Lowering Your Dementia Risk
Dementia isn’t an automatic part of ageing. About 45% of cases are linked to 14 things you can change. None are glamorous, all are doable, and it’s never too late to start.
The 14 risk factors. Early life: less education. Midlife: hearing loss, high LDL cholesterol, depression, head injury, inactivity, diabetes, smoking, high blood pressure, obesity, too much alcohol. Later life: social isolation, air pollution, untreated vision loss.
The dementia risk ladder
No pill prevents dementia, so this ladder is about stacking the odds. Every step helps on its own; together they add up.
- Step 1 · Self-careMove moreWalking, swimming, gardening, dancing: anything that gets you a bit puffed.
- Works
- Inactive people have about 20% higher risk (observational); trials show small boosts to thinking skills
- Cost
- Free (walking shoes optional)
- How long
- Aim for 150 minutes a week, for life. Any amount beats none.
- Watch for
- Start gently if you have heart or joint problems.
The best exercise is the one you’ll still be doing next year.
- Step 2 · Self-careStop smoking, ease up on alcoholTwo of the big midlife risks, and both are fixable at any age.
- Works
- Smoking raises risk about 30%, heavy drinking about 20%; risk falls after quitting, even later in life
- Cost
- Quitline (13 7848) is free; nicotine patches are PBS-subsidised. Quitting saves thousands a year.
- How long
- Ongoing. Most people need a few attempts to quit, which is normal.
- Watch for
- Keep alcohol to 10 standard drinks a week or less, with some alcohol-free days.
A “brain-healthy” red wine is still mostly wine.
- Step 3 · Self-careStay connected and keep learningFriends, clubs, volunteering, a language, an instrument, a new job skill.
- Works
- Social isolation and less education are each linked to about 60% higher risk; evidence is observational, not trials
- Cost
- Free to cheap: libraries, community groups, U3A-style courses
- How long
- Ongoing. Regular beats occasional.
- Watch for
- Low mood or loneliness that sticks around is worth raising with your GP.
Brain-training apps make you good at brain-training apps. Real-world learning travels further.
- Step 4 · Allied healthHearing test and hearing aidsHearing loss is one of the two biggest changeable risks.
- Works
- Hearing aids linked with about 19% less cognitive decline; in one trial, about 48% slower decline in higher-risk people (no difference overall)
- Cost
- Free for eligible pensioners and veterans (Hearing Services Program); otherwise about $2,000–12,000 a pair
- How long
- Wear them every day. It takes a few weeks to get used to them.
- Watch for
- Earwax, ear pain or sudden hearing loss need a GP visit first.
Hearing aids in the drawer don’t count. Sorry.
- Step 5 · Allied healthEye checks, glasses and cataract surgeryUntreated vision loss is a later-life risk factor.
- Works
- Cataract surgery linked with about 30% lower dementia risk (observational); untreated vision loss raises risk about 50%
- Cost
- Optometrist eye tests are usually bulk-billed; cataract surgery is free as a public patient (waits vary)
- How long
- Eye test every 1–2 years over 65, or as advised.
- Watch for
- Sudden vision loss or a curtain over your vision is an emergency.
Squinting is not a personality trait. Book the eye test.
- Step 6 · PrescriptionTreat high blood pressureAim for a top (systolic) reading of 130 or less from about age 40.
- Works
- Intensive treatment cut dementia by about 15% in a large 2025 trial, with fewer memory problems too
- Cost
- Under the $25 PBS co-payment, often about $10–25 a month
- How long
- Long term. Lifestyle first; tablets if numbers stay high.
- Watch for
- Dizziness on standing, ankle swelling with some tablets. Don’t stop without talking to your GP.
High blood pressure is silent. The cuff is the only way to know.
- Step 7 · PrescriptionLower high LDL cholesterol, manage diabetes and depressionUsually a statin for cholesterol, plus whatever keeps blood sugar and mood on track.
