High LDL cholesterol and vision loss were added to the Lancet Commission’s list of modifiable dementia risks, expanding the framework from 12 factors in 2020 to 14.
The update suggests targeted intervention across those factors could prevent or delay about 45% of dementia cases worldwide, up from roughly 40% under the earlier list.
Hearing loss remains the strongest modifiable risk factor, with a relative risk of 1.9 and 8.2% attributable risk; less education ranks second at 7.1% and smoking third at 5.2%.
Blood pressure control remains one of the few drug-backed prevention strategies, with the commission supporting systolic pressure below 130 mm Hg from midlife onward.
Alcohol guidance stayed cautious: risk rises above 12 units a week in the U.S. or 21 in the UK, while evidence on lighter drinking remains mixed.
If nearly half of dementia cases could be delayed, why are hearing loss, blood pressure, and vision still underused as prevention targets?
Could dementia prevention work better with sex-specific strategies, since women may face stronger cognitive effects from hypertension, diabetes, and hearing loss?
Is hearing loss really the biggest modifiable dementia risk, and does treating it with hearing aids actually protect the brain?