There are a number of reasons and ways that inflammation in the brain, often referred to as neuroinflammation, can arise, explains Julia Schubert, a research associate at Institute of Psychiatry, Psychology and Neuroscience, King’s College London. “[There is] direct damage such as traumatic brain injury, infections, or autoimmune conditions like multiple sclerosis where the blood–brain barrier is compromised and immune cells from the periphery enter,” she says.
“There is also evidence of neuroinflammation being involved in several mental health and neurological conditions such as depression, schizophrenia, and Alzheimer’s disease. One of the big questions in research is whether inflammation is a driver of these conditions or a consequence of them. The relationship is complex and varies across disorders.”
But all of us as we age can experience inflammation in the brain.
Neuroinflammation “is common with advancing age,” adds Niharika Duggal, assistant professor at the department of inflammation and ageing at the University of Birmingham. “A known contributor is ‘inflammaging,’ which is the chronic, low-grade elevation of inflammatory cytokines,” or systemic inflammation, which is associated with an increased risk of developing chronic diseases in old age.
Things that contribute to inflammaging, include lifestyle factors such as obesity, sedentary behaviour, immune ageing microbiome dysbiosis (or imbalanced gut microbes), the accumulation of senescent cells (or so-called ‘zombie’ cells, which stop dividing but don’t die off when they should, and release inflammatory molecules); and aged immune cells in the brain.
How can inflammation affect brain function?
Inflammation activates immune cells in the brain (mainly microglia), which release molecules called cytokines, Schubert explains.
“While this is a normal defense mechanism, prolonged or excessive activation can damage neurons, disrupt signaling between brain regions, and contribute to symptoms such as cognitive difficulties, fatigue, or mood changes. Again this is complex as there are often other mechanisms besides inflammation driving brain changes, which depends on the health condition.”
As inflammatory molecules can interfere with neurotransmitter signalling, thus slowing down communication between brain cells, “over time, this contributes to problems with memory, attention, and processing speed, and increases vulnerability to neurodegenerative diseases such as Alzheimer’s and Parkinson’s”, Duggal says.
“Chronic activation of microglial cells can damage neurons and reduce their ability to form new connections, which is essential for learning and memory.”
How to know if your brain function is affected by inflammation?
Signs and symptoms vary depending on the cause and severity, but common ones include cognitive changes like memory problems, confusion, difficulty concentrating, mood and behavioural changes (neuroinflammation has been linked with depression), Duggal observes. “Neuroinflammation has also been linked with fatigue and sleep disturbances.”
The problem with symptoms of inflammation on the brain, like confusion, tiredness, fogginess, slowed thinking and changes in your mood, is that these could be linked to other health conditions or lifestyle factors, says Mackenzie.
“It would be hard to say that brain fog is due to chronic inflammation versus your brain fog being due to poor sleep or hormone shifts, for example.”
The key is knowing your own body. “If you’re somebody that knows that they have quite a high-stress lifestyle or is juggling lots of balls, and you start to notice inflammation in your body, often physical symptoms come first – stiffness, swelling, pain that you haven’t had before. Coupled with cognitive changes could be a sign it’s linked to chronic inflammation and it’s worth paying attention to.”
Longevity doctor Harpal Bains says she often sees patients in clinic who initially present with things like digestive issues or aches and pains that they can’t explain. “These symptoms often go hand in hand with brain fog, forgetfulness, lowered immunity, weight gain, persistent gas and bloating,” she says. “People often put it down to just getting older, or they consider it to be normal for them, but just because you’ve had it for 10 years, or your family had it too, it doesn’t make it normal. It deserves investigation.”
How to reduce the impact of inflammation on your brain
Sadly there is no single anti-inflammatory lifestyle; research suggests it’s the usual health-promoting behaviours that can reduce inflammation and support brain health, Schubert notes.
“These include maintaining a balanced, nutrient-rich diet like the Mediterranean-style diet; engaging in regular physical activity (read more here on how different forms of exercise can impact inflammation); ensuring adequate and consistent sleep; managing stress through approaches like mindfulness, yoga, or meditation,” she says. “Together, these factors may not prevent inflammation entirely, but they can help reduce the risk of associated conditions and support resilience of brain function.”
Scientists are learning more about how the state of our gut, specifically, can impact the brain, and how it can influence everything from mood to cognition and mental health, Mackenzie notes. “We now have more evidence about how gut health impacts the brain due to the gut-brain axis and having good gut health can impact how our brain copes with inflammation,” adds Mackenzie. The gut-brain axis is the bidirectional communication between the central nervous system and the enteric nervous system, which controls the digestive system, also sometimes referred to as your ‘second brain.’
“Eating less processed food, which we know can contribute to inflammation in the body, and eating plenty of fibre and factoring fermented foods into your daily diet, is important for gut health,” she says. When fibre is digested by gut bacteria, short-chain fatty acids, like butyrate, are produced, and studies have shown these substances can help dampen down inflammation.
You’ve heard it many times before, but getting enough sleep is crucial, too. “We know sleep is important for brain health because it’s when we filter out toxins and plaque build up,” Mackenzie says. Some studies have suggested a link between poor sleep and higher inflammatory biomarkers, though experts are still figuring out why and how disrupted sleep contributes.
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We know that keeping our brains active, by reading, socialising, being intellectually stimulated and learning new things, is important, but Mackenzie also emphasises stress management and reducing the burden of overstimulation on the brain from the always-on world we live in.
“We think chronic stress can weaken the blood-brain barrier, so there’s more chance of inflammation impacting the brain, which over a long period of time can have a cascade effect,” she says. “Our brains aren’t made for the world that we live in – basically we’re too busy. Constantly task-switching or juggling too many plates is bad for cognitive function.”
With this in mind, Mackenzie advocates purposely factoring in moments throughout the day to day dream – when you’re not scrolling on your phone or trying to do 10 things at once – as a tool for managing stress levels. “It’s called the default mode network, where mind wandering happens, which is often where creativity and problem-solving happens. It’s why you often have your best ideas in the shower,” she says.
“I often advise people to introduce time blocking – when you do something for 40 minutes followed by a 20-minute break – and just let your mind wander. Task switching constantly doesn’t give our brain time to reduce that chronic level of hormone secretion to take us back to baseline,” she says.
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