Dementia is a syndrome characterised by a decline in cognitive functions, including memory, reasoning, and communication, to the extent that it interferes with daily activities (WHO, 2025). In 2020, The Lancet Commission released a significant report led by 28 worldwide dementia experts. The report identified 12 specific factors that could potentially increase the risk of developing dementia. These factors include hearing loss, hypertension, obesity, smoking, depression, social isolation, type 2 diabetes, physical inactivity, excessive alcohol consumption, traumatic brain injury, air pollution, and a lack of education in early life. Subsequent studies have reinforced these risk factors. In 2024, The Lancet Commission added the two other risk factors high LDL cholesterol and visual loss. This article explores the lifestyle choices that may reduce the risk of dementia.
Lifestyle Choices In Dementia Risk Reduction
Being Physically Active:
Physical activity is linked to a reduced incidence of dementia. For example, a systematic review and meta-analysis by Markku and colleagues included 58 studies with more than one-year follow-ups that measured physical activity at baseline and assessed all-cause dementia, Alzheimer’s disease or vascular dementia. The researchers found evidence that physical activity was associated with a lower incidence of all causes of dementia and Alzheimer’s disease. This shows that being active is a lifestyle choice that can help protect against these conditions. Furthermore, resistance exercise is the most effective way to slow the cognitive decline in patients with cognitive dysfunction, especially in patients with dementia. A systematic review and network meta-analysis by Huang and colleagues, which included 71 random controlled trials with 5606 participants, found evidence that all types of exercise effectively enhanced or preserved global cognition. Among the different forms of exercise, resistance training showed the highest likelihood of being the most effective intervention for slowing the decline in global cognitive function. Henceforth, being physically active and choosing resistance exercise is the strategy to prevent cognitive decline.
Being Cognitive Engaging:
Engaging in reading, learning new skills, and dancing can help delay cognitive decline. Tao and colleagues analysed 29 studies involving 1,708 older adults with mild cognitive impairment, Alzheimer’s disease and dementia in a systematic review and meta-analysis. The researchers found evidence that dance interventions had a significant positive impact on global cognition, memory, and balance, and they also notably reduced depression among the participants. However, dance activities did not affect the participants’ executive functions.
Being Socially Interactive:
Staying socially active reduces the risk of dementia. For example, a larger study conducted by Shen and colleagues, which included 462,619 UK Biobank participants with a follow-up of over 11 years, found that social isolation was associated with a 1.26-fold increased risk of dementia independently of various risk factors, including loneliness and depression.
By Managing Chronic Conditions:
Managing chronic conditions like obesity, diabetes, and high blood pressure can lower the risk of dementia. A meta-analysis by Peters and colleagues, which included studies from 20 countries involving 28008 individuals in randomised double-blind placebo-controlled clinical trials, provides class I evidence that antihypertensive treatment in late midlife and later life can help lower the risk of dementia. Nonetheless, researchers are unsure about the potential for additional BP lowering in those with already well-controlled hypertension and antihypertensive treatment commenced earlier in the life course to reduce the long-term risk of dementia.
By Cutting Down Ultra-Processed Food:
Consuming a diet rich in ultra-processed food can increase the risk of dementia. A systematic review and meta-analysis by Henney and colleagues, which included 10 observational studies with 867,316 individuals, provides evidence that high consumption of ultra-processed food is associated with dementia risk.
Conclusion:
Adopting a series of positive lifestyle choices, such as being physically active, cognitively engaging, socially interactive, managing chronic conditions, and reducing the amount of ultra-processed food, can significantly impact cognitive health and potentially delay the onset of dementia. By incorporating these strategies into daily life, individuals may enhance their cognitive longevity and reduce the likelihood of developing dementia.
Where to Seek Help: If the condition interferes with your daily activities, please seek help from your GP or local health provider.
References:
Henney, A. E., Gillespie, C. S., Alam, U., Hydes, T. J., Mackay, C. E., & Cuthbertson, D. J. (2024). High intake of ultra-processed food is associated with dementia in adults: a systematic review and meta-analysis of observational studies. Journal of Neurology, 271(1), 198–210. https://doi.org/10.1007/s00415-023-12033-1
Huang, X., Zhao, X., Li, B., Cai, Y., Zhang, S., Wan, Q., & Yu, F. (2022). Comparative efficacy of various exercise interventions on cognitive function in patients with mild cognitive impairment or dementia: A systematic review and network meta-analysis. Journal of Sport and Health Science, 11(2), 212–223. https://doi.org/10.1016/j.jshs.2021.05.003
Iso-Markku, P., Kujala, U. M., Knittle, K., Polet, J., Vuoksimaa, E., & Waller, K. (2022). Physical activity as a protective factor for dementia and Alzheimer’s disease: systematic review, meta-analysis and quality assessment of cohort and case–control studies. British Journal of Sports Medicine, 56(12), 701–709. https://doi.org/10.1136/bjsports-2021-104981
Livingston, G., Huntley, J., Liu, K. Y., Costafreda, S. G., Selbæk, G., Alladi, S., Ames, D., Banerjee, S., Burns, A., Brayne, C., Fox, N. C., Ferri, C. P., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Nakasujja, N., Rockwood, K., … Mukadam, N. (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
Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., Costafreda, S. G., Dias, A., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Ogunniyi, A., … Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), 413–446. https://doi.org/10.1016/S0140-6736(20)30367-6
Peters, R., Xu, Y., Fitzgerald, O., Aung, H. L., Beckett, N., Bulpitt, C., Chalmers, J., Forette, F., Gong, J., Harris, K., Humburg, P., Matthews, F. E., Staessen, J. A., Thijs, L., Tzourio, C., Warwick, J., Woodward, M., & Anderson, C. S. (2022). Blood pressure lowering and prevention of dementia: an individual patient data meta-analysis. European Heart Journal, 43(48), 4980–4990. https://doi.org/10.1093/eurheartj/ehac584
Shen, C., Rolls, E. T., Cheng, W., Kang, J., Dong, G., Xie, C., Zhao, X.-M., Sahakian, B. J., & Feng, J. (2022). Associations of Social Isolation and Loneliness With Later Dementia. Neurology, 99(2). https://doi.org/10.1212/WNL.0000000000200583
Tao, D., Awan-Scully, R., Ash, G. I., Pei, Z., Gu, Y., Gao, Y., Cole, A., & Baker, J. S. (2023). The effectiveness of dance movement interventions for older adults with mild cognitive impairment, Alzheimer’s disease, and dementia: A systematic scoping review and meta-analysis. Ageing Research Reviews, 92, 102120. https://doi.org/10.1016/j.arr.2023.102120
World Health Organisation. (2025). Dementia.
© 2025 Dr Mukta Bhattarai Pandey (MD, PGDip Public Health, MRCP(UK), MRes)