Not everyone is keen to take statins but new research shows they can play a role in protecting the brain. Here’s why Geir Selbæk takes them 

At the age of 60, Geir Selbæk, a professor and research director at the Norwegian National Centre for Ageing and Health, reluctantly decided to start taking statins. “My father and his two brothers had all needed a coronary bypass operation at 60,” says Selbæk. “So when I reached the same age, I started thinking about this, and some examinations revealed I had some plaques in my coronary arteries.”

But despite his family history, Selbaek’s reluctance to take statins stemmed from the reported side effects of the cholesterol-lowering drugs which can include digestive problems and aches and pains. Like many users, he began to worry that the drugs were causing him muscle and joint stiffness.

“It’s hard to tell because the side effects are similar to what happens anyway with age,” he says. “Last autumn, I forgot to renew my prescription, and had six weeks without statins, but my joints were still stiff. So I eventually concluded that for me it’s not the drugs, I’m just getting older.”

Like Selbæk, not everyone is keen to take statins, but a fascinating new study may add to their appeal. Beyond their well-characterised effects on LDL or “bad” cholesterol, they seem to play an additional role in protecting the brain.

Using data from several hundred thousand people in South Korea, the research showed that statins appear to reduce risk of dementia by 13 per cent, even in people who already have low cholesterol levels.

A separate study by Stanford University, published on Thursday, also found the strongest evidence yet that the shingles vaccine helps cut dementia risk too – those who had the jab were 20 per cent less likely to be diagnosed with dementia than those not vaccinated.

For Selbæk, a scientist known as Norway’s leading dementia expert, the statins finding was particularly intriguing, and he suggests that it may be related to wider benefits for the heart and its connecting blood vessels. “What is good for the heart is good for the brain,” he says. “If you look at the risk factors highlighted for dementia, a lot of them concern the health of blood vessels or the heart.”

Right now, Selbæk is not convinced there’s enough evidence to start offering statins to protect everyone from dementia. However he predicts that in the near future, health systems will be able to offer more personalised recommendations for people in their fifties and sixties to protect them from cognitive decline, which in some cases could involve statins.

“At the moment, the evidence for statins is still much stronger for coronary heart disease than dementia,” he says. “So that’s the reason I’m taking them. But in future, we’ll be able to take people, and make pretty precise predictions based on their life history, their genetic risk factors, blood tests for biomarkers like p-tau217 which correlates with the amount of amyloid plaques building up in your brain. So that will allow very sophisticated predictions for whether you’re one of those people who will really benefit from statins to reduce your dementia risk.”

Instead, for now Selbæk is relying on a collection of positive lifestyle choices to stave off his own risk of cognitive decline.

Wearing a hearing aid

Just like coronary artery disease, hearing loss also runs in Selbæk’s family. “My father and his brothers all developed hearing impairments in their late fifties,” he says.

As part of an international team of researchers who collate the latest evidence on dementia risk factors for the prestigious Lancet Commission, Selbæk was well aware of the connection between untreated hearing loss and cognitive decline. The diminishing auditory stimulation to the brain is thought to accelerate the deterioration of various vital structures.

“By hearing things, you’re consistently training the brain,” he says. “So I think that’s the main reason why hearing impairment is associated with increased dementia risk. But also there are indirect effects. If your hearing is bad, you tend to isolate, become lonely, and maybe depressed, and all of these things are risk factors of dementia in themselves.”

In 2023, a major study showed that wearing hearing aids can cut dementia risk by 50 per cent in high-risk older adults, and Selbæk took the decision to get an aid himself after coming to the realisation in his fifties that his own hearing had become impaired.

“I was walking in the woods with my wife, and she pointed out a beautiful birdsong, and I thought she was joking because I didn’t hear anything,” he says. “I understand why people get hearing aids but leave them in the cupboard because to start with it’s quite a weird sensation. It takes time for the brain to become accustomed. But now it’s fantastic. Before I would give lectures and I’d be exhausted afterwards as I was struggling to hear what the students were saying. It’s been very important for my health.”

