Nearly 10 million people develop dementia each year, and more than 57 million people worldwide are currently living with dementia. Alzheimer’s disease is the most common form of dementia, accounting for an estimated 60–70% of cases. In the United States, Alzheimer’s disease was the sixth-leading cause of death in 2024.
But there is also encouraging news.
The World Health Organization (WHO) estimates that up to 45% of dementia risk is associated with potentially modifiable risk factors — meaning there are things we can do throughout our lives that may help reduce or delay our risk of cognitive decline and dementia.
That makes brain health an important part of any long-term health optimization strategy.
Changes associated with dementia can begin in the brain years before obvious symptoms appear. Historically, dementia prevention was often discussed only after cognitive symptoms emerged. Today, however, advances in cognitive testing, blood-based biomarkers and brain imaging are giving clinicians more opportunities to identify risk earlier.
And this is important because dementia isn’t one single disease with one single pathway.
Dementia Prevention Is Personal
What I find most fascinating about dementia is how unique each case can be. There are many roads that can lead to cognitive decline and dementia — which is also what makes prevention complicated.
You have to understand which risk factors are most relevant to you before you can meaningfully address them.
That’s why I believe the best approach to dementia prevention is holistic and personalized. Rather than focusing on one supplement, one lab value or one lifestyle change, we should look at the entire picture: cardiovascular health, metabolic health, physical activity, nutrition, cognitive stimulation, social connection, hearing, vision and environmental exposures.
I reviewed the current WHO guidance on dementia risk reduction to create a practical game plan for protecting brain health for decades to come.
What Protects Your Heart Also Protects Your Brain
One of the most important connections in brain health is the relationship between cardiovascular health and cognitive health.
Your blood vessels supply the brain with the oxygen and nutrients it needs while helping remove metabolic waste. When vascular health deteriorates, the brain can be affected as well.
High blood sugar, insulin resistance and excess ApoB-containing cholesterol particles can contribute to vascular disease. High blood pressure places chronic stress on blood vessel walls. Excess body fat, particularly visceral fat around the midsection, is associated with inflammatory and metabolic changes that can affect overall health.
The WHO specifically recommends managing conditions such as hypertension, diabetes and high cholesterol as part of dementia risk reduction.
The earlier you identify and address these risk factors, the more opportunity you may have to influence your long-term health.
My advice:
- Get appropriate cardiovascular and metabolic labs early and monitor them over time.
- Discuss ApoB, LDL-C, glucose, A1c and other relevant markers with your healthcare provider.
- Monitor blood pressure regularly.
- Pay attention to body composition and visceral fat rather than focusing exclusively on scale weight.
- Work with your physician to establish personalized targets based on your individual risk profile.
Keep Your Brain Connected, Challenged and Engaged
The brain thrives on stimulation.
Cognitive activity, learning and social engagement can all contribute to maintaining cognitive health. WHO’s updated recommendations include cognitive stimulation and engagement in social activities for adults with normal cognition or mild cognitive impairment.
One transition that deserves more attention is retirement.
Work provides an enormous amount of cognitive stimulation: interacting with colleagues, solving problems, managing relationships, learning new information and making decisions. When that stimulation suddenly disappears, it’s important to replace it with activities that challenge the brain.
Social connection matters, too.
Conversation requires us to listen, interpret language, formulate responses, read facial expressions and body language, and retrieve information from memory. Maintaining relationships can therefore provide meaningful cognitive stimulation while also supporting overall well-being.
Hearing and vision are part of this equation. When hearing or vision deteriorates, people may gradually withdraw from conversations and social situations. WHO specifically includes hearing support, including hearing aids when needed, among its dementia risk-reduction recommendations.
My advice:
- Maintain a regular social network, even if it is small.
- Have your hearing and vision checked regularly.
- Use glasses or hearing aids when appropriate.
- Find hobbies that require problem-solving or learning.
- Volunteer or participate in activities with other people.
- Learn something new — a musical instrument, language, craft or skill.
- Tell stories to your kids and grandkids. They may roll their eyes, but your brain loves it.
