Dementia is often associated with ageing, and so it’s easy to assume that memory loss and cognitive decline are simply part of getting older. But medical evidence tells us differently.
Dementia is not an inevitable outcome of aging, and several of the factors are possible to control or treat or prevent dementia. The World Health Organization (WHO) estimates that up to 45% of dementia risk could be prevented or delayed by addressing modifiable risk factors.
That does not mean all dementia cases can be prevented. Age is the most widely known risk factor, and genetics and other factors that people cannot control also play a role. But cardiovascular health, being physically and socially active, and treating conditions like high blood pressure and diabetes might be useful for brain health in the long term.
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As World Alzheimer’s Day is on September 21, here are some practical things to work on.
1. Keep your body physically active.
Physical activity is the most important lifestyle factor associated with healthier ageing.
Such workouts are good for cardiovascular health and have a connection with blood pressure, blood sugar, weight management and general physical health. These factors are also important for the brain, and in the heart and blood vessels, there are disorders that are also related to brain health.
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Dementia risk reduction is associated with physical activity, WHO says. Even someone who can’t keep up a detailed exercise plan, regular exercise is best suited to their age and physical ability.
For long-term fitness, walking, cycling, swimming, dancing and other moderate exercise are all ways to stay active.
2. Keep blood pressure, blood sugar and cholesterol in check.
What is good for the heart is often good for the brain as well.
High blood pressure, diabetes and high cholesterol are among the health conditions associated with increased dementia risk. Managing these conditions can therefore form an important part of protecting cognitive health.
Health check-ups are helpful to identify problems that may not appear to be obvious at the beginning. And if a doctor tells you to take blood pressure pills, diabetes pills or cholesterol pills, take them as directed rather than waiting for medical advice, and take them every day.
The WHO's updated recommendations focus on hypertension, diabetes and high cholesterol as part of dementia risk reduction.
3. Don’t smoke and limit alcohol.
The effects of smoking on blood vessels and overall cardiovascular health are also associated with alcohol consumption and dementia risk.
Stopping smoking has health benefits at any age. Reducing harmful alcohol consumption is another way to curb several health risks at the same time.
The WHO lists tobacco use and harmful alcohol consumption as modifiable factors on dementia risk.
This is not to say that someone who drinks occasionally will go on to develop dementia. Most likely that harmful or excessive consumption is a problem.
4. Eat a balanced, heart-healthy diet.
There is no single food that can give protection against Alzheimer’s disease. It is more about eating habits that matter.
A balanced diet should include a lot of vegetables and fruits, whole grains, legumes, nuts and other nutrient-rich foods, but not excessive use of saturated fat, salt, added sugar and highly processed foods.
It is also related to brain health, too, to manage weight, blood pressure, blood sugar, and cholesterol.
The WHO recommends a healthy, balanced diet as part of its dementia risk-reduction guidance.
5. Stay socially and mentally engaged.
Brain health is much more than diet and exercise.
Staying connected with other people and engaging in mentally stimulating activities can also be beneficial. Reading, learning something new, playing music, solving puzzles, or just maintaining regular social interactions can keep the brain engaged.
The WHO’s new guidelines advise cognitive stimulation and social activities for adults with normal cognition or mild cognitive impairment.
And there’s no need to make it a brain training program. Activities that are fun enough to keep you engaged can be a useful way to remain mentally active.
6. Protect your hearing.
Hearing loss as people age is also something we should be paying attention to.
Untreated hearing difficulties can make communication difficult and may lead to social isolation. Hearing loss is also a modifiable risk factor for dementia.
In the updated guidance, hearing aids may be offered as part of dementia risk reduction strategies when appropriate.
If you notice that conversations are becoming difficult to follow, you frequently need people to repeat themselves or regularly increase the volume of television and phones, consider getting your hearing assessed.
7. Reduce exposure to air pollution and prevent head injuries.
Dementia risk is influenced by factors besides personal lifestyle choices.
The latest WHO recommendations include reducing exposure to air pollution as part of dementia risk reduction. Previous Lancet Commission studies have also identified traumatic brain injury and air pollution as modifiable dementia risk factors.
Simple precautions can include avoiding unnecessary exposure to heavily polluted environments when air quality is poor and using appropriate protective gear during activities where head injuries are possible.
Preventing falls and using helmets during cycling or other activities can also lower the risk of traumatic brain injury.
What about vitamins and supplements?
It is tempting to think taking a daily supplement designed for “brain health” will prevent dementia. The evidence does not support that assumption.
WHO's 2026 guidelines do not recommend vitamin B or E supplements, omega-3 fatty acids or multivitamin and mineral supplements for reducing dementia risk when there is no diagnosis of deficiency. There is not enough evidence of their benefits to outweigh potential harms, the organisation says.
That is not to say supplements are never appropriate. Someone with a diagnosed nutritional deficiency may need supplementation, but this should be based on medical advice rather than the belief that supplements can prevent Alzheimer's disease.
Dementia risk starts across the life course.
One of the most important lessons from current research is that dementia risk does not suddenly appear old.
Risk factors can accumulate throughout life. Previous Lancet Commission research indicated that many factors have been associated with different stages of life, including early life education, blood pressure, obesity, hearing loss, head injury and alcohol consumption in midlife, smoking, physical inactivity, diabetes, depression, social isolation and air pollution later in life.
That’s never too early to think about brain health, and also not too late to make healthier changes.
Most importantly, risk reduction should not be a source of blame. People can follow a healthy lifestyle and still develop dementia, while some individuals may have risk factors they cannot control.
The goal is not to ensure that dementia will never happen. It is to improve the odds of good physical and cognitive health for as long as possible.
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