From Lymphoedema to Dementia: The Expanding Role of MLD in Healthy Ageing.

Across the world, people are living longer than ever before. By 2030, one in six people will be over the age of 60, and by 2050 the number of adults over 80 will triple to 426 million (1).

While longevity is something to celebrate, it also brings challenges. Older adults face a higher risk of multiple chronic conditions at once - arthritis, diabetes, cardiovascular disease, depression, dementia, and many others. At the same time, their resilience to infections such as influenza is reduced, and the risk of cancer is increased.

At the heart of many of these conditions is inflammation, a process that, while essential for healing, becomes harmful when it remains chronically active.

Persistent low-grade inflammation is now recognised as a major driver of age-related decline and has been termed inflamm-aging.

Manual Lymph Drainage (MLD), is well know for its benefits in managing lymphoedema, but mounting evidence suggests it may also help address broader issues of healthy ageing, from skeletal muscular aches and pains to brain health.

Common Health Issues in Ageing

The World Health Organization highlights a wide range of conditions that become increasingly common with age: back and neck pain, osteoarthritis, chronic obstructive pulmonary disease (COPD), diabetes, depression, dementia, and sensory decline (1). Many older adults also undergo cancer therapy and joint replacements, struggle with obesity, and live with hypertension, heart disease, or stroke recovery.

Importantly, these conditions rarely appear in isolation. Instead, they cluster together - arthritis with depression, diabetes with cardiovascular disease, or obesity with sleep problems. Co-morbidity adds complexity to treatment and often reduces quality of life.

For individuals already living with lymphoedema, these overlapping conditions can worsen symptoms. For example, diabetes and obesity increase the risk of secondary infections, while immobility from arthritis or joint replacement further inhibits lymph flow.

Inflammation: The Central Culprit

Inflammation plays a role in nearly every one of the conditions described above. Research shows that low-grade inflammation is linked to cardiovascular disease, obesity, metabolic syndrome, depression, dementia, and cancer (2).

But inflammation is not only a symptom - it can be a cause. A Finnish population study followed nearly 1,000 adults for 10 years and found that elevated inflammatory markers un midlife predicted poorer performance on cognitive tests a decade later (2).

These results suggest that inflammation in our 40s and 50s may influence how well we think and remember in our 60s and 70s.

Scientists are also discovering that inflammation may have a form of memory. Animal studies indicate that once the brain has experienced a strong inflammatory event, certain neurons in regions like the amygdala can “remember” it. Even after the original trigger for the inflammation has been resolved, these neurons can reactivate immune pathways and trigger renewed inflammation (3).

In other words, the body may carry the scars of past immune challenges into older age. This persistent immune memory could explain why some chronic conditions such as colitis, arthritis, or depression, can persist long after the initial onset, and why early-life inflammation may shape the trajectory of ageing.

Inflammation and Cognitive Decline

Of all the health issues associated with ageing, cognitive decline is among the most feared. Alzheimer’s disease, dementia, and related disorders are devastating for individuals, families, and healthcare systems. Increasingly, inflammation is being recognised as a major player in their development.

The Harvard Medicine review on brain health notes that runaway neuroinflammation can kill more neurons than amyloid plaques or tangles themselves (3).

Microglia and astrocytes, the brain’s resident immune cells, normally act as housekeepers - removing waste, repairing synapses, and supporting neurons. But under chronic stress they flip into a destructive state, releasing toxic chemicals that damage brain circuits.

Young adults are not immune. A longitudinal U.S. study showed that chronic inflammation in adolescence and young adulthood was linked to worsening working memory performance over time (4). These findings reinforce the idea that inflammation across the life span can accelerate cognitive ageing.

Another major breakthrough is the rediscovery of the meningeal lymphatic system - lymph vessels lining the meninges of the brain. Once thought not to exist, these vessels are now known to drain cerebrospinal fluid, remove waste, and play a role in immune surveillance (5). Dysfunction of this system has been shown to worsen amyloid accumulation in Alzheimer’s disease models, while boosting lymphatic drainage improves cognition in animals (5).

