Professor Eef Hogervorst

Professor of Psychology – Sport, Exercise and Health Sciences

Professor Eef Hogervorst is a neuropsychologist and epidemiologist whose research addresses dementia diagnostics, development of lifestyle related preventative treatments, and how design can help people to remain independent following diagnosis. She is particularly interested in the role that (early) menopause and hormones play in the incidence of dementia – and whether it is compounded by socioeconomic inequality. Her work is published in more than 200 international peer reviewed papers, and she has co-edited several books about dementia. Over the years, she has secured over £10 million in research funding to support collaborations with a range of partners.

Addressing dementia and age-related cognitive decline

Dementia is not a natural part of growing older. It is caused by diseases that damage the brain and prevent it from working properly. As Professor Hogervorst’s research demonstrates, people can still live well with dementia. The sorts of support and interventions she is developing help people to lead busy, active lives – and remain relatively independent for as long as possible.

“Women have a greater risk of developing dementia. Around twice as many have Alzheimer’s disease – the most common type of dementia – compared to men.”

Alzheimer’s Society – Why is dementia different for women?

I’ve spent my career investigating the risk factors for dementia and age-related cognitive decline – and devising ways to prevent it. Not just in older people, but by studying children too as early prevention may be the most effective.

Dementia is caused by diseases affecting the brain, characterised by a decline in cognitive function – memory, planning, visual-motor skills and personality changes. This decline means that people become increasingly dependent on others – their family, friends and carers – to perform everyday activities like shopping, cooking, travel and banking.

Although there isn’t a cure for dementia, it is possible to help prevent or at least delay its onset and effectively support the people living with it. These are the dual aims of my research.

Rather than focusing on medical treatments, my work looks at the part diet, exercise and lifestyle play in maintaining good brain health. I’m also involved in work that looks at adaptations we can make around the home that mean people with dementia can live more independently for longer.

One of my longer-term projects is based in Indonesia, my mother’s homeland. This work has been supported since 2005 by the British Council’s Newton Trust, the Economic and Social Research Council, and Alzheimer’s Research UK – and is ongoing with several universities.

Indonesia is always quick to implement research findings which makes it a great place to work.

Photograph of a sliced block of raw tempeh - beside a small bowl of its main ingredient, fermented soybeans
Tempeh is made from fermented soybeans

We’re looking at the possible causes of a recent dramatic increase in dementia cases among the population and ways to redress the rise – including via diet, exercise, lifestyle changes and education.

Interestingly, environmental factors may also play a part – and the Government is trying to address this. The rivers that irrigate the fields where rice and the popular vegetable Kangkung (water spinach) are grown have become seriously polluted. The neurotoxic heavy metals in the water may be exacerbating the rise in dementia cases – pointing to the importance of where and how we grow our food.

Meanwhile, our work showing that Indonesia's ever popular tempeh protects against dementia may reflect the relationship between gut and brain health.

We are now turning our attention to children and the prevention of dementia. I was commissioned to test a BBC / Premier League initiative – an exercise programme aimed at primary school children, called Super Movers.

Exercise has long been known to boost brain function, and Super Movers – developed by colleagues at Loughborough and trialled in primary schools – delivered clear improvements in 1,000 children tested for concentration and classroom achievement.

The programme comprises a host of activities for teachers to use – helping children to get the most out of the school day. And, with research suggesting that strong educational outcomes can help to reduce the incidence of dementia – it’s never too early to start getting active both physically and mentally.

The application of knowledge to create practical solutions is important to me. It’s essential to try to enhance people’s resilience, helping them to enjoy full and fulfilling lives.

An older person using a resistance band during an exercise class

At the other end of the life course, I’ve worked with geriatric experts in the UK (Loughborough), Netherlands (TU Delft) and Portugal (Coimbra) to develop a bespoke exercise programme for older people – cheekily called, Couch potatoes for cognition.

We’ve found that exercise generally and the programme specifically are beneficial for all older people – helping to improve memory function. More excitingly, we’ve demonstrated that regular exercise helps to slow the cognitive and physical decline of people with dementia.

One ongoing area of interest for me is the role of hormones in cognitive decline and the emergence of dementia. It’s something that I’ve been exploring for about 25 years now – particularly the benefits of oestrogen treatment for memory improvement and dementia prevention.

