Health: Why are nightmares in middle age being linked to Dementia?

Dementia rates are on the rise globally, with scientists working hard to improve our knowledge of the condition. Now, a new study has linked bad dreams in middle age to a greater risk of developing dementia later in life.

The study – published in The Lancet journal eClinicalMedicine and led by Dr Abidemi Otaiku of the University of Birmingham’s Centre for Human Brain Health – suggested people who had frequent bad dreams in the mid-life years (35-64) were more likely to be diagnosed further down the line. Data from more than 600 adults in the US was examined, and none of the participants had dementia at the start of the study.

As Otaiku points out, more research is needed to get a clearer picture of what’s going on when it comes to nightmares in middle age and dementia. However, he says the findings are potentially “important” because “there are very few risk indicators for dementia that can be identified as early as middle age” – and “bad dreams could be a useful way to identify individuals at high risk of developing dementia”.

So, what else do we need to know at this point? We asked Dr Otaiku to talk us through…

What might these findings mean?

“If we can identify people who are at risk of getting dementia, several years or decades before memory and thinking problems start, doctors will be better placed to provide treatments that might delay or even prevent dementia from developing at all,” says Dr Otaiku. “Therefore, finding out that nightmares in middle-aged adults might be linked to increased dementia risk later in life, might help contribute towards this strategy.

“A caveat is that such treatments are not yet available,” he adds. “However, scientists are actively working on developing them. In addition, we already know that there are a number of things we can do right now to improve the health of our brain, and thereby reduce our risk of dementia, such as eating a healthy diet, having regular exercise, and keeping alcohol within recommended limits.

“And perhaps most intriguingly, given that nightmares are treatable, these findings raise the possibility that treating nightmares might even help to slow cognitive decline, and delay or prevent dementia.”

So, what’s going on – why could nightmares and dementia be linked?

“My theory is that frequent nightmares or bad dreams – in some adults – are a very early symptom of Alzheimer’s disease or other dementias, which manifest for several years or even decades before memory and thinking problems arise,” says Otaiku.

“We know that the same brain regions that regulate our emotions during wakefulness, also regulate our emotions during dreaming. Therefore, nightmares that develop before the onset of dementia, could be caused by neurodegeneration of frontal brain regions that normally ‘down regulate’ negative emotions across wakefulness and dreaming. This may result in depression and anxiety during the day, and nightmares and bad dreams during the night.”

Could there be other factors at play? For example, we often associate bad dreams with times of high stress and anxiety

“In this study, participants were asked a range of questions about their physical health and psychological wellbeing, including how stressed they were, and also levels of anxiety and depression.

“Whilst those with frequent bad dreams were more stressed, and were more likely to have anxiety or be depressed, the link between bad dreams and future dementia remained strong even when taking these factors (and others) into account,” says Otaiku. “This suggests that there may well be a direct link between dreams and dementia in some individuals.”

I get lots of bad dreams – should I be worried?

As Dr Otaiku already pointed out, lots of things have been associated with a raised risk of dementia – and, generally speaking, many of these can be adjusted throughout our lives to help lower the risk, such as eating a healthy, balanced diet, keeping active, not smoking, watching our alcohol intake and treating issues like hearing loss and social isolation.

And if you are middle-aged and prone to nightmares? “Having frequent bad dreams can be due to things like stress, low mood, or anxiety. And for many people, having lots of bad dreams may just be a lifelong tendency,” Otaiku reassures. “I suspect only a small proportion of frequent bad dreams are due to underlying dementia.”

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Health: Five myths about quitting smoking, as research shows 40% of cancers ‘could be prevented’

Experts run down the common misconceptions about ditching cigarettes. By Katie Wright.

New estimates from the World Cancer Research Fund have highlighted the lifestyle factors responsible for around 155,000 cases of cancer each year.

The organisation believes that eating healthily, being active, maintaining a healthy weight and stopping smoking could prevent some 40% of diagnoses.

The figures come after Cancer Research UK said “ending smoking” would slash the number of cancer cases which are linked to deprivation, and a study published last week in the journal PLOS suggested these numbers would drop from 27,200 to 16,500 in England alone – and it’s not just lung cancer rates that are affected.

“Smoking puts people at higher risk of multiple cancers including in the mouth, throat and bladder,” says Dr Naveen Puri, associate clinical director at Bupa Health Clinics (

“It also contributes to your arteries narrowing and makes your blood more likely to clot, meaning smokers have a significantly higher risk of heart disease, heart attacks, strokes, and dementia.”

