Protect your brain for life

In a 2026 U.S. survey of adults age 40 and older, 99% said brain health is as important as physical health, or more. But only 9% said they knew “a lot” about how to look after it.

Three in four said lifestyle habits matter for brain health, but fewer than half strongly linked those habits to lowering dementia risk. Two in three would like brain health advice from their health care provider, yet only 14% had ever talked about it with their doctor.

The Lancet Commission reported that people with healthier lifestyles, like regular exercise, not smoking, avoiding too much alcohol and staying mentally active, tended to get dementia later, if at all. Overall, they had more healthy years and fewer years of illness.

Physical activity keeps your heart, body and brain healthy. Quitting smoking also lowers the risk of stroke, type 2 diabetes and high blood pressure. You don’t have to wait decades to feel the benefits.

Good-quality education for every child helps build what researchers call “cognitive reserve”: a brain that can cope better with damage later on. The Commission recommends education for all, and staying mentally active through adult life.

There is good news if school was cut short for you: new evidence shows that staying mentally active in midlife makes a difference, even for people who had little education.

The midlife risks, biggest first

• Hearing loss (about 7%)
• High LDL (“bad”) cholesterol (about 7%)
• Depression (about 3%)
• Traumatic brain injury (about 3%)
• Physical inactivity (about 2%)
• Smoking (about 2%)
• Diabetes (about 2%)
• High blood pressure (about 2%)
• Obesity (about 1%)
• Drinking too much alcohol (about 1%)

High LDL cholesterol was newly added in 2024. The Commission recommends finding and treating it from midlife, from around age 40.

Untreated vision loss was newly added in 2024. Social isolation and air pollution were already on the list. Air pollution matters across life, but most of the research so far is in older adults.

These risks are a reminder that brain health isn’t only personal. Supportive communities, housing that helps people live with others, eye care everyone can reach, and clean air all play a part.

Traumatic brain injury at any age raises dementia risk, and fine particle air pollution is linked to higher risk too.

Helmets, safer sport, fall prevention and planning around bad-air days are covered in the Brain health in your 20s to 60s+ guide. Concussion signs and recovery are in the Brain injury & concussion guide.

Risk factors tend to cluster in the same person. That’s why the Commission suggests working on several at once rather than just one.

Among U.S. adults 45 and older, a quarter of those with four or more risk factors said their memory or thinking was getting worse, compared with about 4% of those with none.

The strongest evidence is for combining several healthy habits, not for any one product. Be wary of anything sold as a quick fix for memory.

Activities that mix movement with learning, like dance steps, a martial art or a new sport, give you two brain boosts in one. Doing them in a group adds a social boost too.

For ideas to match your energy and body, see the Sports & exercise for your mind and Body basics for your mind guides.

Muscle-strengthening means working the legs, hips, back, belly, chest, shoulders and arms. Weights, resistance bands or body-weight moves all count.

Easy starts

• Carrying shopping bags
• Gardening that involves digging or lifting
• Sit-to-stand from a chair
• Wall push-ups

Falls can cause serious injuries, including brain injuries. Programs that teach you to move more safely can help prevent falls. Check with your clinical provider before starting vigorous exercise if you haven’t been active.

High blood pressure often doesn’t cause anything you can see or feel. A check at your provider’s office can show if it’s high, even when you feel fine.

It is common: about half of U.S. adults age 45 and older have high blood pressure. The Commission recommends keeping the top number (systolic) at 130 or less from age 40.

High LDL (“bad”) cholesterol in midlife is linked to about 7% of dementia worldwide, one of the two biggest single risks. The Commission recommends finding and treating it from around age 40.

A blood test can check your levels. Work with your clinical provider on what your numbers mean and what to do.

More than 2 in 5 American adults have prediabetes. Lifestyle changes can cut the risk of type 2 diabetes in half.

The CDC’s National Diabetes Prevention Program helps people lose a small amount of weight (about 5% to 7%) and build up to 150 minutes of brisk walking a week. Participants lowered their risk of type 2 diabetes by 58%, or 71% if they were over 60.

Obesity in midlife is one of the 14 risks. The Commission recommends keeping a healthy weight and treating obesity early, which also helps prevent diabetes.

Focus on habits, not a number on the scale: regular meals with plenty of vegetables, fruit, whole grains and fish, and less salt, sugar and solid fat.

For how food and drinks affect your mood and energy, see the Food, drinks & mood guide.

Long or repeated exposure to sound at or above 85 decibels can damage hearing. Normal conversation is about 60 to 70 decibels. Concerts, sporting events and headphones at full volume can reach 94 to 110.

Simple habits

• Move away from the noise if you can’t turn it down
• Protect the ears of young children
• Rule of thumb: avoid noise that is too loud, too close, or lasts too long
• Wear earplugs or earmuffs for loud activities

Nearly half of people over 75 have disabling hearing loss, but fewer than 20% of Americans with hearing loss get hearing aids. Cost has been a big barrier. Since late 2022, lower-cost over-the-counter hearing aids have been available in the U.S.

For life with hearing loss, communication tips and community, see the Deaf & hard of hearing guide.

About one third of older adults have some vision problem by age 65. When sight goes untreated, people often stop driving, reading, going out and exercising, which are all good for the brain.

Researchers estimated that nearly 100,000 U.S. dementia cases might have been prevented with existing vision treatments, like glasses or cataract surgery. The Commission calls for eye screening and treatment that everyone can reach.

For support with sight loss, see the Blind & low vision guide.

In one study, older adults who learned quilting or digital photography had more memory improvement than those who only socialized or did less demanding activities.

Ideas

• Join a book or film club
• Learn (or relearn) a musical instrument
• Take a language, cooking, art or computer class
• Try a craft that takes real focus

A large trial found that certain structured training in reasoning and speed of thinking helped older adults keep their skills over 10 years. But there is no good evidence that commercial brain-game apps have the same effect.

Mental activity in midlife is what the Commission highlights, and it doesn’t have to happen in a classroom. Taking on new tasks at work, learning a hobby, or volunteering in a new role can all keep your mind working in fresh ways.

• Play cards or games with friends, in person or online
• Set a regular call or video chat with someone far away
• Sing in a choir or join a walking, hobby or faith group
• Take a class at a community college, library or senior center
• Volunteer at a school, library, hospital, animal shelter or place of worship

Hearing loss makes people pull back from conversation and social life. Treating it can make it easier to stay connected.

Small fixes

• Ask people to face you when they talk
• Choose quieter cafés or quieter times
• Get a hearing check if groups feel tiring

The Commission calls for age-friendly communities and housing that bring people together, because isolation is a risk communities can lower, not just individuals.

Ideas

• Check in on a neighbor who lives alone
• Invite a friend to learn something new with you
• Start a walking group at work, school or your place of worship

The National Institute on Aging advises getting enough sleep, generally seven to nine hours a night, as part of caring for your thinking skills.

The Lancet Commission did not put sleep on its list. Research is