What can I concretely do to prevent dementia?
A combined approach, including regular physical activity, blood pressure and diabetes management, not smoking, maintaining social contacts and staying cognitively active, currently gives you the best and most well-supported chance of reducing your risk of dementia.
Dementia cannot be prevented entirely, but roughly one third of all cases is linked to factors you can influence yourself. This makes targeted prevention worthwhile, even though it offers no guarantee1,2,3.
The largest modifiable risk factors are physical inactivity, smoking, untreated high blood pressure in middle age, type 2 diabetes and high cholesterol. High blood pressure and diabetes nearly double the risk or more. Smoking is associated with an almost twofold higher risk of dementia and a 27% greater chance of mild memory problems. These are precisely the conditions your general practitioner already treats you for, and that treatment therefore counts for your brain health as well4,1,5.
Social and mental well-being play an equally important role. Living alone or being widowed early is associated with a more than twofold higher risk of dementia. Depression is also a modifiable risk factor. A low level of education substantially increases the risk; staying cognitively active appears to be protective4,1,5.
Physical activity is one of the best-supported pillars. Both cardio exercise (walking, cycling, swimming) and strength training show protective effects on the brain: better blood flow, better clearance of harmful substances and increased growth factors for brain cells. Conclusive evidence for definitive dementia prevention is still lacking3,2.
Individual measures on their own, such as diet alone or more exercise alone, have produced disappointing results in studies. The strongest indications come from combined approaches. The Finnish FINGER study and the American US POINTER study (2025, n=2,111) show that guided exercise, a healthy diet, cognitive training, social activities and blood pressure and cholesterol control together produce measurably better outcomes. The benefit in US POINTER was statistically significant and greatest in people who already had somewhat more difficulty with thinking and remembering. Two other large European studies (MAPT, PreDIVA) found no overall significant effect, but did find positive results in higher-risk groups6,5.
The claims are based on large observational cohort studies, including a Chinese study with 46,011 participants, and randomised controlled trials (FINGER, US POINTER, MAPT, PreDIVA). The evidence is predominantly moderate in strength: the associations are consistent, but largely observational. Causality has not been definitively proven for most individual risk factors. The studies using combined approaches provide the strongest evidence for a causal relationship.