The health benefits of stopping smoking are undeniable, but when it comes to giving up cigarettes, there are a lot of misconceptions out there. Here, Puri busts five of the most common myths about quitting…

1. It’s too late for me to quit

If you’ve smoked for many years, you might think there’s no point because the damage is already done – that couldn’t be further from the truth.

“Stopping smoking isn’t easy, but the benefits could add years to your life and these benefits start from the first hour that you stop,” Puri says. “The risks you face as a smoker lower from the very first day that you quit.”

2. All it takes is willpower

Having the determination and motivation to quit is extremely helpful, but you don’t have to rely on willpower alone.

“Research has found that e-cigarettes can help you give up smoking,” Puri says. “There are different medications that your doctor can prescribe to you, too, as well as over the counter smoking cessation aids, such as nicotine gums and lozenges, and nicotine inhalators, which can all help to reduce your cravings.”

3. You must go cold turkey

So, you’ve decided you want to quit. Do you have to throw away all your cigarettes and go cold turkey?

“You’re more likely to give up if your goal is achievable,” Puri says. “If you start slowly, you’re likely to succeed or even exceed your expectations. You may find it easier to quit for one, three or five days as a first step, and see how you feel.”

He suggests committing to a date when you’ll stop, or trying 28 days smoke-free, the same way you might do Dry January or Sober October: “Experts recommend having a goal in place, because it gives you something to work towards and aim for, meaning you can create a plan.”

4. The cravings will be unbearable

Giving up smoking is about more than just not buying cigarettes. It’s important to understand the lifestyle triggers that can increase your cravings.

“Many people smoke when they have intense negative emotions, for example, when you feel anxious or stressed,” Puri says. Or you may associate smoking with certain activities, such as drinking alcohol, finishing a meal, or hanging out with friends.

“You may find it helpful to find a replacement – for example, chewing gum,” he continues. “Letting your friends know you’ve quit and to avoid smoking near you, and taking some slow, deep breaths if you feel stressed.”

5. You have to do it alone

“Stopping smoking can be more effective if you choose your quit method and then establish a social support network to help motivate you to stick with this when your willpower starts to wane,” Puri says.

It’s completely normal to have moments of weakness and it can help to plan for what to do in the event that you’re about to ‘fall off the wagon’.

“Tell friends, family, and colleagues that you’re planning to quit and ask for their support,” Puri advises. “Get social support from healthcare professionals too, like your local stop smoking service. You’re up to four times more likely to stop with their help.”

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Breast cancer awareness month: Seven women share their experiences

Breast cancer can be an emotional challenge as well as a physical one.

From wild swimming and crochet, to poetry and saying yes to help, seven women tell us what’s been key to helping them cope…

Writing was cathartic

Emma Davies, 43, works for the Royal College of Nursing and lives in Exeter with husband Darren and children Toby, eight, and Chloe, four. After being diagnosed in 2019 she wrote a book, Take My Hair But Not My Humour (One Mum’s Journey Seeing Off Breast Cancer).

“Two things stand out: asking for and getting the support I needed, and writing my book. My priority was getting through this – and for the first time in my life, I felt like my true authentic self. I asked for help and didn’t feel guilty, advocated for myself, asked ALL the questions. I had an excellent hospital team, but also contacted Reframe (, which provides personalised cancer support. My nurse, Suzanne, was an absolute godsend, and became a weekly go-to and source of advice.

“The book came about after I started sending blog updates to friends, who kept saying, ‘You’re funny, you should write a book’ – so I did! Using my slightly sweary, dark humour, I was able to document my quest to kill ‘Lumpy’ and found it so cathartic. I now donate £2 from every paperback sale to my local FORCE cancer charity, who were absolutely amazing throughout my treatment too.”

Finding community is everything

Kreena Dhiman, 42, lives in West Sussex with husband Satty and children Amaala, three, and one-year-old triplets Aanav, Arvaarn and Anaayan. She was diagnosed in 2013 and is a proud Breast Cancer Ambassador for Estee Lauder Companies Breast Cancer Awareness Campaign, which is marking its 30th anniversary and aims to give a voice to underrepresented communities and empower them to regularly check their breasts (

“As a South Asian woman, for me, community was key. Cancer was taboo, none of my peers were talking about it, and voices sharing personal cancer experiences were almost non-existent.

“The communities I found through social media became my lifeline. It’s the people who have walked in your shoes that provide the deepest empathy, it’s those who have known the word cancer intimately that catch you when you fall. The comfort of finding your tribe is so powerful.

“As time’s passed, I’ve found community outside of social media is so important. The work The Estee Lauder Companies UK & Ireland’s Breast Cancer Campaign do helps build community, particularly in prominent settings like the wonderful Future Dreams House alongside the Future Dreams Charity.”

