Memory and Brain Health: 14 Risk Factors You Can Change

The main levers

Many of these will look familiar.

• Hearing loss and vision loss
• High blood pressure and high cholesterol
• Diabetes and obesity
• Physical inactivity
• Smoking and heavy alcohol use
• Depression and social isolation
• Poor sleep
• Head injury and air pollution

A brain-friendly week

Combine aerobic exercise, strength training, mostly plant-based eating, social time and a mentally demanding activity. A large Finnish trial of this multi-pronged approach improved cognition in at-risk older adults.

When to see a doctor

See a doctor if memory loss affects daily life, if you repeat questions often, get lost in familiar places or struggle with routine tasks. Early assessment matters, since some causes are treatable.

Brain health and the heart

What is good for the heart is good for the brain. High blood pressure, high cholesterol, diabetes, smoking and obesity damage small blood vessels in the brain, raising the risk of vascular dementia and Alzheimer's disease. Treating them in midlife and later reduces risk. Regular exercise improves blood flow and encourages growth of brain connections. Atrial fibrillation, a common irregular heart rhythm, raises stroke risk; ask your doctor to check your pulse.

Protect your heart to protect your mind.

Alcohol, smoking and head injury

Heavy drinking is linked to brain shrinkage and dementia; keep alcohol low or avoid it. Smoking doubles the risk of dementia in some studies; stopping at any age helps. Protect your head: wear helmets on two-wheelers, use seat belts and prevent falls. Treat head injuries seriously and seek medical care if there is a headache, drowsiness, confusion or vomiting after a blow.

These simple choices add up over time.

Brain health and mood

Chronic stress, depression and loneliness are linked to poorer cognition. Look after emotional health: keep in touch with friends, share worries, practise relaxation, and seek help for persistent low mood. Treating depression can improve concentration and memory. Purposeful activity, laughter and enjoyable hobbies are good for the brain too.

A healthy mind needs both challenge and rest.

Supporting someone who is worried about memory

If a loved one is worried, listen without judgement and encourage a check with the doctor. Offer to go together, and to keep notes of examples. Reassure them that many causes of memory trouble are treatable. If they refuse, try again later and involve a trusted friend or doctor. Avoid arguing about what they forgot.

Make life easier with routines, lists and reminders, and avoid unnecessary stress.

Love, patience and practical help matter more than any test.

What counts as normal ageing and what does not

Normal ageing brings slower recall, occasional word-finding difficulty and the need for lists. Warning signs include repeating the same question within minutes, getting lost on familiar routes, trouble handling money or medicines, new personality changes, difficulty following conversations and abandoning hobbies. A doctor can assess with history, cognitive tests, blood tests and scans, and rule out treatable causes such as thyroid disease, vitamin B12 deficiency, depression, medicines, infections and sleep apnoea.

The Lancet's 14 modifiable risk factors

The 2024 Lancet Commission lists 14 risk factors that together may account for about 45 per cent of dementia: less education, hearing loss, high LDL cholesterol, depression, traumatic brain injury, physical inactivity, diabetes, smoking, hypertension, obesity, excessive alcohol, social isolation, air pollution and vision loss. Addressing them across life, including after 65, may prevent or delay many cases. It is never too late: treating hearing and vision, managing blood pressure and staying active all help.

A brain-healthy daily routine

Move: a daily walk and strength training. Eat: vegetables, legumes, fish, nuts, whole grains and olive oil. Sleep: seven to eight hours. Connect: meet friends, join groups. Challenge: learn something new. Protect: wear seatbelts and helmets, treat hearing and vision loss, control blood pressure and sugar, avoid smoking and limit alcohol. The FINGER trial in Finland combined these elements and improved cognition in at-risk older adults over two years.

Practical memory aids that work

Keep a calendar and notebook in a fixed place. Use a daily routine, alarms and phone reminders. Put keys, glasses and wallet in the same spot every day. Label cupboards. Use a pill organiser. Repeat names when you meet people and link them with an image. Break tasks into steps. These aids compensate for normal slips and support those with early memory problems.

Depression, anxiety and memory

Low mood and anxiety can mimic or worsen memory problems. Persistent sadness, loss of interest, poor sleep or appetite and hopelessness deserve treatment, which can improve thinking as well as mood. Talk to your doctor. Counselling, medicines, exercise and social activity all help. Do not assume that memory loss means dementia; treat what can be treated.