inside a plain brown paper lunch bag.

Fold the top down a few times. Then microwave for two to three minutes, until the popping starts to abate. Voilà. Microwave popcorn without the trans fats and chemicals. 

If brain-fitness awards were given to types of fitness pursuits, dance would earn the first-place trophy year after year after year.

That’s because it combines several brain-health prescriptions into one.

If you dance with a group or a partner, you are exercising social smarts.

If you are learning new steps, you’re also boosting your intellectual fitness.

Dance, by nature, is fun, which helps to reduce stress.

Ballroom dancers have performed higher on tests of cognition than did nondancers, and competitive ballroom dancers have scored higher on many different measures of cognitive performance, including reaction time.

In a study of 256 octogenarians by researchers at the Mayo Clinic, crafting activities—such as woodworking, pottery, ceramics, and quilting—reduced the likelihood of mild cognitive impairment by 55 percent.

In a smaller study done in Germany, 60- and 70-year-olds who took art classes improved their scores on tests of psychological resilience over 14 weeks, indicating that their ability to cope with stress had grown.

Also, fMRI (functional MRI) scans revealed that their brains had sprouted new connections in areas that tend to lose connections with increasing age. 

Just a quarter teaspoon of the spice twice a day has been shown to reduce fasting blood sugar up to 29 percent in people with type 2 diabetes.

This is important because type 2 diabetes can raise your risk of dementia. The spice has also been found to reduce blood cholesterol and inflammation, both of which can further reduce your risk.

Cinnamon can help you add some sweetness to foods without using sugar.

Sprinkle it on oatmeal, fruit, pancakes, and coffee, and experiment by adding it to other main-course dishes like chili.

Research tells us that counting sheep doesn’t help us nod off any more quickly than lying in bed and letting our minds wander, but here’s a tactic that does seem to help: visualizing a relaxing scene, such as a waterfall.

When Allison Harvey and Suzanna Payne of England’s Oxford University asked 50 insomniacs to try different distraction techniques on different nights, it was the waterfall visualizations that came out on top.

Study participants who pictured waterfalls nodded off 20 minutes faster than others who counted sheep or did nothing in particular.

In one study, nursing home patients with dementia participated in daily, two-hour-long therapy sessions that included bowling or croquet, as well as gardening, brain games, and crafts.

Patients who participated in these sessions were still able to perform the tasks of daily living, such as eating or using the bathroom, unassisted, after 12 months.

Residents who did not participate in the sessions lost ground in their ability to perform these tasks without help.

The physical act of pulling weeds and raking leaves raises the heart rate and strengthens muscles in your hands, arms, shoulders, back, and legs.

Being outdoors and surrounded by beautiful flowers can relax the mind.

Finally, gardening requires intellectual smarts to plant the right seeds in the right places at the right time of year, to prune plants when they need it, and to combat pests and other obstacles. 

If you own a dog or cat, agility training offers an intellectually stimulating form of exercise for both of you.

It involves leading your pet through a series of obstacles, ranging from catwalks to hurdles to tunnels.

It provides exercise for both of you and causes you to think quickly as you shout commands and use your body language to communicate with your pet.

One study found an improvement in sleep when study participants consumed two kiwis an hour before bed.

Though it’s unclear why this fruit might help, one theory holds that it is high in serotonin.

When researchers asked overweight and obese office workers to use a standing workstation for 30 minutes out of every hour, the workers’ post-meal blood sugar response improved, thus reducing their risk for developing Alzheimer’s.

Set a timer to buzz every half hour. Get up and stretch, do some light calisthenics, or go for a short walk for a minute or two before sitting back down.

Stand when talking on the phone, while waiting for the bus or a plane, and while chatting at get-togethers.

Deciding whom to invite, what to serve, and who is sitting next to whom forces your brain to contemplate complex social decisions.

Is Sally likely to get along with George? Do any of your guests have food allergies?

Cooking the dishes and ensuring that they’re all ready around the same time the guests arrive requires a great deal of strategic planning, which is a high-level intellectual skill.

With each recipe, you follow step-by-step instructions.

If you are doubling portions, then there’s also some math involved, and there’s plenty of measuring and estimating, too. 

Researchers from National University of Singapore found that people who performed Vajrayana meditation - a Tibetan style that involves connecting with and visualising enlightened beings - experienced improved attention and performed better on cognitive tasks just after their meditation sessions, possibly because the meditation boosted blood flow to their brains.

Try it now. Sit comfortably with your eyes closed. Focus on your breath. Notice how it feels as it comes in your nose and goes back out again. Don’t try to control it or change it. Just allow it to come in and out naturally.

If you notice other sensations, such as an ache in your back or an urgent thought about something on your to-do list, just keep returning to the breath.

Allow distractions to pass through your mind like clouds pass through a sky. Every time you notice yourself following your thinking, just redirect your mind where you want it to go.

Every time you return to the breath, you are training your concentration and bringing yourself to the present moment.

In addition to following the breath, you can try bringing your awareness to a word (such as one or peace) or a location in your body (such as your heart).

You can also concentrate on an idea or belief, such as a feeling of gratitude, compassion, or love.

Fruit is naturally sweet. Sprinkle a little cinnamon on top of berries for a simple, low-calorie brain booster.

Or puree berries, watermelon, and other fruits, and freeze them. 

Sometimes called “yogic sleep,” yoga nidra is a guided visualization that deeply relaxes the body.

In one study, college students who practiced yoga nidra for eight weeks experienced less stress, worry, and depression.

Other research shows that yoga nidra may also help to keep blood sugar in check.

This is an important finding because diabetes is a risk factor for Alzheimer’s disease.

Find a class, or listen to a number of free sessions on the Internet. 

