New research on dementia risk factors is pushing readers to look at everyday habits differently, after the Lancet Commission’s 2024 update identified 14 modifiable behaviors and conditions that could prevent or delay nearly half of all cases worldwide. Two new additions, high LDL cholesterol and vision loss, joined the list this year.
What Are the 14 Dementia Risk Factors Identified by the Lancet Commission?
The 14 dementia risk factors span early life, midlife and late life stages, and addressing them could prevent or delay about 45 percent of dementia cases globally, according to the Lancet Commission’s 2024 update.
The list breaks down by life stage. Early life includes less education, tied to 5 percent of cases. Midlife factors are hearing loss (7 percent), high LDL cholesterol (7 percent), depression (3 percent), traumatic brain injury (3 percent), physical inactivity (2 percent), diabetes (2 percent), smoking (2 percent), hypertension (2 percent), obesity (1 percent) and excessive alcohol (1 percent). Late life factors are social isolation (5 percent), air pollution (3 percent) and vision loss (2 percent).
High LDL cholesterol and vision loss are new additions in 2024, expanding the 2020 list of 12 factors. The Commission, authored by 27 world-leading dementia experts, argues that the earlier these risks are addressed, the greater the benefit.
Which Modifiable Dementia Risk Factors Matter Most for Prevention?
Four factors carry the greatest weight in the modifiable dementia risk category. Hearing impairment and high LDL cholesterol account for 7 percent of cases each, followed by less education in early life and social isolation in later life at 5 percent each, according to the Lancet Commission.
Hearing loss and cholesterol are both midlife concerns that respond to intervention. Using hearing aids appears to reduce the excess risk from hearing loss, and the Commission recommends detecting and treating high LDL cholesterol starting around age 40. Less education in early life reflects the value of cognitively stimulating experiences that build reserve over time, while social isolation in later life points to the protective role of community connection.
Lead author, Professor Gill Livingston of UCL Psychiatry, said timing matters. “It’s never too early or too late to take action, with opportunities to make an impact at any stage of life,” she said.
How to Prevent Alzheimer’s and Dementia Through Lifestyle Changes?
The Commission outlines 13 recommendations for reducing dementia risk that individuals and governments can act on, from making hearing aids accessible to treating depression, preventing head injuries and reducing air pollution exposure.
Priority steps include providing quality education, supporting lifelong cognitive activity, screening and treating vision impairment, managing high blood pressure and diabetes, reducing smoking and harmful alcohol use, preventing obesity through healthy diets and building inclusive communities that reduce isolation. Detecting and treating high LDL cholesterol from around age 40 is a specific midlife priority.
Livingston said lifestyle changes can also delay onset. “Healthy lifestyles that involve regular exercise, not smoking, cognitive activity in midlife (including outside formal education) and avoiding excess alcohol can not only lower dementia risk but may also push back dementia onset. So, if people do develop dementia, they are likely to live less years with it,” she said.
Why Are the 14 Dementia Risk Factors More Urgent Now?
Global dementia cases are projected to nearly triple, from approximately 57 million people in 2019 to 153 million by 2050, driven largely by population aging, according to the Lancet Commission. Worldwide costs associated with dementia already exceed $1 trillion annually.
That trajectory is why the Commission is urging governments and individuals to act across the life course, with a focus on those most vulnerable. Wendy Weidner, Alzheimer’s Disease International’s Director of Research and Publications, said targeted interventions matter most in lower-resourced settings and disadvantaged groups.
“While we have yet to find a cure for dementia, every proactive step in addressing dementia risk can make a world of difference at a personal and societal level, and policymakers have an essential role to play,” Weidner said.
