Dr. Eric Larson is a leading expert on aging and dementia and one of the creators of a massive living lab studying the brains of 5000 Seattle residents as they age over decades. The research is called the Adult Changes in Thought (ACT) Study. Dr. Larson is optimistic when it comes to preventing the devastating disease, but not because miracle medicines might be on the horizon. Instead, he believes Alzheimer’s and other types of dementia are directly impacted by the lifestyle choices individuals make. He’s finding people are increasingly paying attention to those lifestyle issues and doing the right thing for their health.

In fact, as an example, he says, the closest thing to a magic pill for reducing the risk of dementia is probably exercise. But that is just one of the 12 modifiable risk factors to prevent the disease. Larson speaks to the dozen modifiable risk factors that were presented in a 2020 report of the Lancet Commission and they include: less education, hypertension, hearing impairment (between the ages 45-65 hearing loss is the biggest modifiable risk factor), smoking, obesity, depression, physical inactivity, diabetes (type 2 leads to a two-fold increased risk of developing AD), low social contact, excessive alcohol consumption, traumatic brain injury, and air pollution.

“There is no inevitability about this condition,” he says of the loss of cognitive functioning. “I was reading the numbers. There’s a 1/3 drop from 2000 to 2016 in the rates of dementia in North America and Europe. We have reached a point where people are better educated, socio and economic indicators have improved. We’re not doing the same stuff our parents were doing as far as health. We realize we need to exercise, and not smoke, and not drink a bunch of alcohol.”

On the other hand, Dr. Larson worries that dementia is increasing in less-advanced, industrializing societies that adopt some of the unhealthier aspects of the Western lifestyle.

Some of the choices that people can make to diminish the risk of Alzheimer’s, besides engaging in physical exercise, are controlling weight and blood pressure; treating or protecting against diabetes; quitting smoking; moderating alcohol consumption; and addressing hearing loss and perhaps even vision impairment.

“A lot of the things that reduce the risk of dementia and Alzheimer’s disease are the things that improve health and well-being in older people,” points out Dr. Larson, who recently retired. But individuals should not wait until they approach old age to adapt to a healthy lifestyle. The earlier they begin, the more likely they are to diminish the chances of losing cognitive function.