15 Health and Lifestyle Factors That Increase Risk of Early Dementia

• New research revealed 15 lifestyle and health factors that could increase the risk of young-onset dementia.
• Research indicates that nearly 40% of all Alzheimer’s disease and related dementias can potentially be prevented or delayed by addressing modifiable risk factors.
• Experts recommend people immediately start following healthy lifestyle habits that can lower their risk of developing dementia, like regular exercise, healthy sleep routines, and a balanced diet.

Multiple lifestyle factors can increase your risk of early-onset dementia, according to a new study.

Young-onset, or early, dementia occurs when people develop dementia symptoms before the age of 65.

New research, published last month in JAMA Neurology, identified 15 key risk factors that could increase the risk of developing this condition. Among the risk factors that are modifiable and/or preventable are orthostatic hypotension (a drop in blood pressure when standing up from a sitting or lying position), depression, and alcohol use disorder.

Other risk factors are difficult or impossible to modify, including low socioeconomic status and having inherited two copies of the apolipoprotein E gene, ε4 allele (APOE4).

The new study followed more than 350,000 people younger than 65 in the UK Biobank, a large biomedical database, to gain insight into the risks of early dementia. After analyzing a broad range of factors, including everything from genetic influences to environmental factors, they were able to pinpoint key factors that increase a person’s risk of young-onset dementia.

“All of these factors increase dementia risk as they all lead to the same fundamental mechanisms that ultimately threaten the brain,” David Perlmutter, MD, FACN, ABIHM, a board-certified neurologist, best-selling author, and a fellow of the American College of Nutrition told Health.

“These mechanisms include inflammation [and] increased activity of damaging chemicals called free radicals,” he said.

Perhaps most importantly, these factors all threaten brain metabolism, Perlmutter explained. This means that these factors impact how the brain can use glucose to power its cells.

“Dementia, and Alzheimer’s specifically, are the consequence of compromised brain metabolism,” he said.

Here are the lifestyle and health factors that contribute to young-onset dementia, and how to lower your risk of developing the disease.

The Alzheimer’s Association estimates that between 220,000 and 640,000 people are diagnosed with early-onset Alzheimer’s or related dementia in the U.S. each year.

This type of dementia tends to be more aggressive than dementia that occurs later in life, Arman Fesharaki-Zadeh, MD, PhD, a behavioral neurologist, neuropsychiatrist, and assistant professor of psychiatry and neurology at Yale School of Medicine, told Health.

For this reason, addressing the modifiable risk factors early on should become a top priority.

Fesharaki-Zadeh explained that there is a good likelihood of someone substantially lowering their risk of young-onset dementia—as well as late-onset dementia—if they address these 15 risk factors.

“The authors cite the 2020 report by [the] Lancet Commission on Dementia Prevention, which supported the assertion that eliminating modifiable risk factors, such as metabolic risk factors, could reduce the likelihood of…dementia,” he said.

“For example, an individual with alcohol use disorder is more likely to have comorbid malnutrition and vitamin deficiency, frailty, loss of muscular strength, as well as neuropsychiatric illness such as depression,” he said. “Such individuals are also more likely to have comorbid metabolic disorders, including hypertension, diabetes, cardiovascular disease, and stroke.”

Likewise, these individuals are likely to have higher C-reactive protein levels due to having a more pro-inflammatory state. They also may self-isolate due to an underlying depression, in turn leading to alcohol use disorder as a behavioral coping strategy.

These behavioral patterns would ultimately lead to a range of chronic medical conditions, including hypertension, diabetes, as well as stroke, Fesharaki-Zadeh explained.

As for the non-modifiable risk factors like having two copies of the APOE4 gene, Fesharaki-Zadeh told Health that about 25% of the population carries at least one gene copy.

“Individuals with APOE have a well-established risk of developing Alzheimer’s disease,” he said. “More specifically, if an individual has one copy of APOE4, the person is three times more likely to develop Alzheimer’s Disease, and with two copies of APOE4, the risk can rise to 12 times more likely.”

According to the Centers for Disease Control and Prevention (CDC), nearly 40% of all Alzheimer’s disease and related dementias can potentially be prevented or delayed by modifying lifestyle factors and preventing chronic diseases like diabetes and high blood pressure.

Both Fesharaki-Zadeh and Perlmutter told Health that based on the researchers’ results, as well as prior research, they would recommend people engage in physical exercise to help prevent dementia.

This means sitting less and moving more.

“An active daily physical exercise practice can have far-reaching benefits, which include enhancing neurocognitive function, due to its well-established effects on neurogenesis (formation of new neurons and new synapses), vasculogenesis (formation of new blood vessels), as well as well-known and established mood benefits,” said Fesharaki-Zadeh.

He also suggests that people eat a Mediterranean-based diet, and learn cognitive, mood, and social stimulation techniques.

“Cognitive stimulation could be in the form of formal educational training, as well as [developing] lifelong learning habits, learning new languages, attending seminars, and developing habits such as learning music and dancing,” he said.

Mood stimulation might include the regular practice of stress reduction, such as mindfulness and yoga, while social stimulation is vital to overall mental, cognitive, and physical health.

“In the era of pandemic and now post-pandemic, quality social connections should increasingly be encouraged and practiced,” Fesharaki-Zadeh explained.

Meanwhile, Perlmutter suggests keeping blood sugar under strict control—even if you are not diabetic—and getting adequate, restorative sleep.

“Our lifestyle choices are profoundly influential in terms of how our brain will perform in the future… Importantly, whether we are talking about early or late-onset dementia, the modifiable changes begin to occur as much as three decades before changes in cognitive function are first recognized,” he said.

Ultimately, the time to take preventative action is now.