14 lifestyle changes that could prevent almost half of all future dementia cases
For years, it was believed that a dementia diagnosis was down to bad luck, but some changes you can instantly make, could prevent hundreds of thousands of cases.
For years, the prevailing school of thought on dementia pegged the cluster of symptoms caused by conditions affecting the brain as, at best, an unlucky lottery we entered as we reached our senior years.
And at worst, it was regarded as an inevitability for those able to run the gauntlet of other age-related illness and make it into their seventh or eighth decade.
These assumptions are being rapidly overthrown, in part due to the discovery of 14 separate lifestyle modifiers, which could lead to the prevention of 45 per cent of cases.
According to the World Health Organisation, dementia – including Alzheimer’s disease, which is believed to make up 60 to 70 per cent of all dementia cases worldwide – is the seventh leading cause of death globally, and now officially the number one cause of death in Australia.
The number of people living with dementia worldwide is projected to reach about 153 million by 2050, while in Australia, it is estimated more than 433,000 people are living with the condition. That number is projected to nearly double to 812,500 by 2054, and tip over a million by 2065.
“Dementia is currently the leading cause of death for females over the age of 75 in Australia, and within a few years will become the leading cause of death for all Australians over 75,” Neuroscience Research Australia (NeuRA) CEO and Institute Director Professor Matthew Kiernan told news.com.au.
“It represents a huge disability and cost burden to the community and there is a lot of pressure on governments to address it,” Prof Kiernan said.
Established in 2017 in part as a result of this pressure, The Lancet Commission on Dementia Prevention, Intervention, and Care is responsible for reviewing the vast amount of existing evidence on what can be done to prevent and manage dementia, as well as to guide policymakers and healthcare professionals.
The key premise is that a significant proportion of dementia cases are potentially preventable by addressing modifiable risk factors.
While The Lancet Commission had previously identified 12 lifestyle modifiers, its 2024 report found evidence to suggest the addition of two more.
Spread across three separate life stages, the modifiable risk factors include:
EARLY LIFE
Not completing secondary education
Low educational attainment increases the risk in cognitive decline, which experts theorise is partially due to having lower cognitive reserves to maintain brain function into ageing. Conversely, lifelong learning has a protective effect.
MIDLIFE
High LDL cholesterol
One of the recent updates to the Lancet Commission’s findings was the inclusion of high LDL cholesterol as a risk factor for dementia. Not only have studies found excess brain cholesterol to be associated with a higher incidence of stroke, it is also associated with higher deposits in the brain of proteins associated with Alzheimer’s disease. People who took medication to lower their cholesterol were not at a higher risk.
Depression
While depression at all ages increases the risk of developing dementia, evidence suggests midlife depression has the most significant impact, with experts theorising this could be because of the way in which depression can shrink the hippocampus, the part of the brain responsible for forming memory.
Hearing loss
A number of studies have established the link between hearing loss and dementia risk, with data suggesting that a person’s risk of dementia increases by 4 per cent to 24 per cent for every 10 decibel reduction in hearing.
“While hearing loss is a natural part of the ageing process, those most affected are normally in the late 60s, early 70s and beyond,” specsavers chief audiologist Nick Taylor said.
“Untreated adult-onset hearing loss can result in communication difficulties that can lead to social isolation and withdrawal, depression, and reduced quality of life. But hearing loss is often thought of as an invisible disability as there are no clear external symptoms, very different from the need for reading glasses when your arm isn’t long enough to focus on small writing.
“Therefore, we recommend that adults from the age of 50 have their hearing health checked on a regular basis (every two years) to identify any early signs of hearing loss and be aware of the support available.”
Traumatic brain injury
Knocks to the head in sport, concussion, motor vehicle accidents and other traumatic injuries can also increase dementia risk, with one study concluding this type of traumatic brain injury could bring on an earlier onset of Alzheimer’s by two to three years.
Obesity
In an analysis of 16 studies that looked at more than 5 million people, researchers found those in the overweight or obese category were at greater risk of cognitive impairment and dementia than those in a healthy weight range.
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Sedentary lifestyle/physical inactivity
The World Health Organisation (WHO) recommends 150 to 300 minutes of moderate physical activity per week, and studies have shown this can benefit brain health in a myriad ways. Improving blood flow, increasing production of healthy proteins in the brain, reducing inflammation and maintaining a healthy weight are some of the benefits thought to reduce dementia risk.
Type 2 diabetes
Type 2 diabetes has been previously linked to an increased dementia risk, but the time of onset matters. Those who develop Type 2 diabetes in midlife are more likely to develop dementia, while those who develop it later in life do not appear to increase their risk profile. Maintaining healthy blood sugar levels and managing pre-diabetes/insulin resistance is a crucial step.
Smoking
The fact that smoking is linked to poor health outcomes is not revolutionary, however the toxic chemicals found in cigarettes, along with smoking’s impact on vascular health, significantly increase a person’s risk of developing dementia. Quitting can reduce this risk.
High blood pressure (hypertension)
Having high blood pressure in midlife is linked with an increased risk of dementia – both Alzheimer’s and vascular. In studies, those who received blood pressure medication had better cognitive function than those who were not treated, which is why regular blood pressure checks and treatment is crucial.
Alcohol
Heavy alcohol use (usually defined as more than 10 standard drinks per week, or more than four standard drinks in one day, keeping in mind that a bottle of full-strength beer represents 1.4 standard drinks in Australia) is linked with dementia, increasing the risk of developing it by up to threefold, according to one study.
LATE LIFE
Social isolation
Loneliness, particularly in later life, can increase a person’s risk of dementia significantly, as well as increasing their risk factors for other health disorders related to dementia risk. Fewer social contacts and less time spent socialising can also speed up progression of symptoms.
Untreated vision loss
New evidence published in the Lancet Commission’s 2024 report found vision loss (untreated) did increase dementia risk, when previously there was not sufficient evidence on the subject. A 2021 meta-analysis of 14 prospective cohort studies on over 6 million people confirmed the increased risk.
Air pollution
Exposure to polluted air has been shown to increase dementia risk, and while in some instances this type of environmental exposure is unavoidable, experts recommend taking measures to avoid heavily polluted areas or days when air pollution is particularly bad, as well as closing air vents when sitting in traffic to avoid car exhaust.
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Originally published as 14 lifestyle changes that could prevent almost half of all future dementia cases
