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Anthea Rowan

This is the 75th instalment in a series on dementia, including the research into its causes and treatment, advice for carers, and stories of hope.
Purpose is defined as a sense of resolve or determination.
My mother’s frequent and treatment-resistant episodes of depression eroded hers. Apathetic, she lost all her verve for life. “I am inert,” she told me once when I texted to ask how she was.
It was the perfect description; depression robbed her of motivation, drive and a sense of purpose.
I would often wonder afterwards if that contributed to her dementia later.
Hong Kong-based clinical psychologist Dr Ritu Verma says research shows that people with a strong sense of purpose tend to have better executive functioning – sharper mental skills for planning and focus – and improved performance on processing speed and memory tests.
“Having purpose helps our brains age better,” she says.

Professor Angelina Sutin, in the department of behavioural sciences and social medicine at Florida State University College of Medicine, led a study which found that a sense of purpose is a “robust predictor of lower risk of dementia and is a promising target of intervention for cognitive health outcomes”.
That study was published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association in 2021.
Sutin describes how purpose was measured in the research. While still in good cognitive health, study participants were asked, “To what extent do you feel your life to be meaningful?” They rated a response on a five-point scale from one (not at all) to five (an extreme amount). Higher ratings indicated greater feelings of meaning in life – or purpose.
If you had asked my mother during one of her lengthy depressions how meaningful her life felt, she would have said, “not at all”.
Sutin believes a lack of purpose might be a dementia risk for several reasons.

Individuals with a lower sense of purpose, she says, “tend to have more chronic medical conditions [such as heart disease, diabetes] and more health-risk behaviours [being sedentary, smoking]”. All of these increase the risk of dementia.
Dr Joshua Stott, professor of ageing and clinical psychology at University College London in the UK, co-wrote research which found that having a sense of purpose cuts the risk of cognitive impairment by 19 per cent.
He speculates that increased purpose potentially leads to changes in behaviour such as eating a healthier diet, getting more exercise and having greater social engagement. These behaviours all support better brain health and reduced cognitive impairment.
The study, published in the journal Ageing Research Reviews in 2022, was interesting because it found that the benefits did not flow from the positive feelings derived from having a sense of purpose.
“Positive mood is more about happiness,” he explains, “but purpose is more about meaning, suggesting that being happy is not associated with reduced future cognitive decline, but meaningful living perhaps is.”
Verma explains that purpose also causes physiological brain benefits.

Research shows that being purposeful “releases dopamine, boosting motivation; maintains serotonin levels, promoting happiness; and also strengthens the brain’s cognitive reserve, which is key in improving resilience to age-related damage to brain tissue,” she says.
A study from the University of California, Davis, published in The American Journal of Geriatric Psychiatry in October, offers more compelling evidence for the powerful Japanese concept of ikigai – your “reason for being”.
It found that having a strong sense of purpose is linked to a 28 per cent reduction in the risk of developing dementia.
Lead author psychiatrist Dr Aliza Wingo emphasised just how profound this protective effect is, stating that a sense of purpose was tied to a later onset and lower likelihood of developing dementia, even for people with a genetic risk for Alzheimer’s.
In short: cultivating your reason for living, whether through relationships, goals or meaningful activities, may be one of the best, most accessible things you can do to keep your brain healthy as you age.
How does retirement affect us and our chance of developing dementia? Is there a danger that when we stop working – given that our jobs often give us definition, drive and direction – we will feel less purposeful?

“Retirement is tricky,” Sutin says.
“Employment often provides meaning and fulfilment, which can decline once employment ends. From that perspective, it can be important to extend employment as long as possible.”
In our senior years, she adds, “a bout of depression or anxiety can trigger … a lack of joy, motivation and purpose” – especially without a job or career to pursue.
“It points to the importance of identifying and treating depression” as soon as possible, she says. “The good news is that the sense of purpose in life can be intentionally cultivated at any stage in life.”
Retirement does not have to mean doing nothing. As Sutin says, it can be “a great opportunity to pursue interests and passions that may not have been prioritised while working”.
Pursuing a hobby – whether joining a hiking group or a gardening or book club – can harness other brain-protective elements.
Exercise, for example, is roundly declared as having the most transformative effect on your brain. Social interaction is so beneficial for our brains that it is listed as one of The Lancet’s modifiable risks for dementia. So, in developing a renewed sense of purpose, you gift yourself – your brain – other neuroprotective elements.

