Reduce Your Dementia Risk: Two New Risk Factors Identified

Reviewed By: Sharyn Rossi, PhD, BrightFocus Foundation

An international group of dementia experts has identified two new risk factors for dementia—untreated vision loss in later life and high low-density lipoprotein cholesterol in mid-life.  

The addition brings the total number of modifiable risk factors for dementia to 14.

The researchers belong to The Lancet Standing Commission on Dementia Prevention, Intervention, and Care. The group regularly evaluates new evidence on potentially modifiable risk factors for dementia—with the goal of informing global public health efforts for risk reduction and dementia interventions.

Among them, BrightFocus Foundation Alzheimer’s Disease Research grant recipient Quincy Samus, PhD. Read on to learn from Dr. Samus about what these new findings mean for reducing your dementia risk.

What does recognizing these risk factors mean for people concerned about their dementia risk? How might someone use these new findings in their daily life?

Dr. Samus: Overall, the collection of Lancet reports on potentially modifiable dementia risk factors are good news, in that the best available evidence suggest the potential for reducing dementia risk at both a population level and an individual level is quite significant. This is particularly important given there are currently no curative treatments for dementia and in context of the increasing prevalence of dementia worldwide—especially among lower-and middle-income countries and those in groups at higher risk of health disparities.  The consideration of the risk factors for dementia using a life course perspective is also particularly valuable—as this suggests that it is never too early in life or too late in life to reduce risk for dementia.  

Finally, the focus on potential modifiable factors is significant, given that many of these factors can be addressed in potentially cost efficient, scalable ways. What’s more is that the risk tends to cluster, therefore public health approaches should prioritize and target high risk groups and communities for maximum impact.  

In translating these findings to everyday life, it is critical that we raise public awareness that risk reduction is possible through brain health campaigns. This should include encouraging individual empowerment to make health and lifestyle changes, goal setting, as well as encouraging individuals to have open and honest communications with their healthcare providers specific strategies or lifestyle changes that they can use to reduce risk. Evidence suggests that the best individual-level prevention strategies should be multifaceted and individually tailored.  

How do you think the addition of these risk factors will affect dementia screening? 

Dr. Samus: As we know, dementia is often underdiagnosed, and diagnosis and screening has been associated with significant health inequities, particularly for groups at the highest risk. Taken on its own, it is not clear whether the addition of cholesterol and vision loss in this Lancet update will have a distinct impact on improving dementia screening or diagnosis. That said, the 2024 Lancet update on the 14 modifiable risk factors for dementia—taken together with the other recent advancements in national dementia prevention and care strategic planning and the emergence of monoclonal antibody treatments for Alzheimer’s disease—creates an unprecedented opportunity and era to use data driven approaches to have real impacts on bending the curve for risk reduction and optimization of outcomes and quality of life among people living with the disease at the population level.    

Dementia screening and diagnosis has historically been challenged by fear of the unknown, stigma and nihilism. I think with the collective emergence of these new risk reduction and treatment developments over the past few years, discussions about brain health and prevention are being recognized as important and even slowly normalized—which is exactly the direction we need to be moving.  

The article states that 45% of dementia cases could be potentially delayed or reduced. What does this mean for people at risk for dementia? 

Dr. Samus: The report uses the most recent literature on worldwide longitudinal risk of dementia and prevalence of all risk factors to calculate what is called population attributable fractions (PAF), which specifically generate estimates of risk by age bands using a life course perspective.  

Given there are multiple modifiable risk factors, the greatest impact in reducing risk, estimated at 45%, is if we were to address all of them. This is with the idea that the benefits are additive if we are addressing one or more.  

Thus, the greatest impact for reducing risk for dementia may be for those in the highest risk groups, or in other words, who have more of the 14 risk factors.  

This is a critical point when we consider the potential we have to impact dementia prevalence and health inequities related to brain health moving forward, since many of the risk factors cluster among group such as those living in poverty, women, and those from socially disadvantaged and marginalized groups.   

[Editor’s note: Some people at higher risk of dementia may not have access to resources that enable a healthy lifestyle. Explore BrightFocus Foundation’s free educational resources for brain health.] 

Summary 

The recognition of these new dementia risk factors represents decades of hard work in supporting research and raising awareness. Experiencing this journey firsthand, Dr. Samus shared three key takeaways:  

1. We must take a global perspective on tackling dementia. This approach means bringing together interdisciplinary, multicultural groups of people to share their unique perspectives and opinions. Doing so advances and harmonizes knowledge and promotes forward thinking about how to maximize influence on policy, health care, and everyday lives of people.  

2. Embrace new, innovative ways to analyze large datasets. The Lancet Commission took a unique approach to their study that allowed them to curate the best available data, consider expert discussion and consensus, and ultimately produce actionable results.

3. Keep an open mind as research moves forward. As we learn more and new evidence emerges, we must refine our understanding and approach to dementia. Researchers should continue to work collaboratively with people from different experiences and professions, and to have optimism that these efforts can and will transform this field. 

“As a researcher, it has inspired me and given me hope that our individual and collective efforts to address brain health and find effective ways to treat dementia and care for people and families living with dementia do matter and are contributing to something greater,” Dr. Samus shared. 

About BrightFocus Foundation

BrightFocus Foundation is a premier global nonprofit funder of research to defeat Alzheimer’s, macular degeneration, and glaucoma. Through its flagship research programs — Alzheimer’s Disease Research, National Glaucoma Research, and Macular Degeneration Research — the Foundation has awarded nearly $300 million in groundbreaking research funding over the past 51 years and shares the latest research findings, expert information, and resources to empower the millions impacted by these devastating diseases. Learn more at brightfocus.org.  

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