The 8 Domains to improve your COG-NITION - Food for the Brain

Food for the Brain’s Scientific Advisory Board comprises leading experts from around the world in diet and lifestyle factors that are known to increase risk of dementia and Alzheimer’s. By carefully analysing the meta-analyses (studies of studies) that identify, and attribute a percentage of risk to a particular risk factor, and most importantly, assessed not only the prevalence, but also the evidence of how making changes reduce risk and the ease of so doing, we have defined 8 domains to identify and address evidence based, modifiable risk factors associated with dementia and Alzheimer’s disease. These are:

These 8 domains have been devised with the intention of supporting brain health and mental wellbeing, and potentially reducing the risk of cognitive decline and development of dementia and Alzheimer’s disease. The 8 domains, along with a person’s cognitive function are assessed when completing the Cognitive Function Test. Each domain is rated from red, orange, yellow, green to show a person which domain needs their most attention to help future-proof them from dementia. Combined, the domain ratings produce an overall Dementia Risk Index (DRI), with 100% being the worst and 0% being the best. The person then has the opportunity to join COG-NITION which is a personalised, interactive brain upgrade programme that targets specific changes to diet, nutrition and behaviour that will have the most impact on reducing a person’s Dementia Risk Index. Once completed the Cognitve Function test is re-taken. You can join our grassroots citizen’s health community helping to research what actually works for reducing Dementia Risk Index and improving cognit-ve function by becoming a Friend of Food for the Brain (which gives you free access to COG-NITION) or by signing up to COG-NIITON (which makes you a Friend) once you’ve completed your Cognitive Function Test.

While many health authorities, for example The British Dietetic Association (BDA) advise several key strategies, in line with NHS guidelines, for reducing the risk of developing dementia and Alzheimer’s disease such as eating a healthy diet, maintaining a healthy weight, exercising regularly, not drinking too much alcohol, not smoking and keeping your blood pressure at a healthy level (The NHS further advise that loneliness, reduced levels of education, and untreated mental illness, such as depression, may also further increase risk). At Food for the Brain we target the most evidence-based interventions that are also achievable. For example, lowering homocysteine with B vitamins, and ensuring optimal omega-3 DHA intake (see ‘Omega-3 & B Vitamins – the dynamic duo for dementia prevention?’ [add link]) not only have the strongest evidence for reducing risk but are also easy to action. The largest and most up-to-date meta-analysis of 396 studies by Professor Jin Tai Yu from Fudan University, Shanghai, a member of our Scientific Advisory Board concluded that “homocysteine lowering treatment [with B vitamins] seems the most promising intervention for Alzheimer’s dementia prevention.”

Risk FactorPrevalence(%)% of AD attributed to risk factor (PAR%)Ease of changingEvidence for effect
High homocysteine level, lowered by B vitamins3022%YesStrong
Low fish & omega-3 intake4922%YesModerate
Low physical activity3422%ModerateModerate
Low intake of polyphenol   rich foods75up to 20%YesWeak
Mid-life smoking2011%ModerateWeak
Mid-life high blood pressure127%ModerateWeak
Mid-life obesity127%ModerateWeak
Depression148%ModerateWeak
Diabetes and pre-diabetes52%ModerateWeak
Low educational attainment2412%Difficult, long-termWeak

Also, the fact that being diabetic or having high blood pressure are risk factors doesn’t mean that taking medication that forces one’s blood sugar down (insulin) or blood pressure down (hypertensive medication) will necessarily work. The studies that exist show minimal effect. At Food for the Brain we focus on tackling the key underlying cause(s) of, for example, diabetes and high blood pressure such as too many carbohydrates and a high glycemic load diet, coupled with a lack of exercise and specific nutrients from vitamin C to magnesium, optimal intakes of which have been shown to reduce risk for both diabetes and cardiovascular disease and high blood pressure.

Certain known risk factors may appear to not be included. Obesity is an example, however it is both a consequence of ‘high carb & GL’ and ‘inactive body’ and is included in the Dementia Risk Index. Those which cannot be changed, for example if a person has had a low level of education early in life, are not included in the DRI calculation, but actions to promote an ‘active mind’ are. Having had a head injury is a risk factor, but are not modifiable so this is not included. Other possible risk factors such as viral or bacterial infection, auto-immune disease or exposure to toxic compounds are not yet included, pending sufficient evidence-base in relation to Alzheimer’s dementia.

Click on the images below to learn more about each of the individual domains.

Domain 1: Eat a low Glycemic Load (GL) diet

Keeping blood glucose levels in the low-normal range is reflected by a low glycosylated haemoglobin (HbA1c). A low HbA1c is usually a proxy for improved insulin sensitivity…

Domain 5: A Healthy Gut is a Healthy Brain

A healthy gut is essential for a healthy brain. In recent years it has become established that there are many ways in which the gut communicates with the brain, and vice versa…

Domain 7: Active Mind

The term “use it or lose it” is very pertinent for preventing cognitive decline in older adults…

Our Cognitive Function Test

Our cognitive function test can help you identify early signs of cognitive decline, as well as give some personalised dietary and lifestyle guidance to help you take positive steps to prevent Alzheimer’s.