The simple tweaks that can prevent dementia (plus delicious recipes to help beat it) - as the latest evidence suggests whether you develop the disease is not simply down to fate

• 40 per cent of cases could be prevented in first place, according to global report
• It says lifestyle factors are responsible for 340k of Britain’s 850k dementia cases
• Report found making small changes in your 70s could have a significant impact 
• Jo McFarlane's much-loved grandmother, Olive, died of the disease, aged 74

Today, and every day, roughly 190 Britons will die from dementia – about 1,350 every week – and numbers are steadily and ominously rising.

It is by far our biggest killer, having overtaken heart disease five years ago as fatalities from heart attacks and strokes continue to decline. Within the next few years, more than one million Britons will be living with the degenerative brain condition.

It’s a statistic made all the more shocking when you consider that the dementia death toll is almost four times the number claimed each week at the moment by the Covid-19 pandemic in the UK.

But despite these grim figures there is hope, as the latest medical evidence suggests that whether you develop dementia is not simply down to fate.

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Dementia, a degenerative brain condition, is by far our biggest killer, having overtaken heart disease five years ago as fatalities from heart attacks and strokes continue to decline

Although incurable, a staggering 40 per cent of cases could be prevented in the first place, according to a global report revealed at the Alzheimer’s Association International Congress last week.

Lifestyle factors, such as diet, lack of exercise – and even hearing loss – are responsible for a whopping 340,000 of Britain’s 850,000 dementia cases, says the report. The leading scientists behind the new study identified 12 risk factors that make us more likely to develop the disease. Crucially, it’s within our power to address each one of them if we want to stay healthy into old age.

The risks begin to mount in childhood, the report said, but even making small lifestyle changes into your 70s could have a significant impact.The report represents a huge leap forward in the understanding of the disease. Three years ago, the same research group became the first to prove how much of dementia is preventable, revealing the role of obesity, smoking, type 2 diabetes and high blood pressure. Hearing loss, if untreated, depression and too little exercise also contribute to an individual’s risk, while lack of education and social isolation were also factors flagged by the experts.

Now, three more avoidable dangers have been added to that list based on new data: traumatic head injury, air pollution and heavy alcohol consumption.

The authors, from The Lancet’s Commission on Dementia, a group of international experts, say the findings should be a wake-up call for us all, and urged everyone to take responsibility for their own health. They said: ‘Around 40 per cent of dementia cases could be prevented or delayed by eliminating these risk factors.’ So what can we do? Well, making changes to diet and lifestyle has a significant effect, not just on reducing the chances of developing dementia but also keeping the mind sharper and younger.

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Around 40 per cent of dementia cases could be prevented or delayed by 'eliminating risk factors', such as giving up smoking, said experts (file photo)

A recent Swedish study found that being a healthy weight, keeping blood pressure in check and staying fit and active were three key factors found to significantly improve mental performance. More than 500 participants, aged 60 to 77, were advised to eat lots of fruit and vegetables, whole grains, fish and low-fat dairy, while exercise plans involved strength training at a gym plus group exercises to improve aerobic fitness, such as jogging and aerobics. 

The researchers followed them for two years and found they performed better in mental tests by the end, having boosted their overall health. Similar lifestyle changes were linked to a 37 per cent reduced dementia risk in another trial involving 3,000 volunteers. Indeed, just making a change to one area, such as giving up smoking, was found to have a big knock-on effect.

It’s something I take seriously, because I’ve seen first-hand how devastating dementia can be. I was 17 when my much-loved granny, Olive, died of the disease, aged 74, having spent two years being cared for by my mum, her only child, in our family home.

Olive suffered from Lewy body dementia, the second most common type after Alzheimer’s, accounting for ten to 15 per cent of cases. Looking back now, the risk factors described by The Lancet’s Commission were all there. My grandfather Jimmy, married to Olive for 40 years, collapsed and died from an aortic aneurism aged 65, just two weeks after retiring from his job as a draughtsman at the Rolls-Royce plant in East Kilbride, south of Glasgow. Her world fell apart. In time, neighbours moved on. Friends passed away.

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Adored: Jo Macfarlane as a baby, sitting on granny Olive’s knee before her dementia set in. Olive suffered from Lewy body dementia, the second most common type after Alzheimer’s

A fall meant she feared going out and she spent a lot of time alone in her empty house, staring out of the window. She began to forget to eat.

When she came to live with us in Fife, 80 miles away on the opposite coast of Scotland, the warm, adoring woman who’d doted on my two younger sisters and me was vanishing, bit by bit.

Every morning the house was woken by her fearful wails ‘Help me! Help’, as she opened her eyes and, again, had no idea where she was. 

