How do some of us remain mentally sharp, socially engaged, and resilient into retirement and old age, while others suffer cognitive decline? The largest ever study of what causes poor brain health as we age finally provides some answers.

Humans are living longer than ever before. We invest in our pensions and our properties, put time and hard work into our careers, look after our health, our families, and position ourselves as smartly as we can over decades, to enjoy a rewarding post-career life.

But longer living also increases the risk of age-related conditions like dementia, depression, and cognitive impairment. Dementia currently affects more than 55 million people worldwide – a figure expected to increase with population ageing.

Yet research suggests that up to 40 percent of dementia cases may be linked to modifiable risk factors.

So how can we give ourselves the best chance that the post-retirement life we’ve planned and invested for, is one we can enjoy – free from the effects of dementia and cognitive decline?

Up to now, little has been known about how to look after our most crucial organ of all: our brain. Cognitive health is crucial, but the causes of its decline and the coming of dementia in old age have remained a mystery.

That could be about to change.

This year, the prestigious Summer Science showcase at the Royal Society on London’s Pall Mall is premiering groundbreaking work that reveals some unexpected truths about what causes cognitive decline – and what we can do to give ourselves the best chance of a retirement free of dementia or declining brain health.

The Art of Resilience for Successful Ageing project by researchers from Brighton and Sussex Medical School, the University of Sussex, and Birkbeck University of London, used the largest-ever and most complex dataset of the population over time, to get the first accurate picture of how literally hundreds of everyday factors shape our cognitive health as we age – from  sleep, through social connection, stress levels, movement, community ties, sensory health, and emotional wellbeing – and how small lifestyle choices can help build cognitive resilience.

Matt Potter spoke to the project lead, Professor Dorina Cadar of the University of Sussex, in the research team’s first interview. 

We wanted to find out what factors give us better cognitive health in later life.

Enjoying retirement is not just about longevity, but healthy longevity. Often people work really hard, and get really stressed, but say, “Well, if I work like this, I'll have a great pension!” But with that lifestyle, they may subject themselves to factors that mean they may be in no position to enjoy that pension. So cognitive resilience is about enjoying a later life worth living; not loss of independence and cognitive decline.

Good brain functioning in later life is the result of thousands of factors. The thing is, before this research project, nobody really knew for sure how important the hundreds of different factors were!

It’s been impossible for medicine to predict, because there are no two people who age in the same way. You can take any two 65-year-old men or 85-year-old women, with similar medical history, even similar genetic background – and yet they tend to experience ageing in completely different ways. One might remain active, socially connected, well supported and intellectually engaged. The other faces greater challenges, cognitive decline and loss of independence far earlier in retirement.

We’d all like to be the former. And at last, this research shows that there are some simple things that we can all do, from early mid-life onwards, to build that health and resilience into our brains as we age.  

First, we need to think about cognitive health in a more holistic way.

One of my frustrations is that you see all these articles telling you that a particular supplement, exercise programme or intervention is the answer. People get confused and overwhelmed by the sheer volume of information, and the truth is, there is no single factor.

Here’s what we do know.

Physically, we know that what works for cardiovascular health – what’s good for the heart – is good for the brain. That means in general terms, a strong factor in brain health is outdoor exercise. Movement shows positive results for both dementia prevention and cardiovascular health.

There are other physical factors. A healthier diet, not drinking heavily and not smoking, those are known. Add to those, treating early hypertension, high cholesterol and diabetes, and if possible avoiding being overweight. All these play a role in brain health.

But then we come to the mental and social factors, and that’s where it’s been less clear up to now. And they turn out to be among the most important. 

I think the surprise for everyone was that the three most significant factors determining cognitive health and successful ageing all involve social connection.

They were things like not feeling lonely; robust mental health, free from depression; the feeling of people having your back.

They were followed by a whole pack of the usual factors people discuss, such as exercise, diet, and all the rest.

To me, these findings have been a powerful source of hope. Because if social factors make up the top three, suddenly we know what needs work. 

It’s really hard. We live in era in which productivity and results are focused on more strongly than mental or cognitive health.

That’s why we see that focus reflected in conditions that start to develop from middle age – such as stress, as a main risk factor for high blood pressure, high cholesterol and so on.  

The thing is, life throws stress at everyone, especially from middle life onwards, when you have competing sets of overwhelming interests: to do well in your job, with your family, to pay your bills, to look after older relatives, grandchildren, properties and so on.

Yet more than anything, we found that things in your life, like feeling connected and supported, and intellectually stimulated – score highly and can predict resilience and ongoing good cognitive health. Basically, the more you feel understood, and supported, and that people have your back, the more likely you are to stay resilient, in spite of everything that life throws at you. It slows down the ageing process.

And of course, the more demanding your work, the more important it is to have those friends, and that support network, as well as all the other factors. 

Yes - it has wide repercussions. The core thing from our findings is that it's about not being insulated, not feeling lonely, not feeling you are facing this world alone. That seems to come as the number one priority in terms of resilience of cognitive function.

From the perspective of companies, the findings of the research are an opportunity to consider that if you want resilient teams and resilient workers who perform well for you, you need to look at building teams where mutual support, rather than competition, is the key.

It means leaders and managers need to look beyond output, and measure how well their teams are supported and integrated, understood and listened to.

This is an important conversation we need to be having. Mental health isn’t a silo, where you can say, “Look after your mental health”, or put on an activity, then send the employee back to face overwhelming tasks without support. What matters is the fundamental human need to feel supported and understood. 

We have to recognise that we are not solitary creatures. Haven’t survived right the way from prehistory by doing everything alone. And maybe successful people need to hear it most of all: You can’t do it all. We need our tribes, or networks of support, so seek them out, join a club, reach out to people. It always helps. As humans, we need to know that we have backing.

The Art Of Resilience & Successful Ageing premiers at the Royal Academy’s Summer Science exhibition in London. https://www.bsms.ac.uk/research/clinical-neuroscience/cds/research/cedar-lab/the-art-of-resilience-for-successful-ageing.aspx

Please note: this content has been reviewed for accuracy; however, it does not necessarily reflect the views of the Bank.