- Works
- High LDL raises risk about 30%; statins lower LDL by a third to a half, but trials haven’t yet shown they prevent dementia
- Cost
- Statins: under the $25 PBS co-payment, about $10–20 a month
- How long
- Long term, with regular blood tests.
- Watch for
- Muscle aches (often not caused by the statin itself). Low blood sugars with some diabetes medicines.
Your heart and your brain share the same plumbing. Look after one, help the other.
Save your money
Popular, heavily marketed or often asked about, but the evidence is weak or says no.
- “Brain health” supplementsGinkgo, fish oil and B vitamins (if your levels are normal) haven’t prevented dementia in trials. Spend the money on walking shoes or a course.
- Brain-training appsYou get better at the games, but trials haven’t shown they prevent dementia.
- Daily aspirinThe large Australian-led ASPREE trial found no drop in dementia in healthy older people, and more bleeding.
- Coconut oilNo good trials. Popular online, not in the evidence.
- APOE gene testsDon’t change the advice for prevention and can cause a lot of worry. Not recommended for healthy people.
What you can do
- Book a heart health check: from 45, or 30 for First Nations people. It covers blood pressure, cholesterol and blood sugar.
- Get your hearing and eyes tested, even if you think they’re “fine”.
- Helmets for bikes and horses. Take head knocks seriously.
- Avoid smoke and traffic fumes where you can.
See your GP if
- You or others notice worsening memory, getting lost in familiar places, trouble with money or medicines, or personality changes
- You have trouble hearing conversations or seeing clearly
- Low mood or loneliness is affecting you
Call 000 for sudden confusion, face drooping, arm weakness or slurred speech. See a doctor the same day for confusion after a head injury. For memory concerns or support, call the free National Dementia Helpline on 1800 100 500 (24/7).
Common questions
Can dementia be prevented?
Not always, but the 2024 Lancet Commission found about 45% of dementia is linked to 14 risk factors that can be changed. Acting on them can prevent or delay it, at any age.
Do hearing aids lower dementia risk?
Hearing loss is one of the two biggest risk factors, and wearing hearing aids is linked with less cognitive decline. Eligible pensioners and veterans can get free hearing aids through the Hearing Services Program.
Do brain-training apps prevent dementia?
There is little evidence they do. You get better at the games, but learning real-world skills and staying social are a better use of time.
Do supplements help prevent dementia?
No. Ginkgo, fish oil, vitamin E and “brain health” supplements haven’t prevented dementia in trials.
What are the early signs of dementia?
Forgetting recent events or conversations, repeating questions, trouble finding words, getting lost in familiar places, difficulty managing money or plans, and changes in mood or personality. Many other things, such as depression, poor sleep or low B12, can cause similar symptoms, so see a GP.
Is dementia hereditary?
Mostly not directly. Having a parent with dementia raises your risk a little, and a gene called APOE4 raises it more. Rare forms passed directly through families usually start before 65.
Does exercise prevent dementia?
It helps. People who stay physically active have about a 20 to 30% lower risk of dementia in large studies. Exercise also lowers blood pressure, diabetes risk and depression, which are dementia risk factors too.
Helpful resources
- CogDRiskFree 20-minute online dementia risk check from UNSW and NeuRA, with a personal report to take to your GP.
- Your Brain MattersFive simple steps for brain health at any age, developed with Alzheimer’s Australia (now Dementia Australia). Free.
Evidence and more information
- The Lancet: Dementia prevention, 2024 Commission report (open access)
- Dementia Australia: How can I reduce the risk of dementia?
- Australian Government: Dementia risk at age 50
- Australian Government: Hearing Services Program
- Nature Medicine: Blood pressure lowering and dementia, CRHCP trial (2025)
- JAMA Internal Medicine: Cataract surgery and dementia (2022)
- The Lancet: ACHIEVE hearing intervention trial (2023)
maladywise.com/dementia-prevention/