Living near a busy road increases the chance of dementia by 10%

Most painfully, she forgot she had a daughter or grandchildren. When it was explained to her gently one day, she sobbed bitterly: ‘No one ever told me I had a daughter.’

It’s a story that will no doubt resonate with thousands of British families, on whom the burden of care so often falls. 

The cost of treating and supporting the dementia population in the UK is £34.7 billion a year, and it’s set to nearly treble by 2040. Unpaid carers, like my mum, save the economy a further £13.9 billion a year.

Imagine if the emotional – and economic – burden could be lifted significantly. A one per cent reduction in dementia cases would mean 8,500 fewer people living with the disease. 

Eliminating all 12 risk factors, the report’s authors say, could save 340,000 from being struck by it – 40 per cent of the 850,000 people estimated to have dementia in the UK.

In this special Mail on Sunday Health section, we’ll explain how to reduce your risk – from looking at ways to combat heart disease and diabetes, to highlighting surprising methods of prevention, such as improving your hearing.

There is still much about dementia risk that science can’t explain, but there is cause for optimism. Armed with new knowledge, it’s never been more possible to alter the course of our later lives for the better.

Brain-boosting breakfasts

Crustless quiche with feta, peas and spinach

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Bake for 30–35mins, or until just set and golden. Serve warm or cold (267 calories per serving)

SERVES 4

• 6 eggs

• 1 tsp olive oil

• 1 onion, finely chopped

• Handful of peas

• 1 bagful fresh spinach, or 200g of frozen spinach, defrosted and with the excess water squeezed out

• 100g feta, crumbled

• 50g cheddar cheese, grated

• Salt and pepper

Preheat the oven to 180C/Fan 160C/GM 4. Fry the onion over a medium heat for 5-10mins, or until softened. Whisk the eggs in a bowl and stir in half the cheese, half the onions and season well.

Pour the egg mixture into a non-stick dish and scatter over the remaining onion as well as the peas, spinach and remaining cheese. Bake for 30–35mins, or until just set and golden.

Serve warm or cold, sliced into wedges.   

Peach and apricot breakfast pots

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In 2 small glasses, layer the apricots and peaches, followed by yoghurt (305cal per serving)

SERVES 2

• 1/2 400g tin peaches

• 1/2 400g tin apricots

• 4 tbsp low-fat

• Greek yogurt

• Handful of oats

• 50g chopped nuts

Toast the oats lightly in a pan on a low heat, stirring frequently, until they reach a golden colour (roughly 5mins).

In 2 small glasses, layer the apricots and peaches, followed by a layer of yogurt, followed by another layer of fruit, until you reach the top of the glass.

Top with a sprinkle of the toasted oats and nuts.

Banana and peanut butter overnight oats

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In the morning, loosen with a little water or milk if needed (380 calories per serving)

SERVES 1

• 1 banana

• 50g rolled oats

• 100ml skimmed milk

• 1/2 tbsp peanut butter

• Pinch of cinnamon

• 2 tbsp low-fat

• Greek yogurt

The night before, stir the skimmed milk and the cinnamon into your oats.

In the morning, loosen with a little water or milk if needed. Top with chopped banana, yogurt and a drizzle of peanut butter.

Blistered tomatoes on toast

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Turn up the heat and allow tomatoes to sizzle until the skins start to blister (213cal per serving)

SERVES 1

• 10 cherry tomatoes

• 1 clove garlic, crushed

• 2 tsp olive oil

• Pinch of dried mixed herbs

• Salt and pepper to taste

• 1 large slice wholemeal or rye bread

Gently fry the garlic in 1 tsp of oil for 1min, then add the cherry tomatoes and mixed herbs. Turn up the heat and allow the tomatoes to sizzle until the skins start to blister.

Toast the bread and drizzle the remaining tsp of oil on the bread.

Place the tomatoes on top and season with salt and pepper.

Baked eggs with greens and yoghurt

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Add the spinach and season with salt and pepper, then mix (343 calories per serving)

SERVES 2

• 1/2 100g pack of fresh spinach, or 80g frozen spinach, with water squeezed out

• 2 eggs

• 2 spring onions, chopped 

• 1/2 a lemon, juiced

• 1 tsp olive oil

• 2 tbsp low-fat natural yogurt

• 2 slices rye or wholemeal bread, toasted

Heat oven to 200C/Fan 180C/GM 6. If using fresh spinach, put it in a colander, then pour over a kettle of boiling water to wilt the leaves.

Squeeze out excess water. In a large, oven-proof pan, heat the oil before frying off the spring onions for a couple of minutes until softened.