I needed to let people help me

Helen Addis, 44, works for ITV’s Lorraine and lives in Surrey with husband Mark and children Archie, 13, April, 11, and Belle, 9. Diagnosed at 39, she set up The Titty Gritty (@thetittygritty) to get people talking about breast cancer, and is an advisor for virtual cancer care clinic Perci Health (

“The rug was pulled from underneath me when I was diagnosed. I’m a very practical person – I like to approach things by thinking: ‘Right, what do I need to deal with this situation?’ Actually, what I needed was to say yes to offers of help from friends and family. However, it took me a while to realise I couldn’t just run around as normal, saying ‘I’m fine’. Accepting people’s offers didn’t come naturally, but it was lovely and helped endlessly. Friends would drop off tray bakes or curries, for instance, and it meant I could focus more on taking care of myself.

“Another thing was reiki. I tried counselling, but it didn’t really click at the time, then a friend suggested a local reiki practitioner. I’d never been into that sort of thing before – but my goodness, it was amazing. I’d drop in after chemo sessions and always felt so grounded and calm afterwards.”

Crafting brings me peace

Joanne Ford, 24, lives in Bedfordshire and works in PR. In early 2021 she was diagnosed with the BRCA2 gene mutation.

“Finding out I had the BRCA gene mutation during the pandemic was hard. It was a crazy time anyway, and I couldn’t go and see my friends, who I would normally turn to. I’d originally taken up crochet so I didn’t spend the whole of lockdown on my phone, watching TikTok – but it soon became a real tonic for coping with the diagnosis.

“All of a sudden, I was having to think about what this meant for my future, seeing people who’ve had preventative double mastectomies – it can be really overwhelming. With crochet, you have to focus. There’s lots of counting, trying not to drop a stitch. It’s lovely having a hobby that’s creative and lets you switch off. I’ve been making jumpers and gifts for friends, and started sharing my creations on Instagram (@jochet.x).”

Podcasts and nature walks were my crutch

Rebecca Hartley, 44, runs Saving Grace Events and Tatton Park Pop Up Festival and lives in Cheshire with son Zach, 15. An ambassador for the Prevent Breast Cancer charity (, she was diagnosed in 2015.

“Podcasts really helped me – especially Oprah Winfrey’s Super Soul [podcast], and I love Diary Of A CEO with Steven Bartlett. During my two years of treatment, going for a walk in our local National Trust park and along the lake, while listening to a podcast, became a real crutch.

“I find being in nature, especially near water, so soothing. And listening to other people’s stories, the challenges they’d faced and overcome, always left me inspired. It’s a reminder that everyone goes through tough times. Some days, I’d put a podcast on and cry the whole way through. But I always felt better afterwards.”

Wild swimming makes me glad to be alive

Yvonne Howells, 66, lives in Warwick with husband Alan. After having a preventative double mastectomy, she raises awareness of hereditary breast cancer alongside Anita Care Lingerie ( and the National Hereditary Breast Cancer helpline (

“My mother died from breast cancer in 1973 when I was just 14. After finding out I’d inherited the faulty BRCA2 gene, I was told I had an 85% chance of developing the disease. Going through a double mastectomy is a painful journey, although one I am so grateful I was able to take. One thing that’s really helped me cope is to stay as fit and healthy as I can. I run regularly and have completed two half-marathons, and do at least one outdoor swim a week – even through winter!

“I have swum in places like Stoney Cove, Bodmin Moor, Bude and Snowden. It makes me feel glad to be alive, and there’s something about cold water that takes you away from everything, and closer to nature. Many people have thought me mad – but when they eventually give it a go, they find it helps their mental health too.”

My poetry kept me connected

Grandmother-of-seven Lorraine Leiter, 69, lives in Essex with husband Ray. After being diagnosed in 2020, she now fundraises for the research and support charity Breast Cancer Now ( and is encouraging others to sign up for Wear It Pink this October (

“I’m normally quite negative, but the day I was diagnosed, it was like a switch flicked. I thought, ‘I’m going to beat this, and I’m going to write about it’. Putting pen to paper has always been how I cope, but this felt like I was writing for my life. It was lockdown, when you couldn’t see friends and family, so I shared my poems in a WhatsApp group, as my way of telling everyone how I was doing.

“It really kept me going – because no matter how bad I felt, I had to get better so I could write my latest poem. They were normally quite light-hearted and always rhymed. I’d write about how I was feeling, what I’d seen at hospital. I’ve written 30 poems over 18 months of treatment (and I’m very happy to say my cancer has gone). I’m hoping to publish them in a book to raise money for Breast Cancer Now.”

