By Arthur C. Brooks
February 23, 2023

It could be possible to spot signs of dementia up to nine years before diagnosis, a new study has found.
The findings, published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, mean that future at-risk patients could be screened to help  identify those who might benefit from early interventions to reduce their risk of developing dementia-related diseases.
They could also help select those suitable for clinical trials for new treatments.
“When we looked back at patients’ histories, it became clear that they were showing some cognitive impairment several years before their symptoms became obvious enough to prompt a diagnosis,” study author Nol Swaddiwudhipong, a junior doctor at the University of Cambridge, said.
“The impairments were often subtle, but across a number of aspects of cognition. This is a step towards us being able to screen people who are at greatest risk - for example, people over 50 or those who have high blood pressure or do not do enough exercise - and intervene at an earlier stage to help them reduce their risk.”
For the study, researchers analysed data from the UK Biobank database and pinpointed problem solving and number recall as two of the early signs patients could develop dementia.
Senior author Dr Tim Rittman, also from the University of Cambridge, said: “People should not be unduly worried if, for example, they are not good at recalling numbers.
“Even some healthy individuals will naturally score better or worse than their peers. But we would encourage anyone who has any concerns or notices that their memory or recall is getting worse to speak to their GP.”
People from the UK Biobank data who went on to develop Alzheimer’s scored more poorly compared with healthy individuals when it came to problem solving tasks, reaction times, remembering lists of numbers, prospective memory (our ability to remember to do something later on) and pair matching.
This was also the case for people who developed a rarer form of dementia known as frontotemporal dementia, the researchers found.

Not remembering numbers could be an early sign of dementia (Getty Images/iStockphoto)According to the study, people who went on to develop Alzheimer’s were more likely than healthy adults to have had a fall in the previous 12 months.
David Thomas, head of policy at Alzheimer’s Research UK, said: “It is increasingly clear that the best chance to affect the course of the diseases which cause dementia lies in intervening at their earliest stages.
“Health services don’t routinely offer the tests needed to detect changes in brain function that happen before symptoms are noticeable, like those alluded to in this study.
“In fact, the NHS is currently unable to guarantee early and accurate diagnosis for people living with dementia - more than a third of people over 65 living with dementia go undiagnosed.
He added: “It’s now more important than ever that NHS services reflect our growing understanding of the importance of detection and early diagnosis.
“We must ensure that people with dementia don’t fall through the cracks at a time when treatment or risk-reduction interventions are most likely to be effective.”
Additional reporting by PA

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“How to Build a Life” is a column by Arthur Brooks, tackling questions of meaning and happiness. Click here to listen to his podcast series on all things happiness, How to Build a Happy Life.

