Modifiable risk factors for dementia (And what you can do about them)
Dementia risk begins decades before symptoms appear. The upside? Nearly half of all dementia cases might be prevented or delayed — by focusing on modifiable risk factors.
According to the 2024 Lancet Commission on Dementia Prevention, Intervention, and Care, up to 48% of dementia cases may be linked to key risk factors — many of which you can influence.
The report emphasises that dementia risk builds across the lifespan — and so does cognitive and physical reserve. Cognitive reserve is your brain’s ability to adapt and cope with damage. Physical reserve helps you bounce back after stress, illness, or injury — and continue functioning well as you age. It’s never too early or too late to make lifestyle changes, such as:
Staying cognitively, physically, and social active
Managing your vascular health
Finding your tribe and building belonging
Staying curious and engaging in lifelong learning
However, prevention isn’t just about information — it’s about change. Many of us already know what supports future brain health. So why can’t we get started or stick with it? Thought traps like “I’ll start tomorrow,” unhelpful patterns, self-doubt, apathy, and feeling overwhelmed by other commitments can get in the way.
That’s where we come in. We’re here to support your efforts to start — and keep going — with healthy lifestyle changes that promote longevity. Let’s walk through key lifestyle risk factors based on the 2024 Lancet Commission and related studies.
1. Missing out on opportunities for education
Missing out on education, complex work, or mentally stimulating activities reduces cognitive reserve — your brain’s ability to adapt and cope with damage.
What helps:
Mentally challenging activities — complex hobbies or work, reading, puzzles, writing letters or diaries, creative arts, higher education — especially in midlife
Staying curious and keeping on learning
Ask: “What am I a newbie at right now?”
2. Depression
Depression, especially in midlife, is a known risk factor for dementia. It may also be an early symptom or a response to cognitive decline.
What helps:
Talk to your GP about a Mental Health Treatment Plan
Engage with a clinical psychologist using evidence-based therapies
Regular physical exercise supports mood and brain health
3. Social isolation and loneliness
Lacking meaningful, supportive relationships increases dementia risk, especially in older adults who live alone or feel disconnected.
What helps:
Build a diverse social network across all ages
Focus on quality over quantity in relationships
Join purpose-driven groups, clubs, or communities
Reconnect with supportive family and friends
4. Physical Inactivity
Heart and brain health are closely linked. Inactivity lowers not only cognitive reserve, but also physical reserve – your body’s ability to recover and stay strong with age.
What helps:
Aim for 150+ minutes of moderate activity weekly
Mix cardio, strength, balance, and flexibility
Movement doesn’t have to be a formal activity — weave it into your daily routine
Choose activities that feel meaningful
5. Obesity, high blood pressure, high cholesterol, and diabetes
These conditions are linked to poor vascular health — a key factor for dementia.
What helps:
Follow a Mediterranean-style diet (high fibre, omega-3s, whole grains, greens)
Maintain a healthy BMI (18–25)
See your GP for regular health checks
Combine lifestyle change with medical and psychological support
6. Excessive alcohol use
Alcohol damages brain structure and increases inflammation. Binge drinking in midlife is particularly harmful.
What helps:
Avoid binge drinking
Drink moderately — or not at all.
Choose alcohol-free days or ‘Dry July’
Understand your triggers for drinking
Consider therapy to shift unhelpful patterns of behaviour
7. Smoking
Smoking damages blood vessels and increases inflammation, raising dementia risk.
What helps:
Quit smoking with support — especially as you approach midlife
Avoid second-hand smoke exposure
8. Head injuries
Traumatic brain injury (TBI) from hits or jolts to the head — especially moderate to severe or repeated injuries — increases dementia risk and contribute to earlier onset.
What helps:
Wear helmets during risky activities and contact sports
Avoid repeated head injuries
Seek medical care after a concussion
9. Air Pollution
Air pollution, especially fine particles, is linked to brain inflammation and cognitive decline.
What helps:
Avoid outdoor exercise in high-pollution areas
Stay indoors on days with poor air quality (urban smog or bushfire smoke)
Use air filters at home if needed
10. Untreated hearing loss
Hearing loss reduces brain stimulation and can lead to isolation and cognitive decline.
What helps:
Regular hearing checks from age 50
Address any shame or stigma about hearing aids
11. Untreated vision loss
Poor vision, if uncorrected, contributes to cognitive decline through reduced sensory input and engagement.
What helps:
Have regular eye exams
Keep your glasses prescription up to date
Treat cataracts and age-related vision changes early
Lifestyle matters — how many protective factors do you have?
In a landmark 30-year UK study, people aged 45–59 who adopted four or more healthy habits reduced their risk of dementia by up to 60% (Elwood et al., 2013).
The protective habits included:
Daily physical activity — e.g., walking 3 km or cycling 15 km
A healthy, brain-friendly diet — low in saturated fat, with 3+ servings of fruit and veg daily
Maintaining a healthy BMI (between 18–25)
Reducing alcohol intake
Not smoking
While no lifestyle change guarantees prevention — because some links are only partly causal — the science is increasingly clear: healthy habits lower your risk of developing dementia. Recent studies indicate that means more years of good health, and less time in poor health if dementia does develop.
“Prevention approaches should aim to decrease risk factor levels early (the earlier, the better) and keep them low throughout life (the longer, the better)” — Livingston et al., 2024, p 572.
Ready to take action — without feeling overwhelmed?
If you’re feeling stuck between knowing what supports brain health and actually doing it, we’re here to help you turn good intentions into action — with tailored support that fits your everyday life.
Upside Stories offers online therapy and structured 10-week programs like Healthy Brain, Happy Heart, designed for midlife and beyond.
Let’s rewrite limiting stories — one healthy habit at a time.
References
Elwood, P., Galante, J., Pickering, J., Palmer, S., Bayer, A., Ben-Shlomo, Y., … Gallacher J. (2013). Healthy Lifestyles Reduce the Incidence of Chronic Diseases and Dementia: Evidence from the Caerphilly Cohort Study. PLoS ONE, 8(12), e81877. https://doi.org/10.1371/journal.pone.0081877
Livingston, G. et al. (2024). Lancet Commission on Dementia Prevention, Intervention, and Care, 404(10452), 572–628. https://doi.org/10.1016/S0140-6736(24)01296-0