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    Risk Reduction

    Risk Reduction

    The need for effective dementia risk reduction strategies that help all communities increases by the day. Two-thirds of Americans have at least one major potential risk factor for dementia. Just as public health works to keep people physically healthy across the lifespan, public health must help people stay cognitively healthy. A growing body of evidence shows that addressing certain modifiable risk factors and promoting healthy behaviors can reduce the risk of cognitive decline, possibly reduce the risk of dementia, and protect cognitive health.

    For an overview of these issues and other related topics:

    Modifiable risk factors

    Toolkit: Social Determinants of Health

    Created for public health agencies, this toolkit provides a framework for identifying and addressing dementia-related SDOH.

    View Toolkit (PDF)

    The science on dementia risk reduction is quickly evolving, and the evidence showing a link between certain behaviors/conditions and cognitive health/dementia is growing stronger. The most notable healthier behaviors that can reduce the risk of cognitive decline and possibly dementia include: 

    • Being physically active.
    • Quitting or never starting smoking.
    • Being heart-healthy, which includes managing midlife high blood pressure and avoiding and managing diabetes and midlife obesity.

    The following are short summaries on the current state of the evidence on a variety of possible risk factors, including the implications for public health:

    Several videos from the BOLD Center of Excellence on Dementia Risk Reduction outline the evidence behind various modifiable risk factors and what this means for public health:

    For additional reviews of the evidence on modifiable risk factors:

    Prevalence of Risk Factors for Dementia in the U.S.

    Dementia Risk Reduction Summit Recording Now Available

    A free recording of the Alzheimer's Association Public Health Center of Excellence on Dementia Risk Reduction’s first-ever Dementia Risk Reduction Summit is now available. The Dementia Risk Reduction Summit explored how public health can address the risk factors for cognitive decline and dementia across the public health prevention spectrum.

    Watch the Summit

    Social determinants of health (SDOH)

    The risk for dementia, many of the modifiable risk factors for dementia, and the ability to address those risk factors are all affected by social determinants of health (SDOH) — the conditions present where people live, learn, work and play that affect a wide range of health risks and outcomes. The Association's Public Health Center of Excellence on Dementia Risk Reduction is currently undertaking a comprehensive review of the evidence on SDOH related to dementia.

    Several studies reported at the 2022 Alzheimer’s Association International Conference (AAIC) demonstrated the impact of inequities on cognitive decline. Experiences of structural, interpersonal and institutional racism are associated with lower memory scores and worse cognition in midlife and old age, especially among Black adults. Socioeconomic deprivation, including neighborhood disadvantages and persistent low wages, are associated with higher dementia risk, lower cognitive performance and faster memory decline. Both summaries are available in English and Spanish.

    The Center hosted a four-part SDOH webinar series, featuring public health experts discussing links between SDOH and dementia risk reduction, along with insights from state and local health departments. The SDOH Toolkit for Public Health Agencies (PDF) provides public health agencies with a framework to identify dementia-related SDOH and implement effective strategies in their communities.

    A series of short summaries developed by the BOLD Center detail the current state of the evidence on a number of SDOH related to dementia:

    The BOLD Center developed a set of infographics that showcase information on SDOH related to dementia as well as strategies to address these issues:

    The BOLD Center held a SDOH workshop at AAIC 2022 in San Diego. This workshop convened researchers and public health officials to discuss SDOH related to dementia risk. Addressing Dementia Risk Through Social Determinants of Health: A Center of Excellence Workshop (PDF) summarizes the scientific evidence presented at the workshop along with insights for public health.

    What public health can do

    Emerging research and practice from around the globe have illustrated successful strategies for addressing dementia risk factors and supporting public health in doing so. At AAIC 2023, the BOLD Public Health Center of Excellence on Dementia Risk Reduction held a conversation with international researchers and organizations about the most effective ways to support public health in prioritizing brain health activities. Read a transcript of the conversation.

    Include risk reduction in Alzheimer's plans

    Addressing risk factors for cognitive decline and dementia should be included in state, local, or tribal Alzheimer's plans. Public health officials should be involved in a jurisdiction's comprehensive planning efforts. Suggested Recommendations for Alzheimer's Plans (PDF) provides examples of risk reduction-related recommendations that could be included in such plans. Our needs assessment tools can also help in the planning efforts.

    Integrate messaging

    Public health practitioners can integrate information and education (PDF) about cognitive health into existing initiatives and programs targeted at the conditions and unhealthy behaviors that are risk factors for cognitive decline and dementia.

    Address hypertension

    Some of the strongest evidence about reducing risk for cognitive impairment involves managing hypertension. The Alzheimer's Association has prepared an action brief on hypertension specifically for public health officials. It explores the heart-brain connection and describes tools and resources that can help public health to address the issue.

    State success: Promoting brain health in South Carolina

    The South Carolina Department of Health and Environmental Control implemented a multi-media campaign focused on brain health and reducing the risk of cognitive decline. Read the case study to learn more or visit South Carolina's Take Brain Health to Heart website.

    Learn More



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