Summary of the evidence on modifiable risk factors for cognitive decline and dementia: A population-based perspective

Dementia cases

47 million worldwide in 2015; projected to triple by 2050

Main focus

Modifiable risk factors for cognitive decline and dementia

Key conclusion

Physical activity and cardiovascular risk management reduce cognitive decline risk

Other benefits

Healthy diet and lifelong learning may reduce cognitive decline risk

Diabetes

Increases risk of cognitive decline and dementia; especially with MCI

Obesity

Mid-life obesity increases dementia risk; late-life obesity may reduce risk

Hypertension

Mid-life high blood pressure linked to decline; late-life may be protective

Cholesterol

Mixed results; statins show no consistent dementia risk reduction

Smoking

Increases risk; quitting reduces risk to nonsmoker levels

Exercise

Regular physical activity lowers risk; must be consistent and somewhat vigorous

Diet

Mediterranean/MIND diet linked to reduced dementia risk

Alcohol

Light/moderate intake may lower risk; heavy use harmful

Cognitive training

Improves recall, but unclear if directly protective

Social engagement

May help, but evidence mixed and inconclusive

Education

More years of schooling lowers dementia risk

TBI

Moderate/severe head injuries increase dementia risk

Depression

History linked with higher dementia risk; may also be early symptom

Sleep

Disturbances increase risk; CPAP treatment may help reduce risk

FINGER trial

Lifestyle interventions (exercise, diet, training, social activity, cardiovascular management) improved cognition

Best strategy

Address multiple risk factors simultaneously for maximum effect

Key message

Healthy lifestyle factors for diabetes, cancer, heart disease also protect brain health

Policy

Governments urged to include dementia risk reduction in health strategies