Purpose can come in seemingly simple acts, too, Verma says. An elderly client shared with her the joy they derive from tidying cupboards – it gave them a sense of accomplishment.
When Mum was suffering from depression, I often urged her to do something small, such as organising a drawer; instinctively, I knew this would help and might prompt her to do another task. But when she was unwell, tidying up any space would have been as challenging as scaling Mount Everest.
Depression is independently associated with the risk of dementia, Stott says, and purpose may be just one pathway by which depression leads to dementia.
Finding purpose to age gracefully
To find everyday purpose in older age, Verma suggests developing these five habits.

Renew old interests. Remember and return to whatever you had a passion for in the past. Did you once enjoy gardening? Colouring? Painting? Practising tai chi or yoga? Walking or cooking?


Explore new interests. This could entail playing bridge, learning to play the piano or another instrument, studying a new language, going to swimming classes, singing, dancing or teaching, earning a new academic degree or travelling.


Volunteer in the community. There are so many ways to do this. Help homeless animals. Tutor schoolchildren. Help at the library or community centre. Organise a beach clean-up or a clothing or food drive – or lend a hand at one.


Make more meaningful social connections. Spend more time with your grandchildren. Join clubs with people whose interests are similar to yours. Show curiosity in the lives of people around you.


Commit to a healthy lifestyle. Stay active, through walking or cycling or whatever you enjoy; engage in mindfulness through yoga or meditation or journaling; eat nutritious whole foods; and have quality sleep, going to bed and waking up at regular times.

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How having a strong sense of purpose, especially in retirement, can reduce dementia risk

Volunteering in the community is a proven way to stoke a sense of purpose in life as we age. Photo: Shutterstock

Hong Kong-based clinical psychologist Dr Ritu Verma says having purpose helps our brains age better. Photo: Dr Ritu Verma

Angelina Sutin is a professor at Florida State University College of Medicine. Photo: Florida State University 

Dr Joshua Stott, a professor at University College London, found that having a sense of purpose was linked to a 19 per cent reduced risk of developing cognitive impairment. Photo: Alzheimer’s Society

Having a strong sense of purpose, by doing meaningful activities, for example, is linked to a 28 per cent reduction in the risk of developing dementia, according to a study in California. Photo: Shutterstock

Exercise is roundly declared as having the most transformative effect on the brain. Photo: Shutterstock 

Why alcohol is so bad for the brain and how any amount increases dementia risk

Any amount of alcohol may increase the risk of dementia, according to a new study led by the University of Oxford. Photo: Shutterstock

Anya Topiwala is a researcher in the University of Oxford’s Nuffield Department of Population Health and a consultant psychiatrist. Photo: University of Oxford

Drinking alcohol can affect the frontal lobe, a part of the brain that is also affected by dementia. Photo: Shutterstock

A big problem with alcohol is that it does not just lower inhibitions, it also lowers resolve. Photo: Shutterstock

Alcohol disrupts the gut-brain axis by affecting the gut biome, triggering inflammatory responses. Photo: Shutterstock

With the proliferation of low-alcohol and non-alcoholic drinks, it is possible to celebrate without drinking any alcohol. Photo: Shutterstock

Unmarried people have lower risk of dementia, including Alzheimer’s disease, study finds

There are many health benefits to being in a happy marriage, but a new study from Florida State University found that unmarried people are less likely to develop dementia, including Alzheimer’s disease and Lewy body dementia. Photo: Shutterstock

Previous studies have found that married men and married women live longer than singletons. Photo: Shutterstock 

Writer Anthea Rowan with her husband on their wedding day, 36 years ago. Photo: Anthea Rowan

While being married can sometimes mean a better social life, there is also a risk that older married individuals have a smaller social network. Photo: Shutterstock

Florida State University postdoctoral researcher Selin Karakose says divorce can lead to greater happiness and life satisfaction if the marriage has been unhappy, and that widowed individuals may experience an increase in friends after losing a spouse. Photo: Shutterstock

In many Asian joint-family systems in which multiple generations often live together, dementia symptoms are less likely to go unnoticed, Zaidi says. Photo: Shutterstock

6 dementia fighting tips from Dr Sanjay Gupta and Marc Milstein, experts on brain health – walk, talk, read, learn, relax, and eat and drink properly

