Could Nearly Half of Dementia Cases Be Prevented?

Source: Peter Kindersley/Centre for Ageing Better

Three-quarters of adults age 40 and older are concerned about their brain health declining in the future, according to an AARP survey of 1,563 adults.

Many older adults try strategies like doing crossword puzzles and taking supplements to stave off dementia, but do such approaches actually work?

Research shows that potentially 45 percent of dementia cases can be prevented or delayed through a series of personal and societal changes.

A new report in the journal Lancet, dated July 31, 2024, highlights two new modifiable risk factors for dementia, bringing the known total to 14.

14 Evidence-Based Modifiable Risk Factors for Dementia

According to the 2024 report, by the Lancet Commission on dementia, highlighting prevention, intervention, and care, there are 14 evidence-based modifiable risk factors for dementia. They include:

• Less education
• Head injury
• Physical inactivity
• Smoking
• Excessive alcohol consumption
• Hypertension
• Obesity
• Diabetes
• Hearing loss
• Depression
• Infrequent social contact
• Air pollution
• Vision loss (new)
• High cholesterol (new)

Modifying all 14 risk factors would potentially delay or prevent a remarkable 45 percent of all dementia cases whether or not a person has the APOE gene (the Alzheimer's gene).

​Now that we know the modifiable risk factors for preventing or delaying dementia, here's what the Lancet Commission recommends that you do to prevent or delay dementia.

Specific Recommendations to Prevent or Delay Dementia

• Ensure that good-quality education is available for all, and encourage cognitively stimulating activities in midlife to protect cognition.
• Make hearing aids accessible to people with hearing loss, and decrease harmful noise exposure to reduce hearing loss.
• Treat depression effectively.
• Encourage the use of helmets and head protection in contact sports and on bicycles.
• Encourage exercise, because people who participate in sport and exercise are less likely to develop dementia.
• Reduce cigarette smoking through education, price control, and smoking prevention in public places, and make smoking cessation advice accessible.
• Prevent or reduce hypertension and maintain systolic blood pressure of 130 mm Hg or less from age 40 on.
• Detect and treat high LDL cholesterol from midlife.
• Maintain a healthy weight and treat obesity as early as possible, which also helps to prevent diabetes.
• Reduce high alcohol consumption through price control and increased awareness of levels and risks of overconsumption.
• Prioritize age-friendly and supportive community environments and housing, and reduce social isolation by facilitating participation in activities and living with others.
• Make screening and treatment for vision loss accessible to all.
• Reduce exposure to air pollution.

The Lancet Commission also recommends being ambitious about prevention starting early in life and continuing throughout life.

Did You Notice Something Missing from the List?

Sleep. Anxiety. PTSD. Severe mental illness. Diet. Infection. Menopause.

​The Lancet Commission cites these domains as potential risk factors as well, noting that each is correlated with dementia. However, at present, there is not enough research to prove that they have a causal relationship with dementia.

That still leaves many opportunities for action by mental health providers, senior care providers, friends, family, and individuals.​

Take the Challenge

Review the list of recommendations above and choose one domain in which to make changes in your own life. Then share this list with others so that each and every one of us has the best chance to have optimal cognitive health as we age.

Facebook/LinkedIn image: JLco Julia Amaral/Shutterstock