Well-being "critical" for dementia risk reduction, research suggests

People who experience higher well-being are less likely to develop dementia later in life, according to research highlighted today (Saturday, 1 June) to mark the beginning of Alzheimer’s & Brain Awareness Month.

More than a decade of interdisciplinary research demonstrates a clear and robust link between higher levels of well-being earlier in life and a reduced risk of developing neurodegenerative diseases such as dementia due to Alzheimer’s.

The findings are highlighted by a chapter in World Happiness Report 2024 by a team of psychologists and brain scientists from the Well-being and Emotion across the Lifespan Lab (WELLab) at Washington University in St. Louis.

The researchers also identify key environmental changes and activities shown to improve the well-being of those living with dementia, by enhancing factors such as autonomy, competence and relatedness.

Their work could be key in forming future dementia prevention and mitigation techniques, given an estimated 139 million people worldwide will be living with the disease by 2050. There are over 10 million new global cases of dementia each year, with a new case every 3 seconds.

Today (Saturday, 1 June) marks the start of Alzheimer’s & Brain Awareness Month – led by the Alzheimer’s Association to raise awareness of dementia and to advance care, support and research efforts in this area.

Dr Emily Willroth, Assistant Professor of Psychological & Brain Sciences, and Director of the WELLab at Washington University in St. Louis, said:

"The global population is aging. And, given that age is the largest risk factor for dementia, this means that the number of dementia cases worldwide is also going to increase in the coming decades.

“Although there are some promising initial biomedical treatments for dementia, there is currently no miracle cure. Therefore it’s critical we act on improving the protective factors – such as well-being – that show promise for reducing the risk of developing this devastating disease.”

A landmark study led by Dr Willroth, published in the journal Psychological Science, used data collected from older adults throughout Chicago and Illinois from 1997 to present day in order to assess the relationship between well-being and dementia.

Participants completed annual clinical evaluations which included assessments of their cognition, as well as their own ratings of how they felt about their lives. Post-mortem data, including an objective measure of the physical substances which build up in the brains of people living with Alzheimer’s disease, was then compared to the measures collected over time.

Researchers found that higher levels of well-being held significant predictive power for the reduced likelihood of developing memory and thinking impairments, even in the presence of the diseases that cause dementia.

The mechanism behind this link is not yet fully understood, and researchers have cautioned against using the results as proof of well-being causing lower dementia risk. But the evidence does suggest a promising avenue for future preventative treatments.

Dr Kyrsten Costlow Hill, a WELLab postdoctoral researcher and also a co-author on the World Happiness Report chapter, explained:

“People who report higher well-being are more likely to be engaged in various activities that we know are really important for brain health, like physical exercise and social interaction. But we think there may also be biological factors at play, too; for example, we know that stress is physically harmful to some of the systems responsible for brain health.”

The researchers further examined existing evidence for improving the lives of those living with dementia. They highlight the importance of physical and outdoor activities as well as social engagement in promoting higher well-being. Other activities such as reminiscence and life review have also been shown to support those living with dementia.

At a broader level, factors such as ‘aging in place’ and increasingly commonplace specialist environments like dementia villages were found to have the biggest benefits.

Karysa Britton, a clinical science PhD student in the WELLab and also a co-author on the World Happiness Report chapter, added:

"People living with dementia, sadly, often report lower well-being including reduced satisfaction with life. But we also know that it is possible to live well with dementia.

“We found that aging in place, with support through use of simple home adaptations and assistive technologies alongside existing social connections, consistently results in increased well-being among those living with dementia and older adults in general.”

‘Supporting the Well-being of an Aging Global Population: Associations between Well-being and Dementia’ is published in World Happiness Report 2024.

The World Happiness Report is a partnership of Gallup, the Oxford Wellbeing Research Centre, the UN Sustainable Development Solutions Network, and the WHR’s Editorial Board. Read the report in full at worldhappiness.report.