We can protect ourselves against the risk of dementia with some simple lifestyle practices. Exercising (above), eating a good diet, drinking less alcohol, socialising, reading more and trying new things all help keep the brain sharp, say brain experts including Dr Sanjay Gupta. Photo: Shutterstock 

The cover of one of Dr Sanjay Gupta’s book. Photo: Simon & Schuster

The cover of Marc Milstein’s book. Photo: Marc Milstein

Drink alcohol mindfully and ask yourself why you are having that drink. Photo: Shutterstock

Learning new things creates new brain cell connections and helps keep your mind sharp. Photo: Shutterstock

Reading is good for brain health. Try to read a wide range of book styles, and join a book club to discuss with others what you are reading. Photo: Shutterstock

During sleep, our brains are restored and repaired, so relaxing is important if we’re going to get those seven hours of quality sleep. Photo: Shutterstock

Relationships keep us engaged, interested and interesting, and may help prevent dementia. Photo: Shutterstock

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The most common cause of moon face is long-term use of corticosteroid medications. Photo: Shutterstock

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Health & Wellness

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Author Anthea Rowan (right) with her mother.

Author Anthea Rowan (right) with her mother, who has Alzheimer’s disease, the most common type of dementia. Photo: Anthea Rowan

Anthea with her mother. Photo: Anthea Rowan

Studies suggest that regular exercise lowers the risk of cognitive decline by 35 per cent. Photo: Getty Images

Staying active can help prevent or delay the onset of dementia, studies suggest. Photo: Shutterstock

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It can be daunting to get a brain scan to test for signs of dementia, but a neurologist behind new research reveals the advantages of knowing early. Photo: Shutterstock

New research has found that dementia can be detected as early as nine years before symptoms manifest, and this could have significant implications for treatment. Photo: Shutterstock

Timothy Rittman, the neurologist who led the dementia research at Cambridge University. Photo: Cambridge University

A brain scan showing signs of dementia. Photo: Getty Images

Lizzie Perry, founder of This is Dementia, with her father, who was diagnosed with the disease at 58. Photo: This is Dementia

The approval in the US of a new drug that slows the onset of Alzheimer’s makes Rittman hopeful about the future of dementia treatment. Photo: Cambridge University

Why women are more likely to have dementia than men as they age, and how exercise and engagement can help lower your risk

Women may be at a greater risk of developing Alzheimer’s than men for a number of reasons: biological, societal or cultural. Experts suggest exercise and social engagement can help offset the risk. Photo: Getty Images

The spread of tau – the protein that clumps into the telltale tangles of dementia – may contribute to Alzheimer’s disease. Photo: Shutterstock

Female twins with a male co-twin were less likely to be diagnosed with dementia than female twins with a female co-twin. Photo: Shutterstock

Prenatal care and monitoring pregnant women’s health is key, as it may impact cognition and dementia risk in later life. Photo: Shutterstock

Taking regular exercise is key for women – and men – to reduce the risk of dementia. Photo: Shutterstock

How high or low blood pressure increases the risk of dementia, and why it’s never too late, or early, to adopt a healthy lifestyle to manage it

Having blood pressure that is too high or too low has been linked to a higher risk of dementia, but it’s never too late to start living a healthy lifestyle that will help maintain optimal blood pressure. Photo: Shutterstock


An optimal blood pressure reading, easily measured with a home device, is around 120/80. Photo: Shutterstock

Dr Ruth Peters was lead author of a study looking at the links between blood pressure and dementia. Photo: Dr Ruth Peters

It’s never too late, or too early, to start thinking about brain health and living a healthy lifestyle. Photo: Shutterstock

Problems with reasoning, planning, judgment, memory and other thought processes may result from damage caused by impaired blood flow to the brain – which may be brought on by high blood pressure. Photo: Shutterstock

‘Like a light switch’: how sundowning syndrome affects dementia sufferers – and their carers; what it is and tips for how to cope

A person with dementia may experience “sundowning” syndrome - towards the end of the day they become more agitated, confused, panicked, resistant to instruction and restless. This affects their carers, too. Photo: Shutterstock

A person in bed, unable to sleep. Conservative estimates suggest about 20 per cent of dementia patients experience sundowning at some point.