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Groundbreaking dementia study finds treatment is best in person

But new research that looked into dementia patients’ experiences of healthcare during the pandemic has warned that while video and telephone consultations may be convenient, they are not always for the best.

The research explored real life experiences of carers and dementia patients during the height of Covid and found patients learning of life-changing diagnosis by phone or online video calls could struggle to absorb the reality of the situation.

The University of Edinburgh research also highlighted difficulties faced by clinicians when it came to properly assessing a patient’s mobility and demeanour.

It also warned that in some cases ‘virtual’ consultations affected the way patients communicated with medical staff, and even sparked discomfort for health professionals who were unable to be sure of who might be listening in to conversations.

Although the research was limited to dementia patients, the findings raise questions over the rising use of remote consultations via telephone or online platforms for GP and hospital patients with a range of health issues.

A key finding of the report was that delivering difficult news concerning a patient’s health was best done face-to-face, with digital diagnosis seen as more difficult and impersonal.

Virtual care has become a common feature in GP surgeries and hospital settings as healthcare facilities strive to work through the impact of the Covid pandemic.

Recently, NHS Greater Glasgow Health Board advised patients with certain conditions such as sprains or strains to speak to a virtual A&E team rather than attend a casualty unit.

While research from The Health and Care Experience Survey showed less than two-fifths (37%) of patients saw their GP face-to-face last year, a fall of 49%.

Many dementia assessment and diagnostic services closed at the beginning of the first UK lockdown in March 2020.

As services began to reopen, many switched to remote consultations and online platforms for video calls and the telephone.

However, dementia diagnosis rates dropped by 7.6% in the UK during the Covid-19 pandemic, while recent figures showed Covid led to a five per cent fall in the number of deaths from Alzheimer’s and other dementias.

According to public health figures, 6,046 people died from dementia in 2021, a drop of 306 on the previous year. Nearly two thirds of all deaths took place in care homes.

The Edinburgh University study found that while most people were understanding when appointments were delayed or held online due to the impact of the pandemic, it also led patients into a false sense of security, feeling their situation was not urgent.

When they eventually received an appointment and were given a dementia diagnosis, the news was received with even more shock and upset.

The report added: “Video call consultation could present challenges for some and it was felt face-to-face provided more opportunity for connection.

“It could be difficult for the person to understand what the healthcare professional was saying when not in the same room together and fully understand their meaning.

“Video call was suggested as a kind of “virtual reality” and “not the real world.”

It also found that the pandemic presented additional problems for people who received a dementia diagnosis during the pandemic, with some feeling the virus had robbed them of precious time.

Entitled ‘Understanding dementia diagnosis during the Covid-19 pandemic: patient and practitioner experiences’ the report made a series of findings to help healthcare providers plan for any future disruptions to patient care.

Significantly, it found that while making use of technology had benefits, patients needed to be given the choice over whether to be seen ‘virtually’ or face to face.

It also highlighted how kindness from healthcare staff or an apparent lack of compassion both have lingering impacts on patients and family as they progress through the illness.

The research was co-produced by “BUDDs”, which stands for Better Understanding Dementia Diagnosis. The group is made up of people with lived experience of dementia and researchers, including people directly affected when many dementia assessment and diagnostic services closed in March 2020.

Principal investigator Dr Tom Russ said: “Conducting memory clinic appointments by phone during the Covid lockdowns was very difficult.

“Clinics across the UK (and abroad) will be able to learn a great deal from our report.”

Louise Arnold, 43, from Edinburgh, whose mother, Muriel, was diagnosed with dementia just prior to the pandemic, took part in the research group.

She said the pandemic added to the stress of caring for her mother, but also brought unanticipated benefits.

“It was a hard two years, but I am almost grateful it happened because I was able to work at home and could keep watch on my mum.

“She would get up at 6am and wander the streets. We had to try to explain to her about talking to people and keeping a distance but she didn’t understand.”

A particular challenge was when her mother’s condition deteriorated and the family called for an ambulance. By midnight, and after waiting several hours with no sign of it, they put her mother to bed.

“At 5am, my dad was awakened with firemen trying to break down the front door,” she said. “The ambulance had arrived in the middle of the night, got no answer at the door – because they were sleeping – and, worried something had happened, called for help to get in.”

Muriel, a former bank computer programmer, died earlier this year, aged 79.

Louise added that one of the most touching moments was at the height of the pandemic when her mother, increasingly distressed by being taken to hospital, was gently spoken to by a young doctor.

“It was really stressful being in hospital, then a female doctor came in and spoke to my mum so well and put her at ease.

“She just knew how to negotiate with her without even knowing her and I was so grateful to her.”

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