Engage in Conversations About Protective Actions

Preserving Brain Health

Recent research has identified important strategies that can help maintain brain health. Ongoing brain health conversations about how these strategies can be used to potentially reduce the risk for or delay cognitive decline. Health care teams can use brain health–related discussions to encourage patients to adopt lifestyle changes that could improve their brain health throughout the lifespan.

Based on available evidence about 14 modifiable risk factors for dementia (less formal education, head injury, physical inactivity, smoking, excessive alcohol consumption, hypertension, obesity, diabetes, hearing loss, depression, infrequent social contact, vision loss, high cholesterol, and air pollution), the 2024 update of the Lancet Commission on Dementia recommended specific actions (several of which can be addressed in primary care) (Livingston et al., 2024):

Neurovascular risk management.

Detect and treat hearing loss
Treat depression

Encourage the use of helmets and head protection

Promote exercise and active lifestyles

Stop smoking

Identify hypertension and maintain a systolic blood pressure of 130 mm Hg or less

Detect and treat high LDL cholesterol from midlife
Maintain a healthy weight and treat obesity

Reduce alcohol consumption

Prioritize age-friendly and supportive community environments and housing

Reduce social isolation by participating in activities and living with others

Screen for and treat vision loss

Minimize exposure to air pollution

The Lancet Commission

The Lancet Commission report stresses that prevention efforts related to the 14 risk factors should begin early in life and continue throughout the lifespan to maximize cognitive and physical health. They also note that dementia prevention strategies can benefit individuals regardless of genetic risk, including those with APOE ε4, a known genetic risk factor (Livingston et al., 2024).

Conversations

Conversations about these recommendations can help provide individuals with practical strategies for preserving brain health. When discussing risk factors with patients, it may be helpful to describe how lifestyle changes may make the brain more vulnerable or more resilient over time; however, it is important to avoid giving the impression that getting dementia is their own “fault” (Science Media Centre, 2020).

Taking Action

While the KAER Toolkit focuses on strategies that primary care providers can use with older adults, it is important that individuals across the lifespan implement everyday actions to improve brain health and lower the risk of cognitive decline and possibly Alzheimer’s disease and related dementias. The Alzheimer’s Association provides useful resources about risk reduction strategies aligned with these recommendations, including several fact sheets and videos.

In addition, individuals of all ages can incorporate the 10 Healthy Habits for Your Brain recommended by the Alzheimer’s Association. Additionally, the Global Council on Brain Health’s report, How to Sustain Brain Healthy Behaviors: Applying Lessons of Public Health and Science to Drive Change, addresses actions that individuals, communities, and policymakers can take to promote healthy brain behaviors. The Council also makes available several resources that accompany the report in its resource library. 

More information about these recommendations (along with possible codes for billing medical services) is available from UsAgainstAlzheimer’s. Additionally, a 2024 GSA publication, Insights & Implications in Gerontology: The Vital Role of Nutrition in Brain Health , explores current evidence on the relationships between nutrition and brain health. 

Kickstart | Approaches to Implement