Protecting Your Brain and Reducing Dementia Risk

Practical ways to support brain health and recognise when changes in memory or thinking need assessment

Dementia is not an inevitable part of ageing.

Age and genetics influence risk, but they are only part of the picture. Brain health is also shaped by blood pressure, cholesterol, diabetes, hearing, vision, physical activity, smoking, alcohol, mood, social connection and other factors across the whole of life.

Current evidence suggests that addressing 14 modifiable risk factors could prevent or delay about 45% of dementia cases worldwide. This does not mean every individual case can be prevented. It means there are meaningful actions that may reduce risk at a population and personal level.

There is no single food, supplement or brain game that guarantees protection. The strongest approach is to look after your heart, body and mind over time.

What is dementia?

Dementia is an umbrella term for a group of conditions that progressively affect brain function.

It may cause changes in:

• Memory
• Language
• Attention
• Planning and organisation
• Judgement
• Behaviour
• Personality
• Ability to perform familiar tasks

Alzheimer’s disease is the most common cause, but dementia can also result from vascular disease, Lewy body disease, frontotemporal degeneration and other conditions.

Dementia becomes more common with age, but it is not a normal or unavoidable consequence of getting older. Younger people can also develop dementia.

Brain health and heart health are closely connected

The brain depends on a healthy supply of blood and oxygen.

High blood pressure, high LDL cholesterol, diabetes, smoking and vascular disease can damage the large and small blood vessels that supply the brain. They also increase the risk of stroke, which may contribute to vascular dementia or worsen other forms of cognitive decline.

Protecting your brain therefore begins with many of the same steps used to protect your heart:

• Check and manage blood pressure
• Check cholesterol
• Assess diabetes risk
• Stop smoking
• Be physically active
• Maintain a weight that is healthy for you
• Take prescribed medicines consistently

High blood pressure during midlife is particularly important. Treating hypertension lowers cardiovascular risk and may also reduce dementia risk.

The 14 modifiable risk factors

The 2024 Lancet Commission identified 14 factors associated with dementia risk that may be modified across the life course:

• Lower-quality education
• Hearing loss
• High LDL cholesterol
• Depression
• Traumatic brain injury
• Physical inactivity
• Diabetes
• Smoking
• High blood pressure
• Overweight or underweight
• Excessive alcohol
• Social isolation
• Air pollution
• Untreated vision loss

You do not need to address all 14 at once.

The most useful starting point is usually the factor that is both relevant to you and realistically changeable.

Be physically active

Regular activity supports blood flow, cardiovascular health, diabetes prevention, mood, sleep and physical function.

People who remain active through adulthood are less likely to develop dementia than people who are consistently inactive. Physical activity may also support memory and thinking by improving blood flow and stimulating processes involved in brain-cell health.

Aim to include:

• Aerobic activity such as brisk walking, swimming or cycling
• Strength exercise at least twice weekly
• Balance and mobility work
• Light movement throughout the day
• Regular breaks from prolonged sitting

Start below the full target when necessary and build gradually.

The best exercise is usually one you can repeat.

Eat for your heart and brain

No specific diet can guarantee that dementia will be prevented.

However, eating patterns similar to the Mediterranean, DASH and MIND diets are associated with better cardiovascular and metabolic health and a lower risk of cognitive decline.

These patterns generally emphasise:

• Vegetables
• Fruit
• Legumes
• Wholegrains
• Fish
• Nuts and seeds
• Olive or other unsaturated oils
• Mostly minimally processed foods

They generally limit:

• Highly processed foods
• Excess saturated fat
• Sugary drinks
• Processed meat
• Excess salt
• Excess alcohol

The benefit is likely to come from the overall pattern rather than one “superfood”.

Look after your hearing

Hearing loss is strongly associated with dementia risk.

Possible reasons include reduced stimulation of the brain, increased effort needed to understand speech, social withdrawal and depression.

