How to reduce your dementia risk, and what causes dementia in the first place.
There is no guaranteed way to prevent dementia. There is, however, much more you can do for your brain health than most people realize. The useful question is not how to optimize every risk factor. It is which ones matter most for you.
Alzheimer's, vascular dementia, Lewy body dementia, and frontotemporal dementia have different biology, but many factors associated with long-term brain health overlap. Hearing, cholesterol, blood pressure, blood sugar, physical activity, smoking, mood, vision, and social connection are among the areas with the strongest evidence. BetterBrain helps you measure the parts that can be measured, understand the rest, and turn a long prevention list into a personal plan.
What causes dementia?
Dementia is not one disease. It is a syndrome, meaning memory or thinking decline severe enough to interfere with daily life, and several diseases can cause it.
Alzheimer's is the most common. Vascular dementia results from damage to the brain's blood supply. Lewy body and frontotemporal dementia have different underlying biology. Mixed pathology is also common.
For prevention, the overlap matters. The brain depends on healthy blood vessels, stable metabolic function, movement, sleep, sensory input, nutrition, and social connection. Many of the same factors that influence heart and whole-body health also influence how the brain ages.
What does “nearly half of dementia cases” actually mean?
The 2024 Lancet Commission identified 14 modifiable risk factors associated with dementia and estimated that addressing them could potentially prevent or delay around 45% of dementia cases at the population level.
That does not mean any one person can lower their risk by exactly 45%. It means dementia is not driven only by age or genes. A meaningful share of population risk is connected to factors that can be changed, treated, or managed.
Which dementia risk factors should you work on first?
Hearing. If hearing loss is present, treat it.
LDL and ApoB. Know your numbers and work with your clinician if they are elevated.
Blood pressure. One of the clearest vascular factors and one of the easiest to measure.
Blood sugar and metabolic health. Diabetes is a recognized dementia risk factor. Fasting insulin can reveal metabolic dysfunction before diabetes develops.
Physical activity. Exercise supports cardiovascular fitness, glucose regulation, blood pressure, muscle, mood, and cognition at once.
Smoking and excess alcohol. Both are modifiable risk factors with effects far beyond the brain.
When BetterBrain looked across its coaching action plans, five recommendations appeared especially often: strength training, omega-3 intake, aerobic exercise, B vitamins, and adequate protein.
That does not mean those are automatically your top five. Someone with insulin resistance may need to focus on metabolic health first. Someone with high ApoB may have a more urgent vascular priority. Someone with low B12, untreated hearing loss, or severe sleep problems has a different starting point.
The list is general. The ranking is personal.Read the five recommendations and the evidence behind them.
The markers behind the list
ApoB and LDL. These help show atherosclerotic risk.
HbA1c and fasting insulin. These give you different views of blood sugar regulation.
hs-CRP. A marker that can add context around systemic inflammation.
Homocysteine, B12, folate, and other nutritional markers. These may identify correctable issues that matter for neurological health.
No one number is a dementia test. Together, they help show which systems are worth your attention.
BetterBrain has mapped roughly 1,500 studies to the biomarkers and techniques inside the app. “Science-backed” should mean more than a phrase on a landing page. When your plan includes strength training, a sleep technique, nutrition changes, or a biomarker target, you can see the research used to support it. See how BetterBrain shows the studies behind each recommendation.
Why coaching matters
Knowing that exercise, sleep, cholesterol, or blood sugar matters is not the hard part. Doing something consistently enough to change it is.
That is where BetterBrain Coaching fits. Your coach helps translate the research into real life, work through what is getting in the way, and adjust the plan as habits, goals, and biology change.
For some people the first priority is medication follow-up with a PCP. For someone else it is finally treating sleep apnea. Someone else may need to start strength training, get their hearing checked, improve insulin resistance, or correct a nutrient deficiency.
The intervention matters.
So does actually doing it.
Common questions
Can dementia be prevented?
Not with certainty. But many important risk factors are modifiable, and addressing them is associated with lower dementia risk at the population level.
What is the number one cause of dementia?
Alzheimer's disease is the most common cause. Among modifiable risk factors, hearing loss is one of the largest contributors in the 2024 Lancet analysis.
Do statins cause dementia?
Current evidence does not support that conclusion. If you take a statin, do not stop it because of a blog post. Discuss questions with your clinician.
At what age should I start thinking about dementia prevention?
Midlife is particularly important because vascular and metabolic risk accumulates over decades. But starting later still matters.
You do not need to control every risk factor. You need to know which ones are yours to work on.
Brain health is not completely out of your hands. At every age, there are factors you can understand, habits you can improve, conditions you can treat, and decisions you can make with better information.