Nearly Half of Dementia Cases Could Be Delayed or Prevented by Addressing These 14 Risk Factors

Key Takeaways

• Vision loss and high cholesterol have been added to the list of modifiable risk factors for dementia.
• Nearly half of dementia cases could be delayed or prevented by addressing these risk factors.
• Taking care of your physical health and engaging in mentally stimulating activities during midlife and later can reduce your risk of dementia.

By addressing 14 modifiable risk factors, which now include vision loss and high cholesterol , an estimated 45 percent of dementia cases could be delayed or prevented entirely - even in individuals with high genetic risk for dementia, according to a recent report.

Written by 27 of the world's leading dementia experts, the new 2024 Lancet Commission report urges health officials and the public to take action to reduce these specific preventable risks beginning in childhood and continuing throughout life.

"Some people will still develop dementia, but if they address these risks they should have a longer, healthier life and will not have dementia for such a long time," said lead author Gill Livingston, MD a professor specializing in the psychiatry of older people at University College London, in a press release.

"It's never too early or too late to take action, with opportunities to make an impact at any stage of life."

Preventing Direct Physical Threats to Mental Sharpness

The Lancet report identifies these 14 modifiable risk factors for dementia:

• High blood pressure
• Diabetes
• Obesity
• Physical inactivity
• Drinking too much alcohol
• Smoking
• Traumatic brain injury
• Hearing Loss
• Exposure to air pollution
• Depression
• Social isolation
• Lower education
• Vision loss
• High LDL cholesterol

Physical risk factors like high blood pressure , diabetes , obesity , and physical inactivity may lead to narrowed or blocked arteries that decrease blood flow to the brain, and brain cells need a constant supply of blood and oxygen to work properly.

Drinking too much alcohol and smoking can also contribute to heart disease and be toxic to brain cells, causing them to die.

Another risk factor that directly impacts mental capabilities is traumatic brain injury , which disrupts how the brain functions.

High Cholesterol and Vision Loss Can Contribute to Dementia Risk

The new guidelines have now added high cholesterol in midlife (from around age 40) to the list of modifiable risk factors. The Lancet Commission estimates that 7 percent of dementia cases are attributable to this "bad" cholesterol, which leads to a build-up of cholesterol in the arteries.

When the list was last updated four years ago, available evidence indicating LDL cholesterol as a possible risk factor was inconclusive, according to Dr. Livingston. Since that time, "new compelling evidence" has found that LDL cholesterol increases the chances of experiencing cognitive decline.

While hearing problems were already on the dementia risk roster, loss of vision was just added in this recent update. A decline in these sensory functions are common as we age, and can lead to confusion and problems processing information and everyday perception.

The Lancet report found that 2 percent of dementia cases were attributable to untreated vision loss in later life.

Air Pollution, Depression, Loneliness, and Lack of Education Can Also Threaten Brain Health

Air pollution has been linked to heart disease , which in turn can raise the likelihood of cognitive impairment. Individuals may have little control over their exposure to air pollution, so it can be difficult to limit. The researchers, however, suggest that people can take some individual actions, such as not using wood burning stoves or coal burning fires and avoiding being outside at times when air quality is at its worst.

Depression and social isolation can contribute to dementia as well because they may lead to changes in health and behaviors that heighten dementia risk, such as physical inactivity, poor diet, higher alcohol consumption, less sleep, and a lack of mental stimulation and engagement.

Although the connection between dementia and education may not be as apparent compared with other risk determinants, the Lancet Commission notes that quality of education in early life is linked to brain resilience.

"People with more and better education have a stronger, more flexible set of neural connections to rely on if they ever do have brain disease that can cause dementia," says Jessica Caldwell, PhD , director of the Women's Alzheimer's Movement Prevention Center at Cleveland Clinic's Lou Ruvo Center for Brain Health. "The other good news in this update is that education is being recognized as impactful beyond early life. This means that people in their thirties through their sixties may also see strong benefits from lifelong learning. Take a class, learn a language, take up a challenging hobby, or research history before you travel."

How to Reduce Dementia Risks

While people can take effective steps to prevent mental decline at any age, Livingston notes that there is now stronger evidence showing that longer exposure to risk is more harmful. She emphasizes that developing healthy habits in childhood - such as getting regular exercise and following a healthy diet to avoid obesity - can form the basis for behaviors later in life that can curb dementia risks.

The new Lancet report outlines several suggestions to help governments and individuals keep the dangers of dementia at bay, including:

• Provide all children with good quality education and be cognitively active in midlife.
• Make hearing aids available for all those with hearing loss and reduce harmful noise exposure.
• Detect and treat high LDL cholesterol in midlife, starting at around age 40.
• Make screening and treatment for vision impairment accessible for all.
• Treat depression effectively.
• Wear helmets and head protection in contact sports and on bikes.
• Prioritize supportive community environments and housing to increase social contact.
• Reduce exposure to air pollution through strict clean air policies.
• Expand measures to reduce smoking, such as price control, raising the minimum age of purchase, and smoking bans.
• Reduce sugar and salt content in food sold in stores and restaurants.

Dr. Caldwell, who is not part of the Lancet Commission, stresses, "There are steps all of us can take when we are young and at midlife to increase our chances of aging well."

Editorial Sources and Fact-Checking

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy . We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Sources

1. Livingston G et al. Dementia Prevention, Intervention, and Care: 2024 Report of the Lancet Standing Commission. The Lancet . July 31, 2024.
2. The Lancet: Nearly half of dementia cases could be prevented or delayed by tackling 14 risk factors starting in childhood, including two new risks-high cholesterol and vision loss. EurekAlert . July 31, 2024.
3. High blood pressure dangers: Hypertension's effect on your body. Mayo Clinic . November 28, 2023.
4. Alcohol and Dementia Risk. Alzheimer's Research UK .
5. Smoking and Dementia Risk. Alzheimer's Research UK .
6. Lee Y et al. Association Between Cholesterol Levels and Dementia Risk According to the Presence of Diabetes and Statin Use: a Nationwide Cohort Study. Scientific Reports . November 12, 2022.
7. Sight and hearing loss with dementia. Alzheimer's Society .

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Don Rauf

Author

Don Rauf has been a freelance health writer for over 12 years and his writing has been featured in HealthDay, CBS News, WebMD, U.S. News & World Report, Mental Floss, United Press International (UPI), Health , and MedicineNet. He was previously a reporter for DailyRx.com where he covered stories related to cardiology, diabetes, lung cancer, prostate cancer, erectile dysfunction, menopause, and allergies. He has interviewed doctors and pharmaceutical representatives in the U.S. and abroad.

He is a prolific writer and has written more than 50 books, including Lost America: Vanished Civilizations , Abandoned Towns , and Roadside Attractions . Rauf lives in Seattle, Washington.

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