Making Limburg the leading province for brain health
Through his research into risk factors and his work translating knowledge into concrete action, Prof. dr. Sebastian Köhler and his team have already set a great deal in motion. And that is a good thing. “The number of people living with dementia will double over the next 30 years. We must do something,” says Köhler, who is pleased to see that the issue is now being taken seriously, even by policymakers. For Köhler, the main priority is spreading knowledge about brain health to the wider public: “Helping people age more healthily, with a healthier brain, that’s what it’s all about for me”.
As Professor of Neuroepidemiology (MHeNs), Sebastian Köhler studies epidemiology – how diseases spread within populations – with a particular focus on diseases of the brain. More specifically, he focuses on Alzheimer’s disease and other forms of dementia. As well as studying the risk factors for developing these diseases, he also looks at how people like you and me can be supported in reducing our risk.
A defining moment
During his Psychology studies, Köhler experienced a moment that would have a profound influence on his work. Köhler recalls: “At the hospital where I did my internship, I worked with people with dementia. I remember a woman with Alzheimer’s who didn’t speak and was quite apathetic. She was barely motivated to participate in the research. But when I asked her about her children, her eyes began to light up. A smile appeared on her face and she started talking. I found it so moving to see the person within her. It made a deep impression on me and taught me that it is not the disease you see, but the person living with it. This experience still motivates me every day to make a difference for these people. Initially, by helping people build as much resilience as possible against the disease. And where that is no longer feasible, by slowing down the process as much as we can”.
Risk factors
Köhler: “My research has two main strands. First, we look for modifiable risk factors for dementia. Second, we focus on translating knowledge into practical actions. This can give people something they can work with themselves to keep their brains healthy. But before we can do that, we first need to make people aware that there is a link between lifestyle factors and dementia, and inform them which factors are involved. We do this through public awareness campaigns such as ‘We Are the Medicine (in Dutch: We zijn zelf het medicijn), which we run together with the Municipal Health Services (GGD) and local councils, as well as through the MijnBreincoach app, which helps people improve their lifestyle with reliable information.
Part of our research is about gaining insight into which interventions are effective. For example, does following a coaching programme focused on exercise and healthier eating have a positive effect? In the FINGER-NL study, we are investigating this by comparing two groups: one receives a lifestyle programme, the other does not. We want to find out whether the brains of the people who followed the programme function better later in life. With around 1,200 participants, this is one of the largest studies of its kind ever conducted. An earlier study in Finland showed that the group receiving the programme demonstrated better cognitive development of than the control group. With our current study, we want to build on those findings and achieve even more, which is why we’ve added extra lifestyle domains, such as sleep intervention and stress reduction”.
Our researchers are highly motivated and are not afraid to step out of the ivory tower of science, and engage with the public.
Interventions and spreading knowledge
Köhler: “Even if people know the risk factors, it doesn’t mean they can easily change their behaviour. That is why, alongside experimental research, we also study how to effectively reach people with our message. As far as I am concerned, that should always be the point of science: how do you actually apply the knowledge? In this line of research, we want to find out how to communicate without scaring people or making those with dementia feel it’s their own fault. We also look at whether people truly gain more knowledge about the link between lifestyle and dementia, and whether they actually change their behaviour.
When we launched the ‘We Are the Medicine’ campaign in 2018, we saw that people who encountered it were more aware of the link and more motivated to improve their lifestyle. Since we were not reaching certain groups effectively at the time, we adapted the materials and app and ran the campaign again in 2025–2026. The results in Limburg show that around 70% of people are aware that they can influence their own dementia risk. A majority know that staying mentally, physically and socially active is important for good brain health. Awareness of specific risk factors has also grown: more than half of the participants now know that not only smoking, alcohol consumption and diet play a role, but also factors like depression, high blood pressure and diabetes.
The most important message remains: you can do something yourself to reduce your risk of dementia. It is not a guarantee: some people are unlucky and others are lucky. We also know that it is not equally easy for everyone, partly due to health inequalities in our society. Helping to reduce those inequalities is therefore one of our key tasks”.
Impact
Köhler: “The campaign has really become a success story. It has had the greatest impact of anything we have done so far, especially since it’s been adopted by the GGD and local councils. Moreover, the World Health Organization (WHO) has recognised the campaign as a best practice, and it has been highlighted by the Dutch Ministry of Health (VWS) as an important approach in its national health policy document and by the Health Council of the Netherlands in its advice on dementia risk reduction. We’re very proud of that.
The success is a real team effort. Of course, we also publish in leading journals, and that is important too, but making a societal impact is really in the DNA of the Alzheimer Center Limburg. The often young researchers are so driven to go out into the community and explain what we do, even spending their weekends at local markets. That’s a big part of our success. They’re not afraid to step out of the ivory tower of science, and engage with the public”.
Brain-healthy neighbourhoods
Köhler: “So far, our public campaign has mainly operated at a regional level. The next step is to get even closer to the people we want to reach: at neighbourhood level. Over the coming years, the idea is to work towards brain-healthy neighbourhoods, for example by setting up a Lifestyle Support Desk in the local community. We have now selected two pilot neighbourhoods in South Limburg where we want to launch such a helpdesk, involving GPs, practice nurses and physiotherapists. It will be a place where people can receive advice about their brain health, discuss their concerns and take part in exercise sessions and workshops.
This way, we want to be present in these neighbourhoods for a year and investigate whether they actually become brain-healthier. This could serve as a blueprint for other municipalities. Ultimately, we hope to lay the foundation for making Limburg the ‘brain- healthiest’ province in the Netherlands”.
Text: Eline Dekker
Photo: Joey Roberts