What Can I Do to Support Brain Health After Someone Develops Dementia?

When someone has already been diagnosed with dementia, it can be easy to think that conversations about dementia prevention no longer apply.

But there is still a lot caregivers can do.

The 2024 Lancet Commission on dementia prevention, intervention, and care identified 14 potentially modifiable risk factors associated with dementia. Researchers estimated that addressing these factors across the lifespan could theoretically prevent or delay almost half of dementia cases worldwide.

That does not mean dementia is 45% preventable, or that an individual can eliminate their personal risk by changing their lifestyle. The estimate applies at a population level, and some of the factors—such as education, air pollution, and social isolation—also depend on broader social and environmental conditions.

For someone who is already living with dementia, however, many of these same factors remain relevant to overall health, comfort, independence, communication, and quality of life.

What are the 14 modifiable risk factors?

The 2024 Lancet Commission identified 14 potentially modifiable factors associated with dementia risk across the lifespan:

Early life

• Less education

Midlife

• Hearing loss
• High LDL cholesterol
• Depression
• Traumatic brain injury
• Physical inactivity
• Smoking
• Excessive alcohol consumption
• High blood pressure
• Obesity

Later life

• Diabetes
• Social isolation
• Air pollution
• Untreated vision loss

These factors occur across different stages of life, and some can be relevant during more than one stage. They also don't all depend on individual choices. Education, air pollution, and social isolation, for example, are influenced by broader social and environmental circumstances.

The Commission estimates that addressing these potentially modifiable factors could theoretically prevent or delay about 45% of dementia cases worldwide. This is a population-level estimate. It does not mean that 45% of an individual's dementia risk can be eliminated, or that dementia can be prevented in every person.

For someone who is already living with dementia, the purpose of looking at these factors is not to place blame or suggest that the dementia could have been prevented. Instead, many of them can provide useful areas for caregivers and healthcare professionals to consider when supporting the person's overall health and quality of life.

Pay particular attention to:

• Hearing and vision
• Physical activity and movement
• Social connection
• Depression and mood changes
• Blood pressure, diabetes, and cholesterol
• Healthy weight and nutrition
• Smoking and excessive alcohol use
• Preventing falls and head injuries
• A safe and supportive environment
• Meaningful mental and social engagement

The goal is not perfection. It is to help the person remain as healthy, connected, comfortable, and engaged as possible.

1. Check hearing and vision

Hearing and vision deserve particular attention because difficulties with either can make dementia symptoms appear worse.

A person who cannot hear a question clearly may seem as though they are not understanding. Someone who cannot see well may become confused about objects, faces, signs, or their surroundings.

The 2024 Lancet Commission added untreated vision loss as a potentially modifiable dementia risk factor. Hearing loss was already included in the Commission's earlier reports.

For caregivers, practical steps include:

• Make sure glasses are current and being worn when needed.
• Keep hearing aids clean, charged, and working.
• Reduce background noise when talking.
• Face the person when speaking.
• Make sure rooms are adequately lit.
• Schedule hearing and vision evaluations when appropriate.

Sometimes a simple sensory problem can make an already difficult situation considerably harder.

2. Keep the person moving

Physical activity is one of the modifiable factors identified by the Lancet Commission.

Movement does not have to mean formal exercise.

Depending on the person's abilities, it might include:

• Walking
• Dancing to familiar music
• Gardening
• Stretching
• Folding laundry
• Sweeping
• Tossing a ball
• Standing and sitting with assistance
• Moving to music

The goal is to find movement that is safe, enjoyable, familiar, and appropriate for the person's current abilities.

Physical activity can support strength, mobility, balance, mood, sleep, and overall physical health.

3. Protect social connection

Social isolation is another modifiable risk factor identified by the Lancet Commission.

For a person with dementia, social connection does not have to mean a large gathering or complicated outing.

It might be:

• Having coffee with a family member
• Listening to music together
• Looking through photographs
• Sitting outside with someone
• Calling a familiar friend
• Attending a familiar community activity
• Cooking together
• Talking about something the person has always enjoyed

Think about connection rather than conversation.

A person does not need to carry on a long conversation for an interaction to be meaningful.

4. Pay attention to depression and changes in mood

Depression is one of the 14 factors identified by the Lancet Commission.

Depression and dementia can also overlap in complicated ways. Changes in mood, withdrawal, loss of interest, sleep changes, or changes in behavior should not automatically be assumed to be “just the dementia.”

