Reducing the risk of cognitive decline

We cannot control every cause of dementia, but a large body of research says that addressing certain factors across life could prevent or delay a meaningful share of cases. The 2024 Lancet Commission estimates that around 45% of dementia cases could in principle be prevented or delayed by tackling 14 modifiable risk factors ^{[Livingston G 2024]} .

This is about lowering risk, not a guarantee - and it is never too early or too late to act ^{[Livingston G 2024]} .

The 14 factors

The Commission lists: lower education, hearing loss, high blood pressure, smoking, obesity, depression, physical inactivity, diabetes, excessive alcohol, traumatic brain injury, air pollution, social isolation, and - newly added in 2024 - untreated vision loss and high LDL cholesterol ^{[Livingston G 2024]} .

Practical actions

You do not need to fix everything. Pick what is realistic:

• Move regularly. Aim toward 150 minutes of moderate activity a week if you can ^{[World Health Organization 2019]} .
• Protect your hearing and vision - get tested, use hearing aids and glasses if needed.
• Look after your heart numbers - blood pressure, cholesterol, blood sugar.
• Stay socially connected and treat low mood; isolation and depression both matter.
• Don’t smoke; keep alcohol low.
• Keep learning and stay mentally active.

Focus on what you can change

Not everything is in our control, but several habits meaningfully shift the odds:

• Stay physically active most days.
• Keep blood pressure, cholesterol, and blood sugar in check.
• Don’t smoke, and keep alcohol within limits.
• Address hearing loss and stay socially connected.

Feed the brain

• Favour a vegetable-rich, whole-food eating pattern.
• Include beans, nuts, fish, and healthy fats.
• Limit ultra-processed foods and added sugar.

Keep the mind and body engaged

• Keep learning new things.
• Stay in regular contact with others.
• Protect your sleep.
• Manage stress with calming routines.

Start small

You don’t need to change everything at once. Choose one habit from each area and build gradually - consistency matters more than intensity.

A balanced note

WHO rates the strength of evidence as varying by factor - strongest for physical activity and managing cardiovascular risk, with others more uncertain ^{[World Health Organization 2019]} . The encouraging message is that healthy habits help your whole body and brain, with little downside.

Turn this into action with Practice.