There is no shortage of products promising a sharper memory. The real evidence on protecting the brain is less exciting to market and more useful: much of it comes down to the same things that protect the heart and blood vessels, plus hearing, sleep and other people.

This article sorts what has solid support from what does not, as of late 2026.

How much of dementia might be preventable

In 2024 the Lancet Commission on dementia, an international expert group, published an updated report naming 14 modifiable risk factors across life. They are less education early in life, hearing loss, high LDL cholesterol, depression, head injury, physical inactivity, diabetes, smoking, high blood pressure, obesity, excessive alcohol, social isolation, air pollution and untreated vision loss. High LDL and vision loss were new additions.

The Commission estimated that nearly half of dementia cases, about 45 percent, could in theory be prevented or delayed if all 14 were removed. That is a population estimate, not a promise to any one person, and age and genes still matter. But it means a good share of risk sits in things that can be treated.

What has the strongest support

Blood pressure control. In the SPRINT MIND trial, published in JAMA in 2019, adults 50 and older with high blood pressure were assigned to a systolic target below 120 or below 140. The lower target reduced mild cognitive impairment, often a step before dementia. The reduction in dementia itself did not reach statistical significance, and the authors noted the trial ended early and may have been too small to show it. Our article on blood pressure and brain health covers this in more detail.

A combination of healthy habits. The US POINTER trial, published in JAMA in 2025, followed more than 2,000 adults aged 60 to 79 at higher risk of decline. Both groups were encouraged to exercise, eat well, stay mentally and socially active and monitor heart health. The group with a structured, coached program improved slightly more on thinking tests over two years than the group that worked on it alone. The difference was modest, but it suggests that structure and accountability help.

Physical activity. The National Institute on Aging describes several studies linking activity with brain health, while noting that more research is needed on exactly how much exercise prevents decline. Since activity also lowers blood pressure, blood sugar and depression, it supports several risk factors at once.

Hearing. Hearing loss is one of the larger risk factors in the Lancet list. Our article on hearing loss and memory explains the link and the case for testing.

Social contact. The NIA cites research in which high social engagement, such as visiting neighbors and volunteering, was associated with better thinking in later life. See loneliness and social connection.

What has weaker support

  • Supplements. The NIA states that no vitamin or supplement is currently recommended for preventing Alzheimer’s or cognitive decline. Recent trials found a daily multivitamin may modestly help memory in older adults, which is different from preventing dementia.
  • Brain-training apps. The NIA warns there is not enough evidence that commercial brain games have the effect seen in research-based cognitive training. Hobbies that keep you learning and around other people are still worth doing for their own sake.
  • Single foods or diets as a cure. Healthy eating patterns support the heart and weight, which helps the brain indirectly, but no single food prevents dementia.

A practical checklist

  • Know your blood pressure, ideally from home readings, and treat it if it is high.
  • Check LDL cholesterol and blood sugar, and treat them when needed.
  • Have your hearing and vision tested, and use hearing aids or glasses if they help.
  • Move most days, including some strength and balance work.
  • Do not smoke, and keep alcohol low.
  • Protect your head: wear a seatbelt and a bike helmet, and reduce fall risks at home.
  • Treat depression and poor sleep rather than putting up with them.
  • Keep people in your week.

One more item belongs on the list. The NIA notes that some medicines and combinations of medicines can cause confusion and memory problems in older adults. A medication review is a simple place to start. And if memory is already changing, see memory changes: when to see a doctor.

At Legacy Medical, Dr. Shtern works through these risk factors with you over time, with labs drawn in the office and close attention to blood pressure. For patients and families concerned about memory, our page on geriatric and memory care explains how she approaches it. To meet her, the first visit is a complimentary meet and greet.

This article is general information, not advice for your situation. Members can call the office with questions about their own care.