I remember the night I fell in love.
The year was 1977, and I was 12 years old. A neighbor kid’s parents had bought an espresso machine—an exotic gadget in those days, even in Seattle. There was just one Starbucks in the world back then, and as luck had it, we lived within walking distance. The neighbor kid and I bought a pound of coffee and had about eight espressos each. Feeling fully alive and inspired to get closer to the universe, I climbed onto the roof of his house. In the process, I cut a gash in my stomach on his gutter. Bleeding profusely, I marveled at how intense the stars were.
Forty-five years later, not a day has gone by that I haven’t renewed my vows with the Bean. I’ve also come to understand how and why coffee captivates me.
Caffeine evolved in certain plants—including coffee shrubs, tea trees, cocoa beans, and kola nuts—as a naturally occurring pesticide to discourage insects from eating them. Stupid bugs. But that doesn’t explain why about 85 percent of Americans consume it in some form each day. (I can only assume that the other 15 percent have no quality of life whatsoever.) The reason is this: When caffeine is ingested, it quickly enters the brain, where it competes with a chemical called adenosine. One of adenosine’s most important jobs is to make you feel tired. Throughout the day, you produce a lot of it to make you eventually relax; neurons shoot it out, and then a receptor, perfectly sized to the adenosine molecule, binds to it, receiving the message that bedtime is approaching.
That’s where caffeine comes in. It is shaped very similarly to the adenosine molecule, so it fits into the receptors. The adenosine can’t park where it’s supposed to, because caffeine is already sitting in its parking spots. (That “first sip feeling” Starbucks advertises on the side of its cups sounds a lot more appealing than “blocking morning adenosine,” but that’s what’s really happening.) In truth, caffeine doesn’t pep you up—it simply prevents you from feeling lethargic. Consume enough caffeine, and you’ll have almost no adenosine plugging into your receptors at all, so you’ll feel wired and jittery.
To get to what really matters, though: Coffee makes you happy. Writing in the journal Psychopharmacology, the researcher David M. Warburton observed what I could have told him without writing a study: A low dose of caffeine can lead to a “significant increase in … happiness and calmness and decreases in tenseness.” He also noted that, among the study participants, these effects did not come from alleviating a craving from a caffeine addiction; the effect was true, pure, and wonderful. A miracle, really.
Caffeine is a gift in ways besides happiness. Combined with exercise, it can improve cognitive performance (that means it makes you smarter, in case you haven’t had your coffee yet), and if you’ve been sleeping less than optimally, it can enhance your reaction time and logical reasoning abilities. Remember this as you head out in traffic: The life your coffee saves could be your own.
It is no exaggeration to say that caffeine is a boon to humanity. As Michael Pollan argues in his audiobook Caffeine: How Coffee and Tea Created the Modern World, caffeine’s arrival into the European diet in the 17th century transformed the economy through enhanced productivity, innovation, and safety. If it weren’t for coffee, you would probably spend your days shivering in a dark cave, and die after getting a splinter. So don’t be an ungrateful wretch: If you like electricity, running water, and lifesaving medicines, give thanks for the miracle of caffeine.
Nothing in life is free, of course. Faced with the holy power of the Bean, adenosine’s malevolent forces fight back. As you consume more caffeine over time, adenosine receptors upregulate, increasing in number to accommodate the caffeine molecules and take in their intended guests as well. This leads to a state of tolerance, in which caffeine has a smaller effect after chronic use. However, this “problem” is really just an opportunity to enjoy more coffee.
Some people believe that the solution to tolerance is to hit the reset button. My wife is one of them: Recently, noticing the increases in my consumption over the years, she innocently proposed that I “take a little break” from coffee. The very suggestion made me fly into a rage. “Here’s an idea,” I replied, heart rate soaring. “Why don’t we just live apart for a year so it feels more like it did when we were first married?” An overreaction? I think not.
I’m at peace with the long-term effects of my devotion to coffee. Sure, my coffee habit is withering my hypothalamus and enervating my adrenal glands, forcing me to take in ever more caffeine as the years go by. But it is well worth it: Research from Japan shows that habitually drinking coffee reduces all-cause mortality. Studies in mice suggest that it does so by, among other things, encouraging autophagy, the biological process of cleaning out cellular trash, which naturally slows as we age. Coffee has also been found to reduce levels of fatty acid in the plasma of aged mice, which has been linked to diabetes and cancer in humans. (People say animal testing is cruel, but if it means giving mice tiny cups of coffee, I am all for it.)
Assuming that coffee does keep me alive for an extra few days or decades, I know how I’ll spend them: drinking more coffee, of darker and darker roasts, whose strong smell helps combat age-related loss of taste and smell. If Starbucks introduces a line of beans called “Indonesian Ashes,” I will be first in line to buy it.
All the research aside, I have my own data on aging and coffee consumption. My Spanish mother-in-law, whom I loved like my own mother, died last summer at the age of 93. She was sharp as ever and the happiest person I knew, up to the very end. She also consumed multiple cups of coffee every day until her last. Our shared love of the Bean drew us together before we even spoke the same language, and sustained our relationship for more than three decades.

In her last weeks, I was lecturing in Barcelona and spending my free time with her, downing many cups and chatting about the secret to happiness. Here was her formula: el amor, la fe, y el café—love, faith, and coffee. In my unbiased opinion, that sounds exactly right.