In some Greek islands, such as Ikaria, people age remarkably well. Cognitive decline is rare. Dementia rates are one-fifth of those in the rest of Europe.
Their example suggests that cognitive decline is not inevitable and that lifestyle and health choices can significantly influence how our brains age.
The good news is that at least 45% of all dementia cases worldwide are preventable by addressing modifiable risk factors, according to research published in The Lancet.
While there are no guarantees, there are many things that we can do to reduce the chances of developing dementia. These can be grouped into
4 categories:
Optimize medical conditions which increase the risk of dementia
Several common medical conditions significantly increase dementia risk.
- High blood pressure during midlife increases risk by damaging the brain's 400 miles of blood vessels.
- High cholesterol forms plaques in cerebral arteries that narrow the brain's blood supply.
- Depression elevates dementia risk, creating a social withdrawal spiral that compounds cognitive decline.
- Type 2 diabetics have a 60-70% higher dementia risk.
- Hearing loss stands as one of the largest modifiable risk factors. Mild hearing loss doubles dementia risk.
- Visual impairment: Also associated with increased risk.
Managing these conditions, especially in midlife, has substantial long-term impact.
Lifestyle changes that protect the brain
Small, consistent habits make a measurable difference.
Exercise: Just 150 minutes of moderate activity per week significantly lowers the risk of dementia. Social connection is equally crucial: Isolation increases dementia risk as every conversation provides a full-brain workout.
Mental stimulation: Learning new skills builds cognitive reserve, literally buying time before dementia symptoms appear. Speaking another language delays dementia onset by 4-5 years through constant mental juggling. Quality sleep, reducing stress, stopping smoking and avoiding excess alcohol are also essential.
The Mediterranean diet
The Mediterranean diet has been supported by strong science for decades.
It emphasizes: Whole grains, legumes, nuts, herbs, spices, fruits, vegetables, and olive oil daily.
Also fish rich in omega-3 regularly, small amounts of eggs and dairy and very little red or processed meat. This approach is high in fiber, minimally processed, and rich in unsaturated fats, the opposite of many Western diets.
Coffee and tea consumption also have protective effects, likely due to caffeine and high antioxidant content.
Targeted
When dietary intake is insufficient, supplements may help:
- Omega-3 is important, in our diet, or alternatively as a supplement.
- Vitamin D and some vitamin B’s can be protective.
A quality multi-vitamin is the easiest way to achieve this. Supplements should complement-not replace a healthy diet.
The highest-impact actions
It feels like a lot of information and things to do!
The highest impact changes are:
- Controlling blood pressure
- Getting hearing aids if needed
- Doing 150 minutes of weekly exercise
- Nurturing social connections
Adopting a Mediterranean diet and supplementing omega-3 fatty acids, vitamin B’s and vitamin D
Reference
Livingston, G et al (2024). Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet, 404(10452), 572–628. https://doi.org/10.1016/s0140-6736(24)01296-0