Trey Todd is a neuroscientist at the University of Wyoming. Photo: Trey Todd

Sundowning was coined in 1987 by Lois Evans of Penn Nursing at Pennsylvania University. Photo: University of Pennsylvania

The pineal gland in our brain produces melatonin, which is what helps prompt us to sleep and awaken. In a broken system it is disrupted. Melatonin supplements might help fight sundowning. Photo: Shutterstock

Taking a patient with sundowning syndrome for a walk at a consistent time each day, morning or evening, may alleviate symptoms. Photo: Shutterstock

Getting out into the daylight early in the day is good for our sleep patterns, whether we have dementia or not. Photo: Shutterstock

Healthy marriage, healthy mind? Dementia risk lower for people married a long time, studies show; expert suggests why

Research suggests that people who have stayed married for a long time have a lower risk for dementia because they feel less lonely, are more likely to eat well and exercise more, and are more cognitively engaged. Photo: Shutterstock

Vegard Skirbekk is a researcher at the Norwegian Institute of Public Health. Photo: Norwegian Institute of Public Health

Anthea Rowan’s parents on their wedding day. Photo: courtesy of Anthea Rowan

A long-time married partner represents a security that provides a buffer against stressors. Photo: Shutterstock

Anthea Rowan and her husband on their wedding day. Photo: courtesy of Anthea Rowan

If you live with a partner long term, you are more likely to develop healthy daily patterns, to eat well and exercise more. Photo: Shutterstock

‘Dementia village’ that’s the first of its kind helps residents live normal lives, has a restaurant, theatre and supermarket – and no one wears a white coat

Residents are free to live their lives as they like at the world’s first “dementia village”, The Hogeweyk in The Netherlands. Photo: The Hogeweyk

The Hogeweyk, a “dementia villlage” in the Netherlands, provides care and a familiar and safe environment in which people with dementia live while retaining their own identity and autonomy as much as possible. Photo: The Hogeweyk

Jannette Spiering is the senior managing adviser and co-founder at The Hogeweyk in the Netherlands, which offers “humanising care for people with dementia”. Photo: The Hogeweyk

Residents relax around the fountain in the theatre square at The Hogeweyk. Photo: The Hogeweyk 

Residents of The Hogeweyk respond positively to their increased autonomy. Photo: The Hogeweyk

Residents at the healthcare facility take part in a painting class. Photo: The Hogeweyk

Hearing loss dramatically raises the risk of dementia, so why are so many people in midlife doing nothing to prevent it? A test is easy to arrange

Hearing loss has been linked to a higher risk of dementia and cognitive decline,  say experts, who recommend testing for preventable hearing problems (above).  Photo: Getty Images

Alison Huang, a senior research associate at the Cochlear Centre at Johns Hopkins, in the US, says hearing loss makes the brain work harder to process sounds. Photo: Johns Hopkins

Jiang Fan from the School of Public Health at China’s Shandong University. Photo: Shandong University

Checking your hearing in midlife is crucial, and can help you stave off cognitive deterioration. Photo: Shutterstock

Can HRT reduce dementia risk? New hormone replacement therapy studies say yes, upending 2002 reports

HRT use has been linked to better cognition, blood flow and brain size and a reduction in all neurodegenerative disease in recent studies. Photo: Shutterstock

HRT (hormone replacement therapy) use has been linked to better cognition, blood flow and brain size and a reduction in dementia and other neurodegenerative disease in recent studies. Photo: Shutterstock

If HRT is started after the age of 65, brain cells will have already been deprived of oestrogen for many years. This could mean there is a decline in neuronal connections – the brain’s messaging system. Photo: Shutterstock

HRT was found to be most effective when introduced early in menopause, says Anne Marie Minihane, director of the UK’s Norwich Institute of Healthy Ageing at the University of East Anglia. Photo: University of East Anglia

Dr Andrea Kwakowsky from at the University of Galway in Ireland believes the “critical period” for starting HRT is within five years of menopause. Photo: University of Galway

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The new free “Think Brain Health Check-in” online tool from Alzheimer’s Research UK doesn’t test your memory but checks how well you’re looking after your brain and gives tips to help prevent dementia. Photo: Shutterstock

Dr Susan Mitchell is head of policy at Alzheimer’s Research UK. Photo: Dr Susan Mitchell

