In March, Brain Health Month reminds us of a truth that science is increasingly confirming: cognitive health is not just a matter of genes or luck. A significant proportion of the risk of developing dementia, including Alzheimer's disease, is modifiable by our lifestyle habits. According to the prestigious journal The Lancet, up to 40% of dementia cases worldwide could be prevented or delayed by acting on known risk factors.
In Quebec, around 170,000 people are currently living with Alzheimer's disease or another form of dementia, and this figure is set to double by 2050 as the population ages. Acting early - ideally in one's forties or fifties - makes a measurable difference to long-term cognitive trajectory.
Why the brain ages and how to slow it down
The brain, like the rest of the body, is subject to biological aging. Neurons become progressively rarer, synaptic connections more fragile, and the brain's ability to regenerate itself diminishes with age. This is a normal process. What is less normal is the accumulation of amyloid plaques and tau tangles that characterize Alzheimer's disease - a process that can begin 15 to 20 years before the first cognitive symptoms appear.
The good news is that the brain possesses remarkable plasticity - its ability to create new connections and compensate for damage. This neuroplasticity can be stimulated and maintained throughout life, provided we adopt the right habits. Here are the six most important according to current evidence.
Habit 1 - Regular physical activity
Physical exercise is, to date, the most effectively documented intervention to protect the brain. It increases cerebral blood flow, stimulates the production of BDNF - a protein that promotes neuronal growth and survival - and reduces systemic inflammation, a major risk factor for dementia. Brain imaging studies show that active people have a larger hippocampus - the central brain region for memory. The recommended target is at least 150 minutes of moderate aerobic activity per week, supplemented by muscle-strengthening exercises twice a week.
Habit 2 - Taking care of sleep quality
Sleep is not a passive period for the brain. It is during deep sleep that the glymphatic system - the brain's waste elimination system - is most active. In particular, it evacuates the amyloid and tau proteins that accumulate in Alzheimer's disease. Chronically disturbed or insufficient sleep is associated with a significant increase in the risk of cognitive decline. The goal is to sleep between seven and nine hours a night, on a regular schedule. Untreated sleep disorders, such as obstructive sleep apnea, represent an independent risk factor for dementia that merits medical evaluation.
Habit 3 - Stimulate your brain intellectually
Cognitive reserve refers to the brain's ability to compensate for damage through richer, more diversified neuronal connections. It is built up throughout life through education, intellectual curiosity, learning new skills and cognitively stimulating activities. Learning a new language, playing a musical instrument, practicing strategy games, reading, writing or engaging in creative activities all contribute to strengthening this reserve. People with high cognitive reserve can live with significant brain damage without manifesting clinical symptoms of dementia.
Habit 4 - Maintaining strong social ties
Social isolation is one of the least intuitive risk factors for dementia - and yet one of the best documented. Social interactions involve many brain regions simultaneously: memory, language, emotional cognition, planning. People who are socially integrated have a significantly lower risk of dementia than those who isolate themselves. Associative activities, voluntary work, book clubs, group physical activities or simply family meals are valuable forms of cognitive and emotional stimulation.
Habit 5 - Adopt a pro-brain diet
The brain represents around 2 % of body weight, but consumes 20 % of the body's total energy. What we give it as fuel has a direct effect on its performance and aging. The Mediterranean diet and its derivative MIND - Mediterranean-DASH Intervention for Neurodegenerative Delay - are the dietary patterns most associated with cognitive protection. They favor leafy green vegetables, berries, nuts, olive oil, legumes, omega-3-rich oily fish, and limit red meats, refined sugars and ultra-processed foods. Conversely, type 2 diabetes and obesity are independent risk factors for dementia.
Habit 6 - Monitor and treat cardiovascular risk factors
What's bad for the heart is bad for the brain. High blood pressure, diabetes, hypercholesterolemia and smoking damage the brain's small vessels and significantly increase the risk of vascular dementia and Alzheimer's disease. Treating these risk factors - ideally before the age of 65 - is one of the most effective interventions for preserving long-term cognitive health. A regular preventive health check-up, including blood pressure measurement, lipid profile and fasting blood sugar, is a concrete step you can take today at many of our branches in Quebec.
Frequently asked questions about brain health and memory
At what age should you start worrying about your memory?
The changes associated with dementia begin silently decades before the first symptoms appear. That's why experts recommend adopting good lifestyle habits as early as possible - ideally in your forties. That said, some memory loss is normal with age: forgetting where you put your keys or the name of an acquaintance from time to time is not a warning sign. On the other hand, forgetting important recent events, getting lost in familiar places or having difficulty managing day-to-day finances warrants medical consultation.
What's the difference between normal forgetfulness and early-onset dementia?
Normal forgetfulness is, for example, not remembering the name of an actor, then remembering it later. A warning sign is no longer remembering an important conversation that took place yesterday, repeating the same questions to the same person at the same time of day, or not knowing how to use an appliance that used to be perfectly mastered. Dementia also affects judgment, planning, language and functional abilities - not just memory. If you notice these changes in yourself or a loved one, a cognitive assessment by a doctor is recommended.
Can I have my memory evaluated in a medical clinic without waiting for a specialist?
Yes, a family doctor or general practitioner can perform a first-line cognitive screening test - such as the MoCA or MMSE - during a consultation. These rapid tests can assess a number of cognitive functions and, if necessary, refer patients for further investigation. Several of our branches in Quebec offer these assessments without prolonged delay. Early treatment is always better than an emergency consultation after symptoms have worsened.
Do supplements like omega-3 or vitamin B12 really protect the brain?
Data are mixed for most so-called neuroprotective supplements. Omega-3s are beneficial for cardiovascular health and may have a moderate effect on cognition, especially if taken from the diet rather than from capsules. Vitamin B12 is important for the nervous system - a deficiency can cause reversible cognitive symptoms - but supplementation in non-deficient individuals does not improve cognitive performance. The best investment remains a balanced diet, sleep, exercise and intellectual stimulation, rather than supplements.
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