Healthcare Guide · November 05, 2026

The 14 Dementia Risk Factors You Can Change (Lancet Commission 2024)

The 2024 Lancet Commission estimates that 14 modifiable risk factors account for 45% of dementia cases worldwide, led by hearing loss and high LDL cholesterol at 7% each. This guide lists all 14 with their shares and what two major trials found.

Dementia is not only a matter of age and genes. A major 2024 review of the evidence found that a large share of it is tied to factors a person can change, and several of them can be measured long before any memory problem appears.

How many dementia cases could be prevented?

The Lancet standing Commission on dementia (Livingston et al., published July 2024) estimated that 14 potentially modifiable risk factors account for 45% of dementia cases worldwide. The Commission's calculation gives 45.3% before rounding.

This is a population attributable fraction (PAF). It estimates the share of cases across a whole population that would not occur if every one of the 14 factors were removed. It is not a prediction for one person, and it assumes the links are causal, which the Commission itself states as an assumption.

The scale of the problem is large. The WHO reports that 57 million people were living with dementia worldwide in 2021, with nearly 10 million new cases every year, and that dementia is currently the fifth leading cause of death globally.

What are the 14 risk factors you can change?

The Commission groups them by life stage. It defines midlife as ages 18-65 and late life as over 65. The figures below are the rounded, overlap-adjusted PAFs shown in the report's Figure 9. Risk factors cluster in the same people, so the numbers are adjusted for overlap and should not be read as stand-alone effects.

Life stage	Risk factor	Share of dementia cases (PAF)
Early life	Less education	5%
Midlife	Hearing loss	7%
Midlife	High LDL cholesterol	7%
Midlife	Depression	3%
Midlife	Traumatic brain injury	3%
Midlife	Physical inactivity	2%
Midlife	Diabetes	2%
Midlife	Smoking	2%
Midlife	Hypertension (high blood pressure)	2%
Midlife	Obesity	1%
Midlife	Excessive alcohol consumption	1%
Late life	Social isolation	5%
Late life	Air pollution	3%
Late life	Untreated vision loss	2%
All 14 together		45%

Two of the 14 are new in 2024: high LDL cholesterol and untreated vision loss. The Commission added them to the 12 factors in its 2020 report.

Which factors can a health check actually measure?

Some of the 14 are circumstances (education, social isolation, air quality). Others are numbers a clinician can read from a cuff, a blood sample or a hearing and eye test:

Blood pressure. The Commission recommends preventing or reducing hypertension and keeping systolic pressure at 130 mm Hg or lower from age 40. See blood pressure numbers explained.
LDL cholesterol. The Commission recommends detecting and treating high LDL from midlife. It comes from a blood test.
Diabetes. Blood sugar markers such as HbA1c show it early. See prediabetes and HbA1c screening.
Hearing and vision. The Commission recommends accessible hearing aids and accessible screening and treatment for vision loss. Both are assessed by hearing and eye specialists, not by scans.
Obesity. Weight and, more precisely, body composition can be measured.

What does the Commission tell people to do?

The Commission's summary lists specific actions across the 14 factors. The ones an individual can act on include:

Use hearing aids if you have hearing loss, and reduce harmful noise exposure. The Commission says the evidence that treating hearing loss lowers dementia risk is now stronger than in its previous report.
Treat depression effectively.
Wear helmets and head protection in contact sports and on bicycles.
Exercise, because people who take part in sport and exercise are less likely to develop dementia.
Stop smoking, with cessation advice made accessible.
Keep systolic blood pressure at 130 mm Hg or lower from age 40, and have high LDL cholesterol detected and treated from midlife.
Maintain a healthy weight, which also helps prevent diabetes.
Stay socially, physically and cognitively active, and get vision problems screened and treated.

Does family history or genetics change this?

The Commission states that risk is modifiable irrespective of APOE genetic status, the best-known genetic risk marker. It says multicomponent interventions that address several risk factors may benefit people with either high or low genetic dementia risk, and that actions to reduce risk should begin early and continue throughout life.

Does changing these factors work? What the trials show

Two randomised trials are often cited. Both are more modest than the headline figure suggests.

FINGER (Lancet, 2015). The trial randomised 1,260 people aged 60 to 77 who were at higher risk of cognitive decline. One group received a two-year programme of diet, exercise, cognitive training and vascular risk monitoring; the other got general health advice. The primary outcome was a cognitive test score, not a dementia diagnosis. The between-group difference in annual change was 0.022 (95% CI 0.002-0.042, p=0.030), a small gain in favour of the programme.

SPRINT MIND (JAMA, 2019). This trial randomised 9,361 adults aged 50 or older with hypertension to intensive or standard blood pressure control, with a median follow-up of 5.11 years. Intensive control did not significantly reduce probable dementia (hazard ratio 0.83, 95% CI 0.67-1.04), though the authors say the trial may have been underpowered for that end point. It did reduce mild cognitive impairment (hazard ratio 0.81, 95% CI 0.69-0.95).

The honest reading: the evidence supports acting on these factors, but no trial has shown that fixing them guarantees you will avoid dementia. For what is normal in ageing and what is not, see our guide to brain ageing.

Where does dementia risk fit in a screening visit?

Most of the 14 factors are measured by routine tools: a blood pressure cuff, blood tests, a hearing test, an eye exam. Imaging does not read them. A scan cannot diagnose dementia risk by itself or replace those checks.

What imaging can add is a look at structure. Our Full-Body Scans line starts with Light at $1,399.

The Complete package is $1,699 and includes a DEXA body-composition and bone-density scan, which speaks to the obesity factor.

The DEXA Total Body & Bone Health Package is also sold alone for $109.

For the brain's blood vessels, the Brain MR Angiography is $699.

The Advanced Package with Brain MRA is $3,799.

Hearing, vision and cholesterol are checked by the specialists and blood tests named above; each package's inclusion list shows what it covers. You can compare options on our health screening page.

If you are worried about memory, or about a family history of dementia, talk to a doctor. This article is general education, not medical advice.