If you notice a significant or persistent change in mood or behavior, discuss it with the person's healthcare professional.

Caregivers can also look for opportunities for:

• Familiar activities
• Meaningful roles
• Social connection
• Time outdoors
• Music
• Gentle physical activity
• Pleasant sensory experiences
• Choices throughout the day

The question is not simply, “How do I keep them busy?”

A better question may be:

“What helps this person feel connected, capable, and like themselves?”

5. Stay on top of cardiovascular and metabolic health

Several of the Lancet Commission's risk factors relate to physical health, including:

• High blood pressure
• High LDL cholesterol
• Type 2 diabetes
• Obesity
• Physical inactivity

The 2024 report added high LDL cholesterol as a new potentially modifiable risk factor.

For caregivers, this means helping the person keep up with appropriate medical care and treatment plans.

That might include:

• Attending medical appointments
• Keeping track of health information
• Helping with medications as directed
• Supporting appropriate physical activity
• Encouraging nutritious meals and adequate hydration
• Following the healthcare professional's recommendations for blood pressure, cholesterol, and diabetes

Caregivers don't need to manage these conditions alone. The healthcare team should help determine what monitoring and treatment are appropriate for the individual.

6. Prevent falls and head injuries

Traumatic brain injury is one of the Lancet Commission's modifiable risk factors.

Fall prevention can become particularly important as dementia progresses.

Look at the person's environment for potential hazards:

• Loose rugs
• Poor lighting
• Cluttered walkways
• Unstable furniture
• Slippery bathroom surfaces
• Inappropriate footwear
• Obstacles on stairs

Also consider whether the person is having difficulty seeing or hearing. Those problems can affect safety as well.

If the person's balance, walking, or mobility changes, discuss those changes with their healthcare professional.

7. Create an environment that supports the brain

A person with dementia may have increasing difficulty processing information from the environment.

You can make things easier by reducing unnecessary cognitive demands.

For example:

• Label important cupboards or doors with words and pictures.
• Keep frequently used items where they can be seen.
• Use familiar objects and photographs.
• Keep important routines consistent.
• Reduce unnecessary background noise.
• Provide good lighting.
• Give one instruction at a time.
• Offer simple choices rather than too many options.

The goal isn't to make the person “remember better.”

It is to change the environment so that the person has less remembering to do.

8. Keep meaningful mental engagement in the person's life

Mental engagement is not one of the 14 Lancet risk factors in the same way that hearing loss or physical inactivity is.

But meaningful cognitive and social engagement can still be an important part of dementia care.

Don't assume that cognitive engagement has to mean crossword puzzles or memory games.

It might be:

• Sorting photographs
• Listening to favorite music
• Gardening
• Cooking
• Folding towels
• Looking through a familiar magazine
• Talking about someone's former work
• Watching a favorite sport
• Doing a familiar craft
• Helping set the table

The activity should match the person's current abilities and interests.

The goal is participation, not performance.

What if the person already has dementia?

You don't need to look at this list and feel that you have 14 more things to manage.

Caregiving is not about creating a perfect lifestyle.

Instead, look for one or two areas where a small change could make everyday life easier.

Maybe the person hasn't had a hearing check in several years.

Maybe their glasses are no longer working well.

Maybe they spend most of the day sitting alone.

Maybe they used to love gardening but no longer participate because the activity has become too complicated.

Maybe the environment is making it harder for them to navigate independently.

Start there.

A helpful way to think about dementia care

Instead of asking:

“What can I do to stop the dementia from getting worse?”

Try asking:

“What can I do today to support this person's health, abilities, connection, and quality of life?”

That shift can make caregiving feel more manageable.

You cannot control every factor that affects dementia. You cannot change a person's age, genetics, or history. And you should not blame yourself for factors that were outside your control.

But you can look for opportunities to make the person's world more supportive.

Sometimes that means a hearing check.

Sometimes it means a walk.

Sometimes it means calling a friend.

Sometimes it means putting a label on a cupboard.

Sometimes it simply means sitting beside the person and listening to their favorite music.

Small changes can matter.

When to talk with a healthcare professional

Talk with the person's healthcare professional about significant or new changes in:

• Memory or thinking
• Mood
• Hearing or vision
• Walking or balance
• Appetite or weight
• Sleep
• Blood pressure
• Blood sugar
• Cholesterol
• Behavior or communication

A sudden change in confusion, behavior, alertness, or physical functioning should not automatically be attributed to dementia. New symptoms can have other causes and may need medical evaluation.