Add the spinach and season with salt and pepper, then mix. Make two small wells in the pan and crack in two eggs. Put the pan in the oven for 12-15mins, then serve with yogurt spooned on top, alongside the toast.

Life-enhancing lunches

Roast sweet potato stuffed with smoky black beans

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Cut the cooked sweet potato in half and spoon the bean mixture inside (343cal per serving)

SERVES 2

• 2 medium sweet potatoes

• 1 tin black or kidney beans

• 2 tsp olive oil

• 1 clove garlic, crushed

• 1/2 tsp paprika

• 1/2 tsp cumin

• Juice of 1/2 a lime

• Salt and pepper

• Pinch of chilli powder (optional)

Preheat oven to 200C/Fan 180C/GM 6. Pierce the sweet potatoes with a fork and roast for 45-60mins.

Heat the oil in a saucepan and add the garlic, paprika, cumin and chilli, if using. Cook for 1min. Add the drained beans, 50ml of water and a pinch of salt and pepper and stir thoroughly.

Cook until this is all warmed through. Remove from the heat and, just before serving, stir in the lime juice.

Cut the cooked sweet potato in half and spoon the bean mixture inside.

Meatballs and beans in tomato sauce

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Place 4 meatballs in each bowl with sauce and serve alone, or with bread (450cal per serving)

SERVES 4

For the meatballs:

• 500g lean beef mince

• 1 slice stale or toasted wholemeal bread

• 1 clove garlic, crushed

• 1 egg

• Salt and pepper

• 1 tsp olive oil

For the sauce:

• 1 tin chopped tomatoes

• 1 tbsp olive oil

• 1 vegetable stock cube

• 1 tbsp tomato purée

• 1 onion, finely chopped

• 1 red pepper, finely chopped

• 1 courgette, diced

• 1 tin butter beans, or any other variety

Blitz the bread in a blender  to make breadcrumbs. Tip into a bowl and mix thoroughly with the beef, garlic, egg and seasoning.

Roll into small balls – about 16 – and place on a plate in the fridge. Gently fry the garlic for 1-2mins, then add the onion, pepper and courgette and fry for a further 5mins, until browned slightly.

Next, add the tomatoes, beans and purée. Fill the empty tin with water twice, add this to the mix and leave to simmer for 15mins.

In another pan, fry the meatballs for 12mins. Taste the sauce and check for seasoning.

Place 4 meatballs in each bowl with the sauce and serve alone, or with bread.

Buttery white beans and tuna

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Add a final drizzle of oil and some chopped fresh herbs if you have any (329cal per serving)

SERVES 2

• 1 tin butter beans

• 1 tin tuna in spring water

• 1/2 red onion

• 1 clove garlic

• 1 tbsp olive oil

• Pinch of dried mixed herbs

• Salt and pepper to taste

• 2 slices wholemeal bread

• Chopped fresh herbs (optional)

Finely chop the garlic and fry in the olive oil for 2-3mins. Add the drained beans, salt and pepper and mixed herbs. Cook until warmed through. Finely chop the onion and drain the tuna and gently toss into the warmed mixture. 

Serve alongside one slice of toasted bread. Add a final drizzle of oil and some chopped fresh herbs if you have any.

Sardine, tomato and pepper pizzettes

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Drizzle over sardine oil and place on middle shelf of oven for 15-25mins (391cal per serving)

SERVES 2

For the dough:

• 150g plain flour

• Half a sachet fast-acting dried yeast (4g)

• 1 tsp salt

• 120ml tepid water

For the topping:

• Tin sardines in oil

• 2 tbsp tomato purée

• 8 cherry tomatoes, cut in half

• 1 green or yellow pepper, chopped

• 4 black olives, finely chopped

• Pinch of dried mixed herbs

Preheat oven to 200C/Fan 180C/ GM 6. Make the dough by adding water to yeast and stirring until dissolved, then gradually pour wet mixture into flour and salt until it has dough consistency.

Mix together into a ball, then knead for 10mins before leaving dough to double in size for 30mins. Break off 4 palm-sized balls and leave remaining dough in fridge or freezer for later use.

Roll the 4 chunks of dough into mini pizzas and prick bases. Drain sardines but retain 1 tbsp oil.

Thinly spread tomato purée on bases, then add sardines, cherry tomatoes, peppers, chopped olives and herbs. Drizzle over sardine oil and place on middle shelf of oven for 15-25mins.

