Reducing Dementia Risk: The 14 Risk Factors

The 2024 Lancet Commission says nearly half of dementia cases may be linked to 14 modifiable risk factors. Here's what they are and what you can do.

Last reviewed: October 2026

Age and genes play big roles in dementia, and we can't change them. But a growing body of research shows that many cases are linked to things we can influence. In 2024, the Lancet Commission on dementia prevention—an international panel of experts—concluded that about 45% of dementia cases worldwide may be linked to 14 modifiable risk factors.

That doesn't mean any individual can guarantee they won't get dementia. It means that, across a population, acting on these factors could prevent or delay many cases. And almost all of them are good for your heart, mood and overall health too.

The 14 risk factors

The Commission grouped them across the life course.

Early life

Less education – Education and lifelong learning build "cognitive reserve," helping the brain cope with damage.

Midlife (about ages 45–65)

Hearing loss – One of the largest single factors. Hearing aids appear to reduce the risk. See our hearing guide in this section.
High LDL ("bad") cholesterol – Newly added in 2024.
Depression – Treating depression is important for its own sake and may help the brain.
Traumatic brain injury – Wear helmets and seat belts; prevent falls.
Physical inactivity – Regular exercise is one of the most consistently supported protective factors.
Diabetes – Prevention and good control matter.
Smoking – Quitting at any age helps.
High blood pressure – Aim to keep systolic blood pressure at or below 130 from about age 40.
Obesity – Linked through effects on blood vessels, diabetes and inflammation.
Excessive alcohol – More than about 21 units (roughly 12 U.S. standard drinks) per week raises risk.

Later life

Social isolation – Staying connected is protective.
Air pollution – A population-level factor that policy can address.
Untreated vision loss – Newly added in 2024; cataracts and other causes are often treatable.

What the evidence shows

Most of these links come from large observational studies, which show associations but can't prove cause and effect. Randomized trials are harder, but there is encouraging evidence:

Blood pressure: The SPRINT MIND trial found intensive blood pressure control reduced mild cognitive impairment.
Multidomain lifestyle programs: Finland's FINGER trial found a two-year program combining diet, exercise, brain training and heart-risk management benefited thinking. In 2025, the U.S. POINTER trial of about 2,100 older adults at increased risk found that a structured lifestyle program improved cognition modestly more than a self-guided program—and both groups improved.
Hearing: The ACHIEVE trial found that hearing aids did not slow decline overall over three years, but slowed it by nearly half in a subgroup of people at higher risk.
Rates are falling: In several high-income countries, the age-specific rate of dementia has declined over recent decades, likely partly due to better education and heart health.

What you can do

Move more. Aim for at least 150 minutes a week of moderate activity, such as brisk walking, plus strength exercises. See the exercise guide in this section.
Know your numbers. Check blood pressure, cholesterol and blood sugar, and treat them if they're high.
Protect your hearing and get it tested. Use hearing aids if recommended.
Get your eyes checked and treat cataracts and other problems.
Don't smoke, and limit alcohol.
Eat a brain-healthy diet rich in vegetables, berries, whole grains, nuts, olive oil and fish. See The MIND Diet.
Stay socially connected – family, friends, volunteering, groups.
Keep learning – new skills, languages, music, hobbies.
Sleep well and get checked for sleep apnea. See Sleep and Memory.
Look after your mood – seek help for depression or anxiety.
Protect your head – helmets, seat belts and fall prevention.

It's never too early—or too late

Some factors matter most in midlife, but research suggests benefits at any age. Even people with Mild Cognitive Impairment (MCI) or a dementia diagnosis can benefit from exercise, social connection, hearing aids and good management of blood pressure and diabetes.

A note on blame

Many people who do "everything right" still develop dementia, and many with risk factors never do. Risk reduction is about improving the odds, not about fault. If you're caring for someone with dementia, it is not because of something they or you failed to do.

Sources

Not medical advice. This article is general information, not a diagnosis or treatment plan for any individual. Talk with a doctor about your situation.

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