Protect your hearing by:

• Limiting exposure to loud noise
• Using hearing protection
• Having hearing assessed when you notice difficulty
• Using recommended hearing devices consistently
• Managing ear disease and wax blockage

There is evidence that treating hearing loss may help reduce cognitive decline in people at increased risk, although research continues.

Do not wait until communication becomes severely impaired before seeking help.

Treat vision problems

Untreated vision loss is also associated with increased dementia risk.

Regular eye examinations can identify cataracts, glaucoma, macular degeneration, diabetic eye disease and incorrect spectacle prescriptions.

Use glasses or contact lenses when needed and arrange prompt assessment for new or worsening visual symptoms. Early treatment supports independence, social participation and safer mobility.

Stay socially connected

Social isolation is a recognised dementia risk factor.

Connection does not have to mean attending large groups or being constantly sociable. Meaningful contact may include:

• Regular time with family or friends
• Walking with another person
• Volunteering
• Community activities
• Clubs or faith groups
• Shared hobbies
• Telephone or video contact
• Supporting or mentoring others

Social activity combines conversation, memory, attention and emotional connection.

Loneliness and isolation also affect mood and physical health, so seeking support matters even when dementia prevention is not the main concern.

Keep learning and challenging your brain

Mental stimulation appears to support cognitive reserve—the brain’s ability to cope with age-related or disease-related changes.

Useful activities may include:

• Learning a language
• Playing music
• Reading
• Studying
• Playing cards or strategy games
• Learning digital skills
• Cooking unfamiliar recipes
• Taking up a new hobby
• Participating in meaningful work or volunteering

Crosswords and puzzles can be enjoyable, but no single brain game has been shown to prevent dementia by itself.

Variety, challenge and social engagement are likely to be more useful than repeatedly performing the same easy activity.

Look after mood and mental health

Depression is associated with increased dementia risk, while dementia itself can also cause mood changes.

Treating depression improves quality of life, sleep, activity and social connection, all of which support brain health.

Speak with your GP if you experience:

• Persistent low mood
• Loss of interest
• Withdrawal
• Poor motivation
• Anxiety
• Sleep disturbance
• Increased alcohol use
• Thoughts of self-harm

Not every concentration or memory problem is dementia. Depression, anxiety, grief, stress and poor sleep can all interfere with thinking.

Prioritise sleep

Sleep supports attention, learning, memory and emotional regulation.

Poor sleep may also worsen blood pressure, diabetes risk, mood and daytime activity.

Seek assessment for:

• Loud habitual snoring
• Witnessed breathing pauses
• Waking gasping
• Morning headaches
• Marked daytime sleepiness
• Persistent insomnia

Obstructive sleep apnoea is treatable and may contribute to both cardiovascular and cognitive risk.

A regular sleep routine, daytime activity, reduced evening alcohol and appropriate treatment of insomnia can all help.

Reduce alcohol

Excessive alcohol can directly damage brain cells and may cause nutritional deficiency, liver disease, falls and head injury.

Australian guidance recommends no more than:

• 10 standard drinks per week
• 4 standard drinks on any one day

Less is safer.

People who drink heavily every day or experience withdrawal symptoms should seek medical advice before stopping suddenly.

Alcohol-related cognitive impairment may improve when drinking stops early enough, but long-term heavy intake can cause permanent damage.

Stop smoking

Smoking increases the risk of stroke, cardiovascular disease, cancer and dementia.

The added dementia risk is lower in former smokers than in people who continue to smoke, which means stopping remains beneficial even later in life.

Evidence-based support may include:

• Nicotine replacement
• Prescription medicines
• Behavioural support
• Quitline on 13 7848
• Follow-up with your GP or pharmacist

Protect your head

Traumatic brain injury and repeated head impacts are associated with increased dementia risk.

Protect yourself by:

• Wearing a helmet when cycling or riding a motorbike
• Using appropriate sports protection
• Wearing a seat belt
• Preventing falls
• Avoiding driving after alcohol or drugs
• Using safe techniques on ladders
• Seeking assessment after significant concussion

Repeated minor head impacts may also matter over time.