It helps you to take deeper breaths and doubles as a breathing meditation.

Use your thumb or index finger to close off the right nostril. Inhale long and slowly through the left.

Then switch so that your finger closes the left nostril and breathe out through the right.

Then inhale through the right and continue to switch back and forth.

Not only will this and other deep-breathing exercises reduce your stress and tension, but they also offer a side benefit of strengthening your attention.

By stimulating the vagus nerve, a warm touch can calm tension and trigger a release in oxytocin.

In one study, University of Wisconsin psychologist Richard Davidson, PhD, and Jim Coan, PhD, of the University of Virginia, told 16 married women that they were about to be shocked with electricity.

In some situations, as the women anticipated the shock, they were holding the hand of their partners or of a stranger. In other situations, the women were alone.

All the while the researchers studied what was happening in the women’s brains, using fMRI scanners.

The fMRIs showed that, when the women held their partner’s hand, they remained more relaxed than when they held the hand of a stranger.

When they anticipated the shock while alone, their stress response was highest.

Our body temperature fluctuates throughout the day and the night, varying from one or two degrees below 98.6˚F to one or two degrees above.

It generally starts to fall during the evening, reaching its lowest point during sleep, and this fall in temperature is one of the mechanisms that cause us to feel sleepy.

You can enhance the sleepiness induced by the body-cooling effect by taking a warm shower or bath in the evening.

The shower warms you by a degree or two. But then the warming effect wears off. As your body cools back down, sleepiness sets in.

In one small study, women who took a long, warm bath in the midafternoon to early evening felt sleepier at bedtime and slept more deeply, too.

Shower or bathe at least 90 minutes before bed to experience the best of the cooling effect.

In addition to helping induce grogginess, this can be a great way to unwind and relax away stress. 

Prayer and a variety of other religious rituals may allow you to let go of worries that may be preying on your mind, and gathering with a community of like-minded people helps you to feel less alone.

In a study by Israeli and American researchers and funded by the National Institutes of Health, Islamic women who prayed daily had a reduced risk of mild cognitive impairment compared with women who did not pray.

A different study by researchers at Arizona State University and the University of Utah found that people who considered themselves to be deeply religious or spiritual, prayed regularly, and attended religious services had lower cortisol responses and lower blood pressure than people who were less religious.

This herb contains antioxidant and anti-inflammatory compounds that may protect brain health.

In one small study, 28 seniors who drank a tomato drink spiked with 750 milligrams of dried rosemary - somewhat more of the spice than you might typically ingest through normal culinary flavoring - performed better on a memory test given six hours later than seniors who did not ingest the spice.

Although such small studies are never definitive, they do point the way toward larger studies.

Even just smelling the herb may offer some benefit. Study participants who sat inside a cubicle that was infused with the scent of rosemary were able to solve a series of math problems more quickly than when they weren’t surrounded by the scent.

It’s thought that rosemary may boost brain function by preventing the breakdown of a key neurotransmitter in the brain.

Keep a potted rosemary plant in your kitchen, and use the herb to flavor everything from soups to roasted vegetables.

Puree some with olive oil to create a pesto.

You can also use the rosemary branch to skewer shrimp for grilling. 

Though many of us may believe we’re quite good at multitasking, we’re probably only fooling ourselves.

Switching back and forth between tasks - such as checking email repeatedly as you complete a work project - actually wastes time and makes you less efficient and productive.

Every time you take a break from what you are doing, you have to start the task at hand over mentally.

This mental restart can take anywhere from a few seconds to many minutes.

More than just ruining our efficiency, multitasking can cause us undue stress.

People who spent time helping others—by driving them to doctor’s appointments, running errands for them, providing child care and other tasks - were able to navigate and survive highly stressful life events over five years better than people who didn’t.

Other research has found that people who volunteer their time have a greater sense of purpose and improved well-being.

They also tend to have less trouble sleeping, less anxiety, and less loneliness. It may be that, by helping others, we get a boost in oxytocin or other brain chemicals, which seem to protect us from stress-induced health problems.

Learning and playing an instrument forces you to sharpen many different cognitive processes, including attention, memory, motor skills, auditory skills, and visual skills.

It’s no wonder studies have found that playing a musical instrument delays the onset of cognitive decline.

When researchers from Emory University tested the cognitive health of 70 older adults, they found that study participants with at least ten years of musical experience performed better on tests of nonverbal memory, naming, and many other cognitive processes than older adults with less training or no training at all.

In addition to helping keep your brain sharp, music lessons may also allow you to maintain fine motor skills, especially if you learn an instrument that requires complex finger motions.

When researchers offered piano lessons to older adults, the study participants were able to improve cognitive abilities - including attention, concentration, and planning - over just six months, compared with study participants who didn’t take lessons.

In a study of 815 people, people who consumed salmon and other fish at least once a week reduced their Alzheimer’s disease risk by 60 percent compared with people who rarely or never ate fish, but farmed salmon has tested eight times higher for PCBs—an industrial pollutant, carcinogen, and neurotoxin—than wild salmon. 

Research shows that the scent of lavender serves as a mild sedative that can slow heart rate, drop blood pressure, and relax the body.

In one study, people who sniffed lavender before bed slept more deeply and felt more refreshed in the morning.

Sprinkle a few drops of pure lavender essential oil on a tissue to tuck under your pillow.

Find more simple tips by grabbing a copy of Outsmarting Alzheimer’s: What You Can Do to Reduce Your Risk by Kenneth S. Kosik, MD, and Alisa Bowman.

Written by Krista Carothers. This article first appeared in Reader’s Digest. For more of what you love from the world’s best-loved magazine, here’s our best subscription offer.