Top 14 Alzheimer's Modifiable Risk Factors: 2024 Lancet Commissions Report
September is World Alzheimer's Month, a crucial time to reflect on your habits and assess areas where you can support your brain health for the future. More and more research has shown we can dramatically reduce our risk of the disease. You might be asking yourself, "Am I at a higher risk? Is this disease something I should be concerned about?" Let’s first review some general facts.
An estimated 6.9 million Americans are currently living with Alzheimer’s dementia, and about 1 in 9 Americans aged 65 or older are affected. As the population in this age group continues to grow, so will the number of individuals facing Alzheimer’s or other dementias.1
Today, we’ll explore important findings from the newly published 2024 Lancet Commissions report to help guide you in reducing your risk.
This is the first part of our two-part series. In the second part, we're excited to partner with Barbie Boules, a registered dietitian and women’s midlife brain health and cardiovascular coach, to review the top takeaways from the report for women entering the menopause transition. We're focusing on women specifically, as 2/3 of Americans with Alzheimer’s are women.1 This exclusive article will be available only to our email subscribers, so if you haven’t signed up yet, we encourage you to do so below and unlock the full article.
We are also excited to be hosting an Instagram Live on September 17th at 10AM PST/1PM EST with NeuroReserve Founder, Dr. Edward Park, and Barbie Boules where they’ll be discussing the 2024 Lancet Commissions report findings and providing simple actions to help you protect your brain. Follow us on our Instagram here to be notified when we go live.
Now, let’s dive into the report.
A Review of the Risk Factors Addressed in the Lancet Report
The Lancet Commission's 2024 report is a comprehensive study released by the Lancet medical journal that examines key risk factors associated with Alzheimer's disease and cognitive decline. The report focuses on how certain lifestyle and health factors during each stage of life can influence the likelihood of developing dementia later in life. This year's report identified 14 modifiable factors—meaning you can take actionable steps to address them.
Some, like hearing loss, can be managed with hearing aids, while quitting smoking, reducing alcohol consumption, and increasing physical activity, are more straightforward adjustments. However, other factors, such as high LDL cholesterol, hypertension, diabetes, and obesity, may require more effort to manage.
First, let's look at the full list of modifiable risk factors identified in the Lancet Commission's 2024 report. They found that nearly 50% of dementias could theoretically be prevented by eliminating the 14 key risk factors.2
1. Lower Education
Education is a key factor to manage early in life, as it provides cognitive stimulation and helps build your brain's "cognitive reserve." This reserve allows your brain to repair itself, work more efficiently, and slow down age-related decline.
Addressing the following risk factors in midlife is crucial, though starting earlier can always be beneficial.2
2. Hearing Loss
Hearing loss affects over 60% of people over 50 and is crucial to manage with hearing aids. If left unaddressed, it can lead to loneliness, depression, and social isolation, all of which may impact cognitive health. When your hearing is impaired, your brain must work harder to interpret sounds, which can divert mental energy from other important tasks, like memory and thinking. This extra effort puts strain on your brain over time. By addressing hearing loss with devices like hearing aids, you allow your brain to function more efficiently, preserving cognitive reserve—the brain's ability to adapt and maintain function as it ages.
3. High LDL Cholesterol
People who do not follow dietary guidelines, such as eating fruit, vegetables, and fish regularly, and avoiding processed meats and sugary drinks, tend to have higher LDL cholesterol. Excess brain cholesterol is linked to increased stroke risk and the buildup of amyloid β and tau, which are associated with dementia.
4. Depression
Depression is a key risk factor for dementia, though its link isn’t always widely recognized. Some theories on how it can reduce self-care, social interaction and cause excess cortisol to be released which may harm the hippocampus or trigger inflammation. Managing depression through self-care, meditation, and medication, when necessary, can be helpful.
5. Traumatic Brain Injury
Traumatic brain injury (TBI) is often caused by sports or car accidents and can lead to an earlier onset of dementia by 2-3 years due to accumulated neurodegenerative changes. You can learn more about the causes and implications of TBI in our past article here. To reduce your risk, it’s essential to use proper head protection, limit high-impact activities, and avoid playing after a TBI.
6. Physical Inactivity
Physical inactivity is a significant risk factor for dementia, but regular exercise at any age can help reduce this risk. Exercise improves brain blood flow, lowers hypertension, enhances brain plasticity, and reduces neuroinflammation.
7. Diabetes
Managing diabetes can help lower your risk, although research is still ongoing to fully understand its connection to increased risk. Some understood mechanism however is how it disrupts insulin signaling, alters brain metabolism, and leads to insulin resistance. This resistance contributes to higher amyloid beta buildup, tau protein changes, oxidative stress, and neuroinflammation.
8. Smoking
Smoking is a significant risk factor for dementia, with recent evidence showing that smoking in midlife is particularly harmful. The good news is that quitting smoking during this time can stop the increased risk, leading to no further rise in dementia risk.
