This article was originally published in February 2023 and was updated August 7, 2024 to reflect the 2024 Lancet Commission report, which adds vision loss and LDL cholesterol as risk factors.

Dementia affects millions of Americans — including nearly one in 10 adults over age 65. While the causes of different dementias vary, a 2024 report from a Lancet Commission identified several modifiable risk factors that together account for around 40% of dementia worldwide. It's the first update on the issue since the 2020 Lancet Commission on the same topic.

This means that many dementia cases might be prevented or delayed by living a healthy lifestyle, said Judith Heidebrink, M.D., a neurologist at University of Michigan Health and co-leader of the Michigan Alzheimer’s Disease Research Center’s Clinical Core.

With the Lancet report as an anchor, here are some tips for how you can reduce your risk for dementia and maintain a healthy brain throughout your life. Keep reading for comments from Heidebrink, fellow neurologist and center director Henry Paulson, M.D., and two U-M experts whose research is cited in the new report: ophthalmologist Joshua Ehrlich, M.D., M.P.H., and general internist Ken Langa, M.D., Ph.D.

1. Keep an eye on your blood pressure                                          

Heidebrink: Aim for a systolic blood pressure of 130 mm Hg or lower in midlife (from around age 40). Research has shown that better control of blood pressure during midlife not only reduces the risk of cognitive impairment and dementia but also of heart attack and stroke.

2. Protect your hearing

Paulson: Be sure to wear ear protection when you’re around excessive noise exposure to reduce your risk of hearing loss. Also, use hearing aids when needed. 

Langa: It's exciting to see that the new Lancet Commission report cites work by a U-M team, led by Elham Mahmoudi, Ph.D., that found that older adults who get a hearing aid for newly diagnosed hearing loss have a lower risk of dementia in the following three years. 

3. Support efforts to reduce air pollution

Heidebrink: There is growing evidence linking air pollution, such as the gases and small particles emitted by cars and factories, to cognitive decline and dementia. Encouragingly, sustained improvements in air quality appear to reduce the risk of dementia.

4. Prevent head injury

Paulson: Physical damage to the brain, including traumatic brain injury, can disrupt normal brain function. Be sure to wear proper protective equipment when playing contact sports or riding a bike, wear a seat belt in cars and see a physician right away if you have concerns about a concussion or TBI.

5. Limit alcohol use and avoid smoking

Heidebrink: It has long been known that alcohol misuse is associated with damage to the brain and an increased risk of dementia. Limiting alcohol consumption to 1 drink per day appears safest. Smoking tobacco also increases the risk of dementia. Stopping smoking, even later in life, can help reduce the risk.

6. Stay cognitively engaged

Paulson: People with more years of formal education are at lower risk of dementia than those with fewer years of formal education. This is because keeping your brain cognitively engaged, helps maintain your brain health. Staying cognitively engaged can mean taking a class at a local college or online, or challenging your mind with puzzles, games or a new hobby. Socializing with others also engages your brain, so keeping up with friends and family is helpful.

7. Follow a heart healthy diet and maintain regular exercise throughout life

Paulson: A good rule of thumb is, “If it’s good for your heart, it’s also good for your brain.” Eating a well-rounded diet full of fruits, vegetables, and healthy fats (such as the Mediterranean diet) can help maintain a healthy weight and mitigate the risk of obesity, high blood pressure, high cholesterol and diabetes, which are known to contribute to dementia in later life. 

Note: The new Lancet Commission report specifically adds LDL cholesterol levels as a key risk factor for dementia, based on recent evidence.

SEE ALSO: What's The Difference Between Dementia & Alzheimer’s Disease (uofmhealth.org)

Maintaining a regular exercise routine — 150 minutes of moderate to intense physical activity throughout your week — helps to maintain good cardiovascular health to ward off dementia.

People often forget how important simple aerobic exercise is for the brain. A brisk walk, or a stint on a stationary bike, three times a week helps your brain work better. And it’s good for your body, too.

8. Maintain healthy sleep patterns

Heidebrink: Sleep benefits the mind in many ways. It gives the brain a chance to lock in memories and enhances the ability to learn new skills. Current research suggests that sleep disturbances like sleep apnea may be linked to a greater risk of developing dementia. Getting enough quality sleep could help reduce your risk.

SEE ALSO: Is everything you know about Alzheimer's wrong? (uofmhealth.org)

9. Stay socially engaged

Paulson: Studies suggest that remaining socially active throughout life may support brain health and possibly reduce the risk of dementia. Schedule regular social outings to stay socially connected with friends and family, or choose a social activity that is meaningful to you, such as volunteering or participating in community groups.

10. Take care of your mental health

Heidebrink: Some studies have linked a history of depression to dementia in later life. Maintaining social activities and hobbies can help ward off depression, and physical activity can help reduce stress. If you experience signs of depression, anxiety, or another mental health concern, be sure to discuss these with your health care provider.  

11. Get your vision checked and corrected if needed

Ehrlich: Growing research, including some here at Michigan, has shown the important influence of vision loss on late-life cognitive health and dementia. The inclusion of vision loss in the Lancet Commission's model is likely to bring greater attention to this important and highly modifiable dementia risk factor.  

In our team's research, dementia risk was higher even when someone had poor vision while wearing their current glasses or contact lenses. So not only is it important to get your vision checked regularly and invest in glasses or contacts if you need them, it's also important to get new lenses if your prescription changes. And if your eye exam suggests a need for surgery, such as for cataracts, or other follow-up, be sure to make an appointment to get the care that you need.

The bottom line

"As the new Lancet Commission report states, it's very optimistic news that the risk of dementia can be significantly reduced when individuals focus on a living a healthy lifestyle," Langa said.

"All the preventive lifestyle interventions identified in the new report are attractive because they are low-cost, don’t have negative side-effects and have wide-ranging positive effects on healthy quality of life."

He adds, "That makes them quite different than new medications for Alzheimer’s disease which are quite costly and come with rare but dangerous side effects."

It's important to note that many dementia risk factors disproportionately affect minority ethnic groups.

“In addition to taking steps as individuals to decrease our own dementia risk, we should take steps as a society to ensure that everyone has equitable access to an environment and resources that promote brain health,” Heidebrink said.

For more information about dementia, including Alzheimer’s disease, Lewy body dementia, vascular dementia, frontotemporal dementia and more, visit the Michigan Alzheimer’s Disease Center website.

Many research studies are also available to contribute to our understanding of dementia, including studies that further investigate dementia in at-risk populations. If you are interested in joining a research study, please contact the Michigan Alzheimer’s Disease Center at 734-936-8332 for a full list of recruiting studies.