As part of this research, I’ve been looking at how the onset of menopause affects brain function and exploring hormone replacement therapy (HRT’s) possible role in alleviating these symptoms. So far, it’s unclear whether the treatment is helpful in this respect – fortunately, we have found that many of the memory symptoms women report during the years leading to menopause are usually temporary.

In 2021, I was invited to join the National Institute for Care and Health Excellence Committee responsible for developing the NICE Guidelines for the medical management of menopause – used by doctors across the UK.

My role as the Committee’s dementia expert has helped to make important revisions around the identification of possible benefits of various treatments. I previously did similar work developing European Guidelines for women undergoing premature menopause.

People with dementia tend to spend most of their time at home. I’ve worked with Loughborough colleagues – Professors Malcolm Cook and Sue Hignett – to develop the Dementia-Friendly Demonstration Home which opened on the BRE Innovation Park in July 2018.

We fitted the Victorian property with a variety of technologies and adaptations that cater for different types and stages of dementia – all of which support independent living by addressing people’s day-to-day needs – including exercise using the Couch potatoes for cognition programme.

This project has taught us many important lessons – described in a forthcoming book that I’ve co-written, Design for Dementia: Living Well at Home. A further book is due in 2024. Drawing on the knowledge of various leading experts, it discusses inclusive design and environments for people living with dementia.

We’re constantly learning about dementia, and I’m proud that my work contributes to this growing body of knowledge. With each discovery and intervention, we move closer to understanding how to live more healthily, happily and independently for longer.

My research journey

My fascination with the brain began when I was growing up in Holland, during my early teens – inspired by an article about neurotransmission. To imagine that this was happening while I was thinking about it blew my mind.

My specific interest in dementia grew out of my experience as a home carer for older people in Amsterdam while I was studying at night school. Some of my clients had developed this horrible disease.

In 1988, while at university, I took a summer job at a research institute, reviewing the potential of hormones to prevent dementia. This work absorbed me – and was really the first step of my research journey, specialising in this field.

I was an undergraduate student at the University of Limburg where I achieved my BA in Mental Health Sciences. I stayed on for my MSc, and then completed a six-month internship in Clinical Neuropsychology at Vijverdal Psychiatric Hospital in Maastricht.

In 1993, I moved to Maastricht University’s Medical Faculty for my PhD – “Modelling of Age-related Cognitive Decline and Cognition Enhancers in Neuropsychology and Psychiatry” – and continued my work there for a year as a postdoctoral researcher.

I was awarded a Blaschko Fellowship at Oxford University, in 1998, to study the role of hormones in Alzheimer’s disease – and then secured funding from the Alzheimer’s Association to stay on as a Research Scientist in the Oxford Project Investigating Memory and Ageing until 2005. I also held a visiting Lectureship at Oxford Brookes University, teaching a Masters module in Cognitive Neuroscience.

During this time, I was involved in some groundbreaking collaborations.

I worked with renowned experts (Professors Henderson and Yaffe) at the University of Arkansas for Medical Sciences, investigating cognitive decline – on the one hand, various risk factors and, on the other, the role of homocysteine and B vitamins in slowing its progress.

Meanwhile, I was collaborating with colleagues at the University of Cambridge in the MRC CFAS Study (Professors Brayne and Huppert), and the EPIC-Norfolk Study (Professors Khaw and Brayne). Both were large-scale projects, investigating dementia and cognitive decline (CFA) and the impacts of lifestyle choices on later-life health (EPIC).

I joined Loughborough in 2005 as Professor of Biological Psychology, and am honoured to hold Visiting Professorships at the universities of Indonesia, Respati and Leicester as well as a Senior Visiting Fellowship at the Institute of Mental Health (The University of Nottingham).

Something that attracted me to Loughborough is the pragmatic approach my colleagues take. Rather than simply collecting data and creating new theoretical models, they tend to develop interventions that are useful for the people they study.

This application of knowledge to create practical solutions is important to me. It’s not enough – with something like dementia – to know about its causes and impacts. It’s essential to try to enhance people’s resilience, helping them to enjoy full and fulfilling lives.

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