MLD as a Non-Drug Therapy for Ageing

MLD is best known as a cornerstone of lymphoedema management where it has been shown to reduce swelling and improve functional mobility and quality of life. Recent research suggests that its benefits may extend far beyond limb swelling:

• Brain health: Experimental studies in Alzheimer’s models show that stimulating lymphatic flow in the head and neck improves cognitive performance and reduces amyloid burden (6).

• Skeletal muscle pain & arthritis: By reducing local inflammation and swelling, MLD can ease joint stiffness and support post-operative recovery after joint replacement.

• Neuroinflammation and stroke: Enhanced lymphatic drainage may help clear toxic molecules after brain injury, supporting rehabilitation.

• Respiratory health: MLD has been shown to improve breathing and reduce cough in long-COVID, and may assist breathing in COPD and post-pneumonia recovery.

• Mental health & sleep: Therapists report improvements in mood, appetite, and sleep among older patients receiving MLD (6). These may be linked to systemic reductions in inflammatory markers.

Why MLD is Unique

The very precise and specific movements of Dr Vodder's MLD have been shown to increase lymph flow, reduce systemic inflammation and modulate both acute and chronic pain.

Applied with a light, pain free pressure, these gentle movements of the skin have a powerful effect on many body systems, and these features and effects make MLD an ideal non-drug treatment in many conditions such as choric regional pain syndrome and fibromyalgia.

Manual Lymph Drainage is:

• Non-invasive: No drugs, no side effects, suitable for frail or polymedicated patients.

• Holistic: Addresses both local symptoms (swelling, pain) and systemic processes (inflammation, immune function, autonomic balance).

• Accessible: The specialised movements of MLD require training in the Dr Vodder method, but simplified lymphatic drainage techniques can be performed by caregivers or for self-massage in some cases.

Looking Forward

MLD remains under-recognised in the fields of gerontology and neurology. Most research has focused on lymphoedema after cancer treatment. Yet, evidence from neuroscience, immunology, and lymphatic biology suggests its potential role is much broader.

An editorial in Lymphology argues that a clinical trial of MLD for dementia is urgently needed (6). As Erickson and colleagues note,

MLD may offer a simple, inexpensive, and safe adjunct for Alzheimer’s and other dementias (6).

Combined with what we know about inflammaging in skeletomuscular and metabolic issues, it's time to broaden the discussion.

Call to Action

If you are an MLD therapist, your experiences matter. Whether it’s an elderly patient whose sleep improved after treatment, or someone recovering from stroke who regained mobility, these stories build the case for recognising MLD in healthy ageing.

We encourage practitioners to:

• Document outcomes related to pain, cognition, mood, and respiratory function.

• Share case reports and patient testimonials within professional networks and blog posts.

• Support calls for research into MLD for neuroinflammation and age-related conditions.

By combining grassroots evidence with rigorous clinical research, MLD could move from being seen as a niche therapy for swelling to a frontline approach for ageing well.

Conclusion

Ageing is not simply a matter of counting years - it is shaped by biology, lifestyle, and environment. Chronic inflammation is one of the strongest threads linking the diverse conditions of older age, from arthritis to dementia.

The Dr Vodder method of MLD, long valued in lymphoedema care, may provide a safe and powerful tool to reduce inflammation, support brain health, and improve overall quality of life. In the decades ahead, as populations age rapidly worldwide, recognising and researching this potential could make MLD a cornerstone of healthy ageing strategies.

References

1. World Health Organization. Ageing and Health Fact Sheet. 2024.

2. Kipinoinen T, et al. Association of Midlife Inflammatory Markers With Cognitive Performance at 10-Year Follow-up. Neurology, 2022.

3. Schmidt C. Inflammation and Brain Health. Harvard Medicine Magazine, 2021.

4. Mac Giollabhui N, et al. Chronic Inflammation and Working Memory. Psychoneuroendocrinology, 2024.

5. Salvador AF, Kipnis J. Meningeal Lymphatics in CNS Diseases. Annual Review of Neuroscience, 2024.

6. Erickson RP, et al. Manual Lymph Drainage for Alzheimer’s Dementia: Editorial. Lymphology, 2025.