Finding a way to enjoy exercise

Living in Lillehammer, which hosted the 1994 Winter Olympics, Selbæk has long cross-country skied in the winter, but until turning 50, he hated running, leaving him with few viable forms of exercise during the spring and summer.

But then in his fifties, he made a decision to try and improve his enjoyment of running. “I think it’s extremely important to exercise regularly, and I’ve made myself a rule,” he says. “I don’t try to run faster or longer than I can, so when I finish, I don’t feel bad and I can look forward to the next time.”

He also began doing regular strength or resistance training, something which has been found to play a surprisingly important role in protecting brain health in later life, protecting various subregions of the hippocampus, the brain structure involved in learning and memory which degenerates during Alzheimer’s and other dementias.

“This is one of the big changes for me,” he says. “I find it extremely boring, but again I’ve found I can get through it by listening to a nice podcast or something. But it’s important, so I now exercise three or four times every week, and I do a 50:50 mix of aerobic exercise, either skiing or running, and resistance training.”

Being mindful

Selbæk points to the impact of daily stress as being particularly toxic for the brain. “It’s probably the reason why depression and loneliness are associated with dementia risk,” he says. “With depression, the stress levels measured in terms of the hormone cortisol are huge. Our brain does not like this over time.”

While his job can be particularly stressful, directing a busy research hub, Selbæk says that he now tries to take pauses and put his life in perspective.

“When I wake up, I try to spend five minutes just thinking about how lucky I am,” he says. “There are so many things happening in the world now, but we’re also privileged in many ways. So I try to think about that, and then when I get stressed during my working day, I try to stop, and ask, ‘Is this important? Should I be stressed?’ And usually I find out that it’s not so important. So I try to add these small pauses of reflection.”

Training prospective memory

Prospective memory is often described as “remembering to remember” and is crucial for many aspects of daily life, such as remembering tasks, appointments or names. Studies have found that the extent to which your prospective memory declines with age predicts your future risk of dementia.

In recent years, Selbæk has noticed that his own prospective memory has worsened. “I can remember everything about a person, but I don’t remember the name,” he says.

However, research has shown that prospective memory can be improved through brain training. Again, while Selbæk doesn’t enjoy Sudoku or crosswords, he has found brain training hobbies which give him pleasure.

“I’m trying to learn Spanish,” he says. “I try to use my spare time to stimulate my mind. And also something which isn’t fun, but I think is good for cognitive reserve, is to follow new IT changes, understand the new updates to your iPhone or laptop and what they offer. There are always new things and it’s a little bit challenging, but it’s good for the mind.”

Eating more plants

Plant-rich diets such as the MIND diet have been associated with neuroprotection, and with age, Selbæk has been inspired to eat more vegetarian food. While he follows the latest research into ageing supplements such as NAD+ and metformin with a very keen interest, he does not take any of them because as yet, he doesn’t believe there’s any evidence that they can reduce dementia risk or actually modulate the ageing process.

“I’m convinced that a larger proportion of meals should be based on plants, like vegetables, fruit, and legumes,” he says. “You have to get used to preparing food that includes these ingredients, but I think I have changed my diet considerably.”

Make compromises 

While it’s vital to take steps in midlife to try and protect your brain, Selbæk is a firm advocate of the role that happiness and some of life’s pleasures can play in ageing well.

Because of this, he says that he’s made an active choice to continue enjoying some of the things which give him joy, even if they aren’t necessarily optimal for ageing.

“I drink wine,” he says. “It’s my hobby, so I have decided I will keep on doing that, even though it might increase my dementia risk, and sometimes impacts my brain health the next day! I do try to stay below seven units per week, and maybe not have that extra glass. But that’s one of my compromises, and another is dairy products like sour cream, butter and cream. Like I go on drinking wine, I’ll go on eating those fats, and accept the risk.”