More than heart disease or cancer, the risk of dementia often creates much greater anxiety and fear in many of the people I work with.

And given that dementia is now in the top 3 leading causes of death, this is a valid concern .

Can we tilt the odds in our favour to avoid getting dementia early in life, and is it avoidable?

The answer is ‘Yes, we can’, and about 45% of all dementia cases are avoidable¹.

14 Ways To Prevent Dementia.

Recent data suggests that 14 modifiable factors account for 45% of the future risk of dementia.

This means that controlling these risk factors in our favour should significantly reduce the future risk of dementia.

Not all of these factors are created equal, and when you address these risk factors is also relevant.

The 14 Factors Include:

1. Hearing Loss
2. High LDL cholesterol
3. Less Education
4. Traumatic Brain Injury
5. Depression
6. Social Isolation
7. Hypertension
8. Obesity
9. Smoking
10. Excess Alcohol
11. Diabetes
12. Physical Inactivity
13. Air Pollution
14. Visual Los

(Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission)

When You Intervene Matters.

As you can see from the graphic, different risk factors impact the risk of dementia at different times.

Addressing visual loss and social isolation are the key factors later in life while addressing education needs matters more early in life.

Most of the factors that can be addressed are best addressed in midlife, between 18 and 65 years of age, and account for over half of the modifiable risk factors.

The earlier you address these, the better.

I would like to focus on 3 of these factors- Inactivity, Blood Pressure, and Diabetes & Insulin Resistance.

Inactivity.

Physical activity is one of the best predictors of longevity.

But most people have little interest in living longer if they do not have the cognitive capacity to enjoy that extra time.

Fortunately, physical activity is not only likely to increase the odds of you living a longer and healthier life, it is also very likely to reduce your risk of dementia.

There is a linear relationship between fitness and the risk of dementia.

Compared to those who are the least fit, having a high level of fitness decreases your risk of dementia by 33%².

This is encouraging, but this study only followed patients for eight years, which is short in terms of dementia risk follow-up.

How about when you evaluate this question over a 44-year time frame?

The impact becomes even greater³.

Compared to a medium fitness level, those in the lowest fitness category had a 41% increase in risk.

This is significant.

But when you compare the highest fitness group to the medium fitness group, the risk of future dementia decreases by a whopping 78%.

The risk reduction is obviously even greater when comparing the high and low-fitness groups.

So, if living longer, at a higher quality of life with preserved cognitive capacity is a priority, then exercise has to be on your list as a high priority.

High Blood Pressure.

It has been long established that high blood pressure is closely linked to higher rates of dementia.

Persistent systolic blood pressures greater than 140 mmHg during midlife are associated with a doubling in the future risk of dementia⁴.

The question is whether treating high blood pressure lowers the risk of dementia.

The trials to date have not been definitive in answering this question.

What seems clear is that blood pressure lowering with medications when necessary is probably effective at lowering the future risk of dementia, but a far better strategy is paying close attention to lifestyle factors that prevent the appearance of high blood pressure in the first place- healthy diet, plenty of physical activity, quality sleep, and managing stress effectively.

Diabetes & Insulin Resistance.

Type 2 diabetes is when insulin resistance reaches the point where blood sugar levels can no longer be kept in a healthy range.

We need to think of these conditions not as separate entities but as existing along a continuum.

Both of these conditions, however, are preventable with appropriate attention to the standard lifestyle factors of nutrition and exercise.

There is undoubtedly a genetic component to the risk of diabetes, but it can at least be delayed until later in life.

Having diabetes increases the risk of any type of dementia by 73%⁷.

Insulin resistance also increases the risk of dementia, but interestingly, it seems to act as a force multiplier of risk if you are a carrier of the APOE 4 gene variant, which is one of the primary genetic risk factors for late-onset dementia.

As someone who carries a single APOE 4 gene variant this is one factor that I am particularly mindful of.

Those with APOE 4 gene variants have an increased risk of dementia, but in the presence of insulin resistance, that risk is magnified⁸.

The take home message is that you cannot control your genetic make-up but you have got significant control of your blood sugar and levels of insulin resistance, that is largely impacted by lifestyle choices.

Dementia Prevention

While there is no 100% way to avoid dementia, there is a LOT that can be done to avoid an increase in future risk, and most of these approaches rely on paying close attention to the core lifestyle factors of nutrition, exercise, sleep and cognitive well-being, particularly in midlife.

You might have to worry more about correcting visual and hearing loss later in life, but for most people, getting the basics right in midlife will get you most of the way there.

Get Support with the Life! Program

If you want to live a healthier lifestyle and reduce your risk of dementia, the Life! program provides a free government-funded lifestyle management program. It aids with weight loss, healthy eating, increased fitness, stress management, and improved sleep quality. You can be eligible for this government-funded program at no cost!