Chicken and roasted vegetable salad

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Season with sprinkle of salt, then roast for 20-25m until chicken is cooked (531cal per serving)

SERVES 2

• 2 chicken thighs

• 150g broccoli florets

• 150g cauliflower florets

• 1 small red pepper, chopped

• Large handful cherry tomatoes, halved

• 1 tbsp extra virgin olive oil

• 100g salad leaves or lettuce (any kind you like)

For the dressing:

• 1 tbsp extra virgin olive oil

• 1 tsp mustard

• 1 tbsp lemon juice

• Pinch of salt

Heat oven to 210C/Fan 190C/GM 8. In a bowl, mix the chicken, broccoli, cauliflower, pepper, cherry tomatoes and olive oil until all is coated.

Put the chicken and vegetables in a baking tray that’s large enough so everything rests in a single layer. Season with sprinkle of salt, then roast for 20-25mins until chicken is cooked through.

When cooked, slice the thighs. Whisk dressing ingredients in a salad bowl, then add the chicken, vegetables and salad leaves. Mix well before serving.

Delectable dinners

Courgette and minty potato parmesan tart

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Put in the centre of the oven for 25mins or until the egg has set (502 calories per serving)

SERVES 2

• 1/2 roll (160g) of ready-rolled puff pastry

• 4 new potatoes, boiled and sliced

• 1 courgette, sliced lengthways or in round slices

• Zest of 1 lemon

• 50g parmesan, grated

• 1 egg, whisked

• 2 tsp fresh mint, chopped

Preheat the oven to 200C/Fan 180C/GM 6. Place the pastry on a lined, greased baking tray and fold the edges up and inwards to create a thin crust. Arrange the potato and courgette on the pastry, then gently pour the egg on top.

Sprinkle with the lemon zest and parmesan. Put in the centre of the oven for 25mins or until the egg has set and the crust is golden brown. Sprinkle with chopped mint.

Crunchy cod and sweet potato chips with smashed minty peas

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Dip the cod fillets into the egg and roll in the breadcrumbs. Bake for 25m (520cal per serving)

SERVES 2

• 2 skinless fillets of cod

• 1 egg, whisked

• 1 slice stale or toasted bread

• Salt and pepper

• 1 lemon

• 1 large sweet potato

• 1/2 tsp smoked paprika

• 1 tbsp olive oil

• 170g frozen peas

• Sprig of fresh mint, chopped

• 1/2 tsp butter

Preheat the oven to 220C/Fan 200C/GM 6. Chop the sweet potato into bitesize chunks, place in a baking dish, drizzle with oil and sprinkle on the paprika. Roast for 45mins.

Blitz the bread into crumbs and mix with a pinch of salt, pepper and the lemon zest. Dip the cod fillets into the egg and roll in the breadcrumbs. Bake for 25mins.

Boil the frozen peas until slightly overcooked, then gently mash with mint and butter. Squeeze the juice of the lemon on the fish.

Stuffed peppers with a 'meaty' mushroom filling

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Top with the pepper ‘lids’, cover in foil and bake for 35-40mins (345 calories per serving)

SERVES 2

• 1 tbsp oil

• 200g mushrooms (any kind), diced

• 1 garlic clove, finely chopped

• 12 cherry tomatoes

• 1 slice wholemeal bread

• Handful of walnuts

• 4 tsp pesto

• 2 peppers

Heat the oven to 220C/Fan 200C/GM 7. Make breadcrumbs by blitzing the bread in a blender, or finely chopping. Heat the oil in a frying pan and fry the mushrooms for 5mins, until tender. 

Turn off the heat and add garlic, tomatoes, breadcrumbs, walnuts and pesto until thoroughly combined. Slice the top off the peppers and remove the seeds. Place in a roasting tin and spoon the mushroom filling into the pepper cavities. 

Top with the pepper ‘lids’, cover in foil and bake for 35-40mins.

Easy one-person paella

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Stir the seafood mix into the pan and cover with a lid. Simmer for 5m (565 calories per serving)

• 1 tsp olive oil

• 1 clove garlic

• 1/2 onion, finely chopped

• 1/2 tsp smoked paprika

• 1 sausage, divided into small balls (or a handful of chicken breast chunks)

• 1/2 tsp mixed dried herbs

• 75g brown rice, or paella rice if you can’t get brown

• 1 tbsp white wine (optional)

• 1/2 can chopped tomatoes

• 300ml chicken stock

• 100g frozen seafood mix

• Juice of 1/2 lemon

Heat the oil in a large pan and fry the sausage balls, onion and garlic for 8mins. Then add paprika, herbs and rice, stirring continuously. 

Splash in the wine and, once it has evaporated, stir in the chopped tomatoes and chicken stock. Season and cook for 10-15mins, stirring occasionally until rice is almost cooked. 

