What Is Your Risk for Alzheimer’s Disease? Key Risk Factors, and How You Can Lower Them

In the U.S., as many as 10% of adults over the age of 65 live with dementia. While Alzheimer’s disease isn’t the only cause of dementia, it’s the most common. 

There are many risk factors linked to developing Alzheimer’s disease. Researchers are finding that there are also many ways to lower your risk.

This is great news if you’re looking for ways to lower your chances of developing dementia. Let’s take a look at all types of risk factors for Alzheimer’s disease and dementia. Along the way, we’ll touch on strategies to address each one. And we’ll focus on the factors you can modify to reduce your risk. 

Risk factors for Alzheimer’s disease

“Developing Alzheimer’s disease is complex. There’s no one simple cause or pathway. It is a mixture of genetics, lifestyle, and social and environmental exposures,” said Dr. Raj C. Shah, MD, board certified family physician.

In addition to family medicine, Dr. Shah is a geriatrician and professor at the Rush Alzheimer’s Disease Center at Rush University in Chicago, Illinois. He has devoted his career to helping patients and their families affected by Alzheimer’s disease and dementia. This includes studying the complex factors that increase someone’s risk for these conditions.

Some risk factors for Alzheimer’s disease — like age and genetics — we can’t change. But there are many others that we can change.

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A group of global experts, known as the Lancet Commission, has found 14 modifiable risk factors that can reduce the risk of Alzheimer’s. Dr. Shah said that by addressing these factors as early as in your childhood, about half of all cases of dementia could either be prevented or delayed. Here are five important risk factors to consider.

Age

Getting older is a risk factor for Alzheimer’s, as it is for many health conditions. According to the American Alzheimer’s Association, in the U.S.:

• About 5% of people ages 65-74 have Alzheimer’s dementia.

• Among those between the ages of 75-84, this number increases to about 13%.

• Around one-third of people over age 85 have dementia caused by Alzheimer’s disease.

As we get older, it’s common to misplace things from time to time. It’s also common to struggle to find the right word. But when these issues start to happen more often, it may be a sign of mild cognitive impairment. 

For 10% to 20% of people with mild cognitive impairment, their symptoms will progress to dementia within the next year or so. For others, symptoms will stay about the same. Or they may even improve.

A healthcare professional can identify conditions that might be adding to problems with thinking or memory. If symptoms start to progress towards dementia, treatments are available to help slow the rate of those changes.

Genetics

Some genetic variants lead to a higher risk of Alzheimer’s disease. Especially for the risk of symptoms appearing before the age of 50, explained Dr. Shah. 

But having these genetic variants doesn’t always guarantee that you’ll get the disease. The same is true for having someone in your family with Alzheimer’s. 

“Having a family member, such as a parent or sibling, with Alzheimer’s dementia doesn’t necessarily mean that you will get dementia,” explains Dr. Shah. “You may have a slightly increased risk.” For instance, he says, “If the number of people in the United States with dementia at age 65 is 2%, having a family member increases the risk to 4%.”

DNA tests can identify some markers for Alzheimer’s risk. These tests are mostly used for research. Testing may be offered in a healthcare setting if there’s a strong family history of Alzheimer’s or if family members developed Alzheimer’s at a younger age. 

There are tests you can take at home. But there are many other factors besides genetics that can affect a person’s risk for Alzheimer’s. It’s best to talk with a healthcare professional about what the results could mean. 

Dr. Shah said, “In the end, it could be more important for persons with a family member with dementia to self-monitor their thinking. If there are concerns or changes, it’s best to talk with their primary care provider earlier.”

Health conditions

Your brain responds to what happens in the rest of your body. Certain health conditions can increase your risk of developing Alzheimer’s:

• Hypertension: High blood pressure raises your risk of Alzheimer’s disease. But controlling high blood pressure with medication can lower that risk.

• Diabetes: In one large study, having diabetes increased the risk for Alzheimer’s almost as much as having a gene type for it. But people with both Type 1 diabetes and Type 2 diabetes can lower this risk by keeping blood glucose within the target range.

• Excess weight: In some people, extra body fat can trigger changes in hormones, blood vessels, and brain cells. This may contribute to the brain changes seen in Alzheimer’s disease.

• High low-density lipoprotein (LDL) cholesterol: Too much LDL cholesterol (“bad” cholesterol) can lead to narrowed blood vessels in your brain. This seems to impact how the proteins that cause Alzheimer’s build up in brain tissue. For some, taking statin medication for cholesterol may lower this risk.

• Hearing loss: People with hearing loss are at higher risk of dementia, which increases with the degree of hearing loss. But hearing aids appear to cut this risk in half.

• Vision loss: Taking in sensory information is important for brain health. Like hearing problems, vision problems can increase a person’s risk for Alzheimer’s.

• Depression: People with clinically significant depression have a greater risk for Alzheimer’s. Depression can also make symptoms worse for those who have Alzheimer’s. Treating depression may decrease the risk of developing Alzheimer’s and improve symptoms in people with dementia.

