Quick facts
- Modifiable factors identified: 14 (Lancet Commission, 2024)
- Share of cases theoretically preventable: around 45%
- The window that matters most: midlife, roughly 45 to 65
- Free NHS Health Check: ages 40-74, once every five years
Around 45% of dementia risk sits in things that can be changed
The rest is age and genetics, and neither takes instructions.
The Lancet Commission on dementia prevention lists 14 modifiable risk factors, together accounting for roughly 45% of cases worldwide.
That figure is a population estimate, not a personal guarantee. Nobody can promise you an outcome.
But it does mean the question "is there anything I can do" has a longer answer than most people expect.
Most of these factors do their damage in midlife โ the decades when nothing feels urgent.
Get your hearing tested, because it is the largest single midlife factor
Untreated hearing loss carries the biggest population-level weight of any factor on the list.
The mechanism is still argued over. Reduced input, extra cognitive load, or simply withdrawal from company.
What is not argued over is that hearing aids are free on the NHS through a GP referral to audiology.
Most people wait around a decade before acting on hearing they know has gone.
Approximate share of cases attributed to four of the fourteen factors. Lancet Commission, 2024.
Vision was added to the same list. An untreated cataract is a risk factor as well as a nuisance.
Book the eye test you have been postponing at the same time as the hearing one.
Treat blood pressure and cholesterol as brain problems
High LDL cholesterol joined the list in 2024, alongside blood pressure, diabetes and smoking.
All four damage the small vessels that supply the brain, and none of them announce themselves.
Nothing on this list feels like a brain problem at the time. That is exactly why it is a midlife list.
Blood pressure is the one worth knowing your own number for. Most pharmacies will measure it without an appointment.
The NHS Health Check covers blood pressure, cholesterol and diabetes risk in a single appointment.
It is free, and it is offered every five years between 40 and 74.
Find out about the free NHS Health CheckNHS โ ages 40 to 74 โ
Keep the diary full, not just the crossword
Social isolation carries roughly the same weight as leaving education early.
Brain-training apps have not shown much. Regularly seeing other people has.
The distinction is worth taking seriously, because one of them is sold to you and the other is free.
Physical activity does double duty here, since it moves blood pressure and social contact at once.
Walking with somebody counts twice.
Retirement is where both quietly collapse, often within a year, and it takes deliberate effort to replace them.
Hearing loss makes this worse in a way that is easy to miss.
Conversation becomes tiring, so invitations get declined, and the isolation arrives through the back door.
None of this replaces a conversation with your GP, particularly if memory changes are already worrying you.
If that is where you are, the assessment pathway is a separate matter from prevention, and the sooner it starts the better.