Stir the seafood mix into the pan and cover with a lid. Simmer for 5mins, or until the seafood is cooked through. Squeeze over the lemon juice.  

Chickpea and courgette parmigiana

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Sprinkle the top with breadcrumbs and parmesan, then bake for 35-40m (422cal per serving)

SERVES 4

• 6 courgettes, sliced into 1cm lengths

• 2 tbsp olive oil

• 1 garlic clove, crushed

• 1 onion, sliced

• 2 tins chopped tomatoes

• 1 tin chickpeas

• 2 balls mozzarella, sliced

• 25g breadcrumbs

• 50g parmesan cheese, grated

• Salt and pepper

Preheat the oven to 200C/Fan 180C/GM 6. Coat the courgette slices in oil and sear the slices in a pan for 3-4mins each side, then set aside.

In the same pan, cook the onion and garlic until soft. Heat the chopped tomatoes and chickpeas in a saucepan, adding the cooked onion mixture, salt and pepper and letting it bubble for a few minutes.

Spoon some of the tomato mixture into the base of an ovenproof dish, then layer with courgette and mozzarella. Repeat until all ingredients are used up.

Sprinkle the top with breadcrumbs and parmesan, then bake for 35-40mins until bubbling and golden brown on top.

Perfect puds  

Spiced compote with honey yogurt and nuts

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Heat rhubarb in a small pan, using dessertspoon of syrup and a splash of water. Add cinnamon and allspice and simmer until rhubarb has disintegrated (222 calories per serving)

SERVES 2

• 1/2 tin of rhubarb in light syrup, or apples or pears

• Pinch of cinnamon

• Pinch of allspice

• 4 heaped tbsp low-fat Greek yogurt

• 2 tbsp chopped nuts

• 2 tsp runny honey

Heat rhubarb in a small pan, using dessertspoon of syrup and a splash of water. Add cinnamon and allspice and simmer until rhubarb has disintegrated.

Allow to cool and serve with 2 tbsp yogurt each, a sprinkling of nuts and a drizzle of honey.

Chocolate mousse with raspberries

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Fold in egg white – whisked to stiff peaks – followed by chocolate. Spoon mixture into 2 small glasses or espresso cups and put in fridge for at least 30mins (296 calories per serving)

SERVES 2

• 1/3 of a 100g bar of dark chocolate

• 2 tsp sweetener

• 3 tbsp low-fat Greek yogurt

• 1 egg white, whisked

• 50g raspberries

Melt chocolate in a glass bowl, placed over a pan of boiling water. Add sugar and stir until sugar is dissolved. Add half yogurt to the bowl and mix, then transfer to another bowl before stirring in the rest of the yogurt. 

Fold in egg white – whisked to stiff peaks – followed by chocolate. Spoon mixture into 2 small glasses or espresso cups and put in fridge for at least 30mins.

Serve alongside a handful of raspberries.

Tinned pear and nut crumble

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Mix together, first with a spoon, then with your fingers, until you have a rough, crumbly mixture. Scatter over the peaches, then bake for 35mins (264 calories per serving)

SERVES 6

• 3 x 410g tinned pears in juice

• 140g plain flour

• 50g porridge oats

• 1 tbsp sugar or sweetener

• 30g cold butter, diced

• 50g hazelnuts, or any nuts you like

• Pinch of cinnamon

Preheat oven to 200C/Fan 180C/GM 6. Drain the pears, but reserve the juice. Tip pears & juice into a baking dish or 6 ceramic pots. In a bowl, mix flour, oats, butter, sugar, nuts and cinnamon. 

Mix together, first with a spoon, then with your fingers, until you have a rough, crumbly mixture. Scatter over the peaches, then bake for 35mins until golden and crunchy on top.

Home-made stracciatella gelato

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After the last stir, melt the chocolate either slowly in a microwave, or in a glass bowl over a pan of boiling water. While stirring the gelato, pour in the chocolate (174 calories per serving)

MAKES 10 PORTIONS

• 375ml whole milk

• 2-3 tbsp granulated sugar

• 190ml double cream

• 100g dark chocolate

The night before making the gelato, place a bowl in the freezer. Next day, pour the milk and sugar into a medium pot and heat gently, stirring occasionally, until the sugar has just dissolved.

Take off the heat and stir in cream, then let mixture cool before placing it in the bowl that’s been chilling in the freezer. Leave in fridge for 3hrs before transferring to freezer. Stir ice cream 3-4 times, roughly every 4hrs, to break up ice crystals – or use a blender.

After the last stir, melt the chocolate either slowly in a microwave, or in a glass bowl over a pan of boiling water. While stirring the gelato, pour in the chocolate, then place in freezer for 30mins before serving.