Mit 45 fürs Gehirn mit 75 vorsorgen: Checkliste der beeinflussbaren Demenz-Risikofaktoren

Dementia is a growing global health challenge, yet many determinants of late-life cognitive decline emerge decades before symptoms appear. Midlife is a practical window for prevention because hypertension, diabetes, obesity, dyslipidemia, smoking, physical inactivity, unhealthy diet, sleep disturbance, and social isolation can be identified and modified before substantial brain injury becomes apparent. This narrative review synthesizes evidence linking midlife vascular and lifestyle exposures to late-life cognitive impairment and dementia. The most consistent data support a life-course model in which cumulative vascular, metabolic, inflammatory, and behavioral risks interact with neurodegenerative pathology and cognitive reserve. Vascular and metabolic factors act largely through small-vessel disease, endothelial dysfunction, and inflammation, whereas physical activity, healthy diet, sleep, and social engagement may strengthen resilience. Although observational evidence is vulnerable to confounding and single-risk trials may underestimate cumulative benefit, multidomain prevention remains biologically plausible and clinically actionable, as recent trials reaffirm. These priorities are especially salient in the rapidly transitioning Gulf Cooperation Council (GCC) countries, where midlife cardiometabolic risk is high and local evidence is limited. Dementia prevention should be embedded in routine midlife care, with vascular risk management and sustained lifestyle support treate

Cognitive decline and dementia represent major and growing global health challenges, driven largely by population aging and increased longevity. Currently, more than 55 million people worldwide live with dementia, a figure projected to rise to approximately 153 million by 2050. Alzheimer's disease accounts for the majority of cases, and despite extensive research, effective disease-modifying therapies remain limited. Consequently, increasing attention has shifted toward prevention strategies targeting modifiable risk factors. Accumulating evidence indicates that dementia is not an inevitable consequence of aging and that up to 45 % of cases may be attributable to potentially modifiable lifestyle and environmental factors operating across the life course. Lifestyle behaviors-including diet, physical activity, smoking, alcohol consumption, sleep, and social and cognitive engagement-have emerged as key targets for intervention. In particular, adherence to healthy dietary patterns such as the Mediterranean, DASH, and MIND diets has been associated with better cognitive outcomes, while unhealthy dietary patterns may increase risk. However, findings across studies remain heterogeneous, and uncertainties persist regarding causality, optimal exposure timing, and specific lifestyle components. Recent large prospective cohorts, meta-analyses, umbrella reviews, and multidomain intervention trials have advanced understanding of these associations but have also highlighted important gaps,

The World Health Organization (WHO) recognises dementia as a public health priority. Currently, more than 55 million people live with dementia, and this figure is expected to almost triple to 139 million by 2050. Alzheimer’s disease is the most common cause of dementia, and there is still no cure. Despite the availability of symptomatic and first disease-modifying treatments, effective treatment remains limited. This makes it even more important to be aware that it is estimated that nearly half of all dementia cases could be prevented by eliminating 14 major risk factors. Consequently, the role of these modifiable risk factors has been the subject of research to inform effective preventive strategies. This narrative review summarises the current evidence on the prevention of cognitive decline and dementia. First, we provide an overview of the current state on risk factors, multimodal clinical controlled trials for slowing down or preventing dementia and primordial, primary, secondary, tertiary and quaternary prevention of cognitive decline and dementia. Second, we evaluate knowledge and action gaps in the field. Finally, we discuss how to address these gaps and what the next steps should be. Overall, to accelerate progress, the following key calls to action are paramount: (1) making prevention of cognitive decline and dementia a priority; (2) promoting brain health throughout the lifespan through coordinated intersectoral action targeting key risk factors; (3) improving acces