• Concussions or traumatic brain injuries (TBI): A single mild concussion may not increase the risk of Alzheimer’s by much. But more serious concussions and head injuries can. The risk goes up further with repetitive or chronic head injuries.

Lifestyle risk factors

Everyday habits, choices, and situations affect both your brain and body. Some lifestyle patterns that increase the risk for Alzheimer’s disease include:

• Smoking: If you currently smoke, this increases your risk for Alzheimer’s by 70%. But quitting smoking reduces that risk, even for long-term smokers.

• Inadequate sleep: Good sleep helps your brain function at its best. Not getting enough quality sleep may increase your risk of Alzheimer’s. One large study found that people who slept less than 7 hours a night in their 50s and 60s had a 30% higher chance of developing dementia later in life.

• Social isolation: A large study in the UK found that people with limited social contact were 26% more likely to develop dementia over time. They also had lower brain volume in areas involved with learning and thinking.

• Excess alcohol: Heavy alcohol intake (14 or more drinks per week) is a known risk factor for Alzheimer’s disease and dementia.

• Limited physical activity: A recent study of more than 60,000 people found that those with the highest exercise capacity had the lowest risk of dementia. Exercise even lowered the risk of Alzheimer’s by 35% for people who had the highest genetic risk.

• Diet and nutrition: Studies suggest that some ways of eating may lower your risk of Alzheimer’s disease. The MIND diet is one example that has been found to support brain health. 

Environmental and social risk factors

Your brain is a resilient organ. But it’s also highly sensitive to your physical, emotional, and social environment. Some environmental and social factors that impact your risk of Alzheimer’s include:

• Air pollution: Particles and gasses in the air are known risk factors for lung disease, heart disease, and cancer. The effect of air pollution on your brain is still being studied. But people who live in places with more air pollution have a higher risk of developing Alzheimer’s.

• Limited education: In general, people who have more years of education have a lower risk for Alzheimer’s disease. If they do develop the disease, it often develops at a later age or progresses at a slower rate. This protective effect is also seen in lifelong learning. People who work in mentally challenging jobs or who learn new skills later in life may also have a lower risk for dementia. 

• Economic and social inequalities: People with lower income levels or those living in neighborhoods with fewer resources are at a higher risk of Alzheimer’s disease. Recent studies suggest that these impacts may begin as early as childhood.

How to reduce the risk of Alzheimer’s

While there’s no surefire way to prevent Alzheimer’s disease, there are ways to reduce your risk. Dr. Shah pointed to a global network of researchers and clinicians studying lifestyle and environmental changes. “Most of these interventions have minimal downsides and may be worth incorporating into a daily routine,” he said. Some Alzheimer’s prevention even begins in childhood. 

Dr. Shah cited the most recent findings of the Lancet Commission as the best ways to lower your risk for Alzheimer’s disease and dementia:

• Keep learning: Quality education in childhood and young adulthood is important. Continuing to learn new things in midlife and older adulthood also has a protective effect. 

• Stay active: Regular exercise lowers your risk of dementia.

• Have your vision and hearing checked: Using all your senses to the fullest keeps your brain engaged and active.

• Don’t smoke: If you smoke now, take advantage of free resources to help you quit. It benefits your brain to quit at any age. If you’re a nonsmoker, avoid secondhand smoke.

• Reduce exposure to air pollution: Limit your time outside on days when the air quality is worse. Daily air quality updates are often included in local weather reports. 

• Get tested and treated for diabetes: Brain health is improved by managing blood sugar with a nutritious diet, physical activity, and medications when needed.

• Aim for a healthy weight: Maintaining a weight that is neither too high nor too low lowers your risk for Alzheimer’s.

• Optimize blood pressure: Aim for a systolic blood pressure of 130 mm Hg or lower, especially after the age of 40.

• Have your cholesterol checked: Talk to your primary care provider about ways to lower your LDL cholesterol if it could be in a better range.

• Limit your alcohol intake: If you drink alcohol, it’s safest for your brain to have no more than 1-2 drinks in a day.

• Work on your sleep: Most adults need at least 7 hours of quality sleep each night.

• Prevent head injuries: Wear a helmet for biking and other sports and check your living environment for fall hazards. If you’re unsteady on your feet, look into assistive walking devices that might help with mobility.

• Remember mental health: Treating depression can have benefits for thinking and memory.

• Stay connected: Isolation isn’t good for brain health. Look for activities and environments that help you connect with other people.

There isn’t one standard recommendation to screen for Alzheimer’s disease. But Dr. Shah said, “If people have concerns about their thinking, it’s important to talk with their primary care provider as soon as possible.” 

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Written by:

Anne Jacobson, MD, MPH

Anne Jacobson, MD, MPH has been a board-certified family physician since 1999. She worked as a full-scope family physician (inpatient, outpatient, obstetrics, and office procedures) in the Cook County Ambulatory Health Network for 15 years.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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