9. Hypertension
Midlife hypertension increases the risk for all types of dementia, including Alzheimer's and vascular dementia. Managing high blood pressure with antihypertensive medication has been shown to protect against cognitive decline.
10. Obesity
Obesity has been linked to a higher risk of cognitive impairment and dementia, especially in people over 65. Obesity often coexists with conditions like diabetes and hypertension, which are also risk factors for dementia. The connection may be due to increased inflammation, cortisol, and other negative health effects.
11. Excessive Alcohol
Heavier drinking in midlife has been linked to a higher risk of dementia and reduced brain grey matter.
The following risk factors should be focused on in later life.
12. Social Isolation
Dementia risk is higher in people who are more socially isolated, such as living alone, having infrequent contact with family or friends, or not participating in group activities. Social isolation has also been linked to lower grey matter volume in key brain regions. Social contact helps reduce dementia risk by building cognitive reserve, encouraging healthy behaviors, and reducing stress and inflammation. Studies show this benefit is consistent regardless of genetic risk for Alzheimer's.
13. Exposure to Air Pollution
Lifelong exposure to air pollution, such as vehicle emissions and smoke, has been linked to an increased risk of dementia and cognitive impairment. This is especially true for individuals with pre-existing cardiovascular conditions like heart disease, stroke, and atrial fibrillation, which may worsen the impact of pollution on brain health.
14. Vision Loss
Vision loss has been linked to dementia risk, potentially due to underlying illnesses like diabetes, shared neuropathological processes between the retina and brain, or the strain of vision loss itself. Fortunately, treatment for vision loss is highly effective and affordable for around 90% of people, but it's often left untreated.
In total these factors add up to a 45.3% reduction of risk.
Women entering midlife face a range of risk factors that can impact their brain health, making it essential to be vigilant and proactive. Managing these factors can be complex, but there are specific strategies outlined in the Lancet report that can be particularly helpful.
In the second part of this series, we’ll delve into these insights with Barbie Boules, a registered dietitian and women’s midlife brain health and cardiovascular coach, to review the top takeaways from the report for women entering the menopause transition. Sign up below to access the full exclusive article.
We also encourage you to join our Instagram Live on September 17th at 10AM PST/1PM EST with NeuroReserve Founder, Dr. Edward Park, and Barbie Boules where they’ll be discussing the 2024 Lancet Commissions report findings and providing simple actions to help you protect your brain. Follow us on our Instagram here to be notified when we go live.
Managing multiple risk factors for dementia can feel overwhelming at times, as each requires attention and effort. However, one adjustment that can address several of these risk factors at once is nutrition.
Nutrition’s Effect on Risk Factors
According to the Lancet 2024 Commission: “Eating a diet high in fruit and vegetables and low in ultra-processed foods is good for many health conditions.”2
Diets like the Mediterranean and MIND diets are specially designed to support brain health by emphasizing anti-inflammatory foods and beneficial nutrients. These diets focus on consuming plenty of fruits, vegetables, whole grains, nuts, and lean proteins while incorporating healthy fats, such as those found in olive oil and fish. At the same time, they limit or avoid harmful foods high in saturated fats, excess sugars, and high sodium levels, which can negatively impact brain health.
A healthy diet plays a crucial role in managing metabolic health, impacting conditions like obesity, LDL cholesterol, hypertension, and diabetes. With the Mediterranean diet’s focus on high dietary fiber, omega-3 and -9 fatty acids, complex carbohydrates, antioxidants, and bioactive substances such as polyphenols, it can help address metabolic syndrome components. These nutrients help combat oxidative stress and inflammation, contributing to better management of these risk factors.3 By managing these metabolic conditions through diet, you can also enhance recovery from TBI and potentially lower your risk of stroke, another area that is important to manage for reducing your risk.4
Managing these risk factors alone adds up to a 15% reduction by simply focusing on a good diet.
Ultimately, eating right every day is key to nourishing your body and brain, and managing risk factors effectively. While focusing on good sleep, regular exercise, and socializing is important, meeting all your nutritional needs through diet alone can be challenging.
We developed RELEVATE, as the world’s first brain health supplement to deliver 17 nutrients from the Mediterranean and MIND diets which have been shown to reduce the risk of brain decline by more than 50%.4 RELEVATE is a realistic way to help fill in any gaps where your diet falls short and supports brain health both in the short-term and long-term. You can learn more and order it by visiting here.
References
1. Alzheimer & Association. Alzheimer’s Association 2024 Alzheimer’s Disease Facts and Figures.
2. Livingston, G. et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet 404, 572–628 (2024).
3. Dayi, T. & Ozgoren, M. Effects of the Mediterranean diet on the components of metabolic syndrome. J Prev Med Hyg 63, E56 (2022).
4. Patel, P. R. et al. Brain Injury: How Dietary Patterns Impact Long-Term Outcomes. Curr Phys Med Rehabil Rep 11, 367 (2023).