Exercise Is One of the Best Things You Can Do for Brain Health
Your brain is remarkably responsive to what’s happening throughout the rest of your body.
That’s why physical activity is such an important part of dementia prevention.
The WHO recommends increasing physical activity as part of dementia risk reduction. Physical activity also supports cardiovascular and metabolic health, which are themselves connected to cognitive health.
And you don’t have to find one magical form of exercise.
Walking, resistance training, running, yoga, Pilates, swimming, cycling and other forms of movement can all be part of an active lifestyle. The key is consistency.
My advice:
- Aim for at least 150 minutes of moderate physical activity each week.
- Include strength training at least twice per week.
- Include some higher-intensity activity if it is appropriate for your fitness level and health status.
- Find activities you enjoy enough to do consistently.
- Don’t underestimate walking and everyday movement.
Build a Brain-Healthy Diet
Nutrition is one area where the internet can make things unnecessarily complicated.
For brain health, I think we can agree on some foundational principles.
Focus on:
- Whole and minimally processed foods
- Plenty of vegetables and fruits
- High-fiber foods
- Adequate protein
- Plant-based proteins and lean animal proteins
- Healthy sources of dietary fat
- Limiting sugar-sweetened beverages and highly processed foods
Fiber is particularly worth emphasizing. Aim for a diet rich in vegetables, fruits, legumes, whole grains, nuts and seeds to help increase your overall fiber intake.
And don’t get distracted by every new “brain health” supplement that hits the market. The updated WHO guidelines specifically state that vitamin B and E supplements, omega-3 supplements and multivitamins/minerals should not be routinely used to reduce cognitive decline or dementia risk in people without a diagnosed deficiency because evidence of benefit is insufficient.
In other words: start with the fundamentals.
Avoid Tobacco and Limit Alcohol
Some exposures are simply not doing your brain any favors.
Tobacco use is an established modifiable risk factor, and WHO recommends tobacco cessation as part of dementia risk reduction. Harmful alcohol use is also associated with dementia risk, which is why WHO recommends reducing alcohol consumption.
I don’t consider alcohol a “healthy” substance.
At the same time, social connection matters for brain health, so context can be complicated. If meeting friends for dinner or at a brewery is an important part of your social life, the social engagement itself may be beneficial even though alcohol isn’t.
The important point is not to use the potential social benefits of drinking as a reason to drink more.
My advice:
- Don’t use tobacco products.
- Keep alcohol consumption low.
- Prioritize social connection that doesn’t depend on alcohol.
- If you drink, discuss your individual risk with your healthcare provider.
Pay Attention to Air Quality
Here’s one area of brain health that deserves much more attention: air pollution.
The WHO’s updated 2026 dementia guidelines added reducing exposure to air pollution as part of its recommendations for dementia risk reduction.
Particulate matter, particularly fine particulate matter known as PM2.5, is an important environmental exposure to understand.
This is especially relevant when thinking about your overall environment — not just what you’re eating and how much you’re exercising.
I’ll dive deeper into air quality and brain health in a separate article.
Don’t Wait for Symptoms to Start Thinking About Brain Health
Perhaps the most important takeaway is that brain health isn’t something you start worrying about when you develop memory problems.
It’s something you build throughout your life.
The current WHO guidelines take a life-course approach to dementia risk reduction, emphasizing healthy behaviors, management of medical conditions, cognitive and social engagement, and reducing environmental exposures.
And this is where personalized healthcare can be particularly valuable.
At Authentic Health in Asheville, NC, we look at health through a comprehensive lens rather than treating individual numbers or symptoms in isolation. Understanding your cardiovascular, metabolic and lifestyle risk factors can help you have a more informed conversation with your healthcare team about your long-term brain health.
You don’t need to overhaul your entire life tomorrow.
Start with the fundamentals.
Move your body. Eat well. Know your numbers. Maintain your relationships. Challenge your brain. Protect your hearing. Don’t smoke. Limit alcohol. Pay attention to your environment.
You have more opportunities to influence your brain health than you may realize — and there’s no reason to wait until something feels wrong to start.