Manage diabetes and weight

Diabetes can damage blood vessels and increase inflammation and cardiovascular risk.

Good management includes:

• Monitoring HbA1c where appropriate
• Taking medicines consistently
• Managing blood pressure and cholesterol
• Regular physical activity
• Nutritious eating
• Smoking cessation
• Regular medical review

Weight is only one part of health. Both excess weight and being underweight may be associated with dementia risk at different stages of life.

Focus on sustainable metabolic health, strength and function rather than extreme dieting.

Be cautious about supplements

Many products are marketed as preventing memory loss or Alzheimer’s disease.

These may include:

• Ginkgo biloba
• High-dose vitamins
• Omega-3 supplements
• Herbal blends
• “Nootropics”
• Memory powders or drinks

No supplement has been shown to reliably prevent dementia in the general population.

Supplements may also interact with medicines or provide excessive doses of certain nutrients.

Treat a confirmed deficiency when it exists, but do not assume that taking more vitamins will protect a healthy brain.

What is mild cognitive impairment?

Mild cognitive impairment, or MCI, means thinking or memory changes are greater than expected for age, but the person can generally still manage their usual daily activities.

MCI is not the same as dementia.

Some people remain stable, some improve and some progress to dementia. It therefore deserves assessment and follow-up rather than either panic or dismissal.

Possible causes include:

• Depression
• Sleep disorders
• Medicines
• Alcohol
• Vitamin deficiency
• Thyroid disease
• Stroke
• Head injury
• Neurodegenerative disease

When should memory changes be assessed?

Everyone occasionally forgets a name, misplaces keys or walks into a room and forgets why.

More concerning changes include:

• Repeatedly asking the same question
• Forgetting recent conversations or events
• Getting lost in familiar places
• Difficulty managing bills or medicines
• Trouble completing familiar tasks
• Increasing problems finding words
• Confusion about time
• Poor judgement
• Marked personality or behaviour change
• Progressive withdrawal or loss of initiative

Often, another person notices the change first.

Speak with your GP when symptoms are increasing, recurring or interfering with daily life.

What happens during an assessment?

Your GP may ask about:

• The changes you have noticed
• When they began
• Whether they are worsening
• Daily function
• Mood and sleep
• Alcohol
• Medicines
• Hearing and vision
• Medical and family history

With your permission, information from someone who knows you well can be very useful.

Assessment may include:

• A brief cognitive test
• Physical and neurological examination
• Blood tests
• Medicine review
• Hearing or vision assessment
• Brain imaging in selected cases
• Referral to a geriatrician, neurologist, psychiatrist or memory clinic

A quick online test cannot diagnose dementia.

Seek urgent help for sudden confusion

Dementia usually develops gradually.

Sudden confusion over hours or days may represent delirium, stroke, infection, medicine toxicity, low blood glucose or another medical emergency.

Seek urgent care for:

• Sudden confusion
• New facial weakness
• New weakness or numbness
• Difficulty speaking
• Collapse
• Severe headache
• Seizure
• Major head injury
• Rapidly changing behaviour

Call 000 when symptoms are severe or sudden.

Start with one change

Choose one practical action:

• Check your blood pressure
• Arrange a hearing test
• Walk for ten minutes most days
• Reconnect with someone
• Stop smoking with support
• Reduce alcohol
• Book an eye examination
• Discuss persistent memory concerns with your GP
• Learn something new

Brain health is built through repeated choices, not one dramatic intervention.

The bottom line

Dementia is not an inevitable part of ageing, and there is no single guaranteed prevention strategy.

The strongest evidence supports looking after cardiovascular health, staying physically and socially active, treating hearing and vision loss, managing diabetes and depression, avoiding smoking and excess alcohol, protecting the head and continuing to learn.

These actions may reduce or delay dementia risk while also improving general health and independence.

Do not ignore progressive changes in memory, judgement, language or everyday function. The sooner you know what is happening, the more you can do.