The Think Brain Health Check-in asks how often you challenge your brain - and then highlights why challenging your brain is key to staving off dementia. Photo: Shutterstock

Getting a good night’s sleep every night is one way to lower the risk of developing dementia. Photo: Shutterstock

Up to 40 per cent of dementia cases could be prevented if people were mindful of the risk factors for the illness and made lifestyle changes to prevent them. Photo: Shutterstock

Can lack of sleep raise dementia risk? Yes, studies say – but with one exception

Having only five hours of sleep a night can increase dementia risk by 30 per cent for adults over 50, one study says. Photo: Shutterstock

One tip to overcome insomnia is to avoid clock-watching. Photo: Shutterstock

Taking a warm shower or bath in the hour or so before bed may help you fall asleep – and stay asleep. Photo: Shutterstock

Professor Roger Wong of the department of public health and preventive medicine at the State University of New York’s Upstate Medical University. Photo: Roger Wong

Sleep aids can heighten dementia risk, Wong says. Photo: Shutterstock

Can’t sleep? Try getting up and engaging in cognitively stimulating activities, like reading or making jam. Photo: Shutterstock

Dementia and ACB scores: how common prescription and over-the-counter drugs raise the risk of memory loss and cognitive decline

Certain common drugs, including antihistamines, antacids, antidepressants and anti-anxiety medicines, can disrupt the neurotransmitter acetylcholine, dubbed the “memory molecule” increasing the risk of dementia. Photo: Shutterstock

The writer, Anthea Rowan, with her mother. Photo: Anthea Rowan

Taking medications that block the action of acetylcholine can lead to memory loss, problems with spatial awareness, and cognitive decline. Photo: Shutterstock

Studies have found that anticholinergic drugs carried “significant’ dementia risk” for the over-65s. Photo: Shutterstock

Doctors need to be mindful of the risks posed by anticholinergic drugs, especially to an already at-risk population: the over 65s. Photo: Shutterstock

How to safeguard your ageing brain: build ‘cognitive reserve’ with mental and physical exercise, and stay active and socially engaged

The phrase ‘use it or lose it’ is not just a hypothesis, it’s a basic biological fact that holds as true for our brains as our muscles or bones. Photo:
Shutterstock

Our brains, like our muscles need regular use to stay healthy and flexible, say experts, and keeping our brains active builds our ‘cognitive reserve’, helping us to stave off dementia. Photo: Shutterstock

Geriatric psychiatrist Dr David Merrill recommends the active pursuit of activities that keep the brain sharp to stave off dementia. Photo: Dr David Merrill

Dorina Cadar says cultural and social engagement, reading, doing crossword puzzles, visiting art galleries, clubs and cinemas, and volunteering all increase our cognitive reserve. Photo: Dorina Cadar

Visiting an art gallery or doing something new and different are good ways to build up cognitive reserve. Photo: Shutterstock 

How yoga benefits dementia patients: new study uncovers brain-health boosts, supporting earlier research

Yoga has health benefits including better brain neuroplasticity, improved sleep quality, and more robust cardiorespiratory fitness, all of which help people experiencing cognitive decline or dementia. Photo: Shutterstock

Dr Diana Karamacoska is a research support programme fellow in healthy ageing and dementia at the NICM Health Research Institute at Western Sydney University. Photo: Courtesy of Diana Karamacoska

Yoga could be helpful in managing brain inflammation, particularly with its mindfulness component. Photo: Shutterstock

Wendy Du is the founder of Shan Studios in Hong Kong. Photo: Wendy Du/Shan Studios

Du has maintained a daily yoga practice for 10 years. Photo: Courtesy of Shan Studios

5 nutrients good for brain health that can delay dementia, or prevent it, and foods to eat with a high concentration of them

Research has identified some key nutrients we need in our diets to maintain good cognitive function and delay or prevent the onset of dementia. Photo: Shutterstock

Eating healthy isn’t just good for our bodies, it’s good for our brains, too. Photo: Shutterstock

Zahinoor Ismail, of the O’Brien Institute for Public Health at the University of Calgary. Photo: University of Calgary

Kale with pine nuts is a dish high in magnesium, and so good for brain function. Photo: Shutterstock

How having a strong sense of purpose, especially in retirement, can reduce dementia risk

Two separate studies have found that having meaning in your life can lower dementia risk by 19 per cent and 28 per cent, respectively