14 Dementia Risk Factors You Can Actually Change

In This Series: Healthy Ageing & Everyday Myths

The Wrong Cuff Turns 125 Into 144. Most People Have Never Had This Measured Properly.
Every 3 Decibels Halves the Time. That Is the Whole Rule, and Almost Nobody Knows It.
Sleep Regularity Beat Sleep Duration: What the Mortality Data Shows
Sitting Is Not the New Smoking. The Standing Desk Did Not Help Either.
Falls at Home: The Fixes With Evidence, and the One That Was Withdrawn
Loneliness Raises the Risk of Dying by Fourteen Per Cent. The Fifteen-Cigarettes Line Came From Somewhere Else.

Disclosure: this article contains affiliate links, marked (paid link). If you buy through one we may earn a commission, at no extra cost to you. As an Amazon Associate I earn from qualifying purchases. It costs you nothing and it does not change what we recommend.

Key takeaways · 7 min read

The 2024 Lancet Commission identified 14 modifiable risk factors covering an estimated 45% of dementia cases at population level.
Two were newly added: high midlife LDL cholesterol (7%) and untreated vision loss in later life (2%).
Hearing loss remains one of the largest single contributors.
Many of the fourteen are cardiovascular. What protects the heart protects the brain.

In this article

The fourteen, by life stage
Hearing and vision are the surprising ones
What 45% does and does not mean
Questions people ask
The short version
Sources

Dementia is widely understood as something that happens to you — genetic, unlucky, unavoidable. The 2024 Lancet Commission put a number against that assumption. Around 45% of dementia cases could potentially be prevented by addressing fourteen risk factors, none of which is a drug.

That is a population figure, not a personal guarantee, and the distinction matters. But two of the fourteen are things most people would never connect to their brain at all, and one of them is treated in an afternoon.

A field at dusk with a hedgerow, two dark trees and an empty bench beside a path. — The world keeps talking. Some of it stops arriving.

The fourteen, by life stage

What the Commission identified

Grouped by when in life the exposure matters most. Two were added in the 2024 update.

Life stage	Risk factors
Early life	Less education
Midlife	Hearing loss, high LDL cholesterol (new), depression, traumatic brain injury, physical inactivity, diabetes, smoking, hypertension, obesity, excessive alcohol
Later life	Social isolation, air pollution, untreated vision loss (new)

Note how many are cardiovascular. The blood supply to the brain turns out to be much of the story — which is why the things that protect your heart keep reappearing here.

Source: Livingston G, et al. “Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission.” The Lancet, 2024.

The two additions, and what they carry

Share of dementia cases attributable to each, at population level.

7%high LDL cholesterol in midlife — from cohort evidence covering over a million participants

2%untreated vision loss in later life — supported by two large meta-analyses

Seven per cent from a single blood measurement most people over 45 have already had taken. Two per cent from a condition that is frequently corrected with glasses or a routine cataract operation.

Source: 2024 Lancet Commission on dementia prevention, intervention and care.

Hearing and vision are the surprising ones

A dim room with a tall bright window and a dark armchair standing in the light on the floor. — A chair, a window, and whatever is left of the afternoon.

Hearing loss has been on this list for years and remains among the largest single contributors. Vision loss joined it in 2024. Both are sensory, both are ordinary, and both are usually treated as quality-of-life issues rather than brain-health ones.

The proposed mechanisms are plausible and not fully settled: a degraded signal makes the brain work harder to interpret it, sensory loss withdraws people from conversation and social contact, and less stimulation may accelerate decline. Causation is not established — early dementia can also cause someone to stop engaging, which looks like sensory withdrawal.

But the practical position is unusually comfortable. Treating hearing and vision loss is worth doing on its own merits, carries almost no downside, and may carry this benefit as well. That is a rare shape for a health decision.

Things worth booking, not buying

Each of these is a specific appointment that maps onto a factor above.

HEARING TESTAmong the largest contributors on the list. If you turn the television up more than you used to, or struggle in restaurants, that is the threshold — not deafness.

EYE TESTUncorrected vision, cataracts and untreated glaucoma. Cataract surgery in particular is common, quick and highly effective.

BLOOD PRESSURE AND CHOLESTEROLTwo of the fourteen, both measured in the same ten-minute appointment, both treatable.

DIABETES CHECKAnother entry on the list, and frequently undiagnosed for years before it is found.

DEPRESSION, HONESTLY DISCUSSEDOn the list, and treatable. Also the factor most likely to be left out of a conversation with a doctor.

HELMETS, GENUINELYTraumatic brain injury is on the list. Cycling and skiing helmets are the everyday version of this one.

Source: 2024 Lancet Commission risk factor list.

What 45% does and does not mean

This number is quoted constantly and misunderstood almost as often, so it is worth being precise.

Reading the figure honestly

Both columns are true at once.

What it isA population estimateIf these fourteen exposures were eliminated across a whole population, models suggest up to 45% of cases might not occur. It reframes dementia as partly preventable rather than purely fated.

What it is notA personal guaranteeIt does not mean any individual can cut their own risk by 45%. Most of the underlying evidence is observational, the factors overlap heavily, and eliminating them entirely is not achievable for anyone.

Nor does it mean the other 55% is your fault for existing. Age and genetics remain the dominant risk factors, and a great deal of dementia occurs in people who did everything on this list.

Source: 2024 Lancet Commission, population attributable fraction methodology.

We make the same point about the modelled figures in our articles on gas stoves and falls, and it applies here with particular force, because dementia attracts more supplement marketing than almost any other condition. A population attributable fraction is a policy tool. It tells governments where to spend. It does not license anyone to sell you a 45% reduction in a bottle.

The small amount that is worth buying (paid link)

Nearly everything on the Commission’s list is an appointment rather than a purchase. These two map onto actual factors.

HOME BLOOD PRESSURE MONITORHypertension is one of the fourteen and one of the most treatable. An upper-arm cuff, validated; wrist units are less reliable.
Browse on Amazon →

CYCLING OR SKI HELMETTraumatic brain injury is on the list. Unglamorous, and the only item here that prevents a factor outright rather than managing it.
Browse on Amazon →

We are not linking brain supplements, nootropics or “memory” formulas. No supplement appears anywhere on the Commission’s list of fourteen factors, and the largest trials of the popular candidates have not shown a benefit for cognition. We are also not linking brain-training subscriptions: they reliably make you better at the games, and the transfer to everyday memory has not held up. Hearing aids and glasses would be the honest recommendations here, and both need a professional fitting rather than a link.

A dark street at dusk with a single warmly lit shop window spilling light onto the pavement. — Late in the evening, and still open.

Questions people ask

Is it too late at 60?

No. The Commission organises factors by life stage precisely because different ones matter at different points — social isolation, air pollution and vision loss are later-life factors, which means they are live now for someone in their sixties. Hearing loss and blood pressure remain worth treating at any age. The framing that helps is that you are always in some stage of this list.

My parent had dementia. Does the list still matter?

More, if anything. Family history raises baseline risk, and modifiable factors act on top of that baseline rather than being cancelled by it. Genetic risk and lifestyle risk are largely additive in the cohort data. If you carry more of the first, the second is where the room to move is.

Does social isolation really belong on a medical list?

It is on the Commission’s later-life list, and it is also the hardest one to interpret — withdrawal can be an early symptom rather than a cause. But it interacts with the sensory factors in a way that is worth noticing: hearing loss makes conversation exhausting, exhausting conversation gets avoided, and avoidance produces isolation. Treating the hearing may be the most effective way to treat the isolation.

What about the new Alzheimer’s drugs?

They are treatments for people who already have the disease, not prevention, and their benefits so far are modest and come with real side effects and monitoring requirements. They do not change anything in this article. Prevention and treatment are separate questions, and this one is about prevention.

The short version

The 2024 Lancet Commission identified 14 modifiable risk factors covering an estimated 45% of dementia cases at population level.
Two were newly added: high midlife LDL cholesterol (7%) and untreated vision loss in later life (2%).
Hearing loss remains one of the largest single contributors.
Many of the fourteen are cardiovascular. What protects the heart protects the brain.
45% is a population estimate from observational data, not a personal guarantee — age and genetics still dominate.
Most of the list is appointments, not purchases: hearing test, eye test, blood pressure, cholesterol, diabetes, depression.
No supplement appears anywhere on the list.
Later-life factors mean it is never too late to act on part of it.

This summarises published population research and is not medical advice. If you are worried about your own or a relative’s memory, a doctor can assess it properly — and several treatable conditions, including thyroid problems, vitamin deficiency and depression, can mimic early dementia.

On the links above: some are affiliate links, marked (paid link). If you buy through one we may earn a commission at no additional cost to you. As an Amazon Associate I earn from qualifying purchases. We link to product searches rather than specific items so recommendations do not break as models change, and we say plainly when we are choosing not to link something. Full policy: Affiliate Disclosure.

Sources

Livingston G, Huntley J, Liu KY, et al. “Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission.” The Lancet, 2024.
Alzheimer Europe. Summary of the 2024 Lancet Commission on dementia risk reduction.
Dementias Platform UK. Analysis of newly added modifiable risk factors in the 2024 Lancet report.

Two of the 14 Dementia Risk Factors Are Your Ears and Your Eyes