14 Brain Health Protocols

Up to 45% of dementia cases could be prevented or delayed.

Genetics and aging play a role… there are also 14 modifiable risk factors. Your habits today shape your brain health decades from now. Here are the 14 risk factors and brain health protocols for each.

#1. Physical inactivity

Exercise may help prevent dementia through mechanisms like increased blood flow and decreased production of beta-amyloid, a protein linked to dementia when it builds up.

What to do:

• aim for 150 min of moderate-intensity aerobic activity or 75 min of vigorous-intensity aerobic activity a week.
• increase this to 6 hours a week if you can.

#2. Excessive alcohol consumption

Excessive alcohol consumption is linked to reduced brain volume and signs of brain damage. Drinking more than 12 drinks a week may increase dementia risk.

What to do:

• Bryan avoids alcohol entirely.
• start with limiting alcohol to 12 drinks or less/week.

#3. Air pollution

PM2.5 (fine particles with a diameter of 2.5 micrometers or less) and PM10 (10 micrometers or less) can cause brain inflammation and increase dementia risk.

What to do:

• monitor air quality in your home: Look for a monitor labeled for indoor use. Place it in a typical breathing zone (e.g., not right up against a wall or near a gas stove or open window). A monitor can help you judge if you need to increase ventilation or minimize gas stove use.
• improve indoor quality: Get a HEPA air purifier and let it run in your bedroom overnight. Upgrade your HVAC filter to MERV 13 if your system supports it and clean or replace your filter regularly.
• monitor outdoor air quality: Use AirNow.gov or your weather app. Reduce long or intense outdoor exercise when the air quality index (AQI) is above 150.

#4. Smoking

Smoking can cause oxidative stress and damage the brain. It's also linked to cognitive degeneration, including volume loss.

What to do:

• if you smoke, get help quitting.
• if you don't smoke, don't start.

#5. Limited social contact

Social isolation can lead to less cognitive stimulation, more brain inflammation, and impaired cognitive functioning.

What to do:

• join clubs and social communities.
• prioritize time with friends and family. Set up recurring plans to put connection on autopilot.
• aim for 1 meaningful conversation a day.
• treat your social life like the important longevity protocol it is.

#6. High cholesterol levels

High levels of low-density lipoprotein (LDL) cholesterol, aka "bad cholesterol," is one of the largest modifiable risk factors for dementia.

What to do:

• get 7-9 hours of sleep.
• exercise regularly.
• eat a heart-healthy diet (fruits, veggies, whole grains, extra virgin olive oil, etc.)
• test cholesterol levels regularly. (You can do this with Biomarkers).
• get a prescription for cholesterol-lowering medications if needed.

#7. Obesity

Obesity can contribute to chronic inflammation, which can damage white matter in the brain.

What to do:

• manage weight through nutrition, exercise, sleep, and stress management.
• work toward a healthy weight range if needed. Aim for a waist-to-height ratio of 0.5 or lower. Divide your waist circumference in inches by your height in inches to find your waist-to-height ratio.
• consider medications for weight management if helpful.

#8. High blood pressure

High blood pressure can cause oxidative stress, brain shrinkage, reduced clearance of beta-amyloid, and more.

Medication for high blood pressure is the only known effective preventative medication for dementia.

What to do:

• monitor blood pressure regularly (aim to maintain systolic blood pressure of 120 mmHg or less from age 40).
• eat a healthy diet, exercise, and get enough sleep.
• take blood pressure medication if needed.

#9. Hearing loss

Less auditory input leads to less stimulation. Hearing loss coincides with 30-40% faster brain shrinkage and increases your risk of dementia up to 5x.

What to do:

• download a decibel app like the Decibel X app.
• protect your ears at 80 decibels or higher.
• wear custom-molded earplugs in loud environments.
• get hearing aids as soon as you need them.

You can learn about Bryan's hearing protection protocol here.

#10. Vision loss

Eye conditions like cataracts and diabetic retinopathy can increase dementia risk. In some cases, treatment reverses the risk.

What to do:

• get an eye exam every 2-4 years, and more often with age.
• address treatable eye conditions.

#11. Depression

Depression is one of the earliest symptoms of dementia. It's unclear if depression causes dementia or if it's the other way around.

What to do:

• watch out for symptoms of depression, like persistent sadness, hopelessness, and appetite changes.
• get treatment if you experience it. E.g., therapy, antidepressants, brain stimulation.

#12. Diabetes

High blood sugar may lead to inflammation in the brain and a loss of neurons.

What to do:

• monitor blood sugar and diabetes risk with HbA1C tests.
• eat a healthy diet and exercise regularly to control blood sugar.

#13. Head injury

This includes head injuries from falls, sports, and vehicle and bicycle accidents. Take precautions to reduce your risk.

What to do:

• wear a helmet when cycling or if your job requires it.
• wear protective equipment when playing contact sports.
• reduce fall risk by reducing clutter, loose rugs, etc., in the home. Especially important with age.

#14. Mental stimulation

A low level of early-life brain stimulation affects cognitive reserve, or how well your brain can adapt and improvise.

More cognitive reserve = fewer cognitive decline symptoms. Some people have brain changes consistent with advanced Alzheimer's disease, but don't show any symptoms thanks to strong reserves.

You can't change early-life stimulation… but you can build cognitive reserve now with mentally stimulating activities, like puzzles, reading, and playing an instrument.

That was a lot. You don't need to address all 14 at once. Pick 1 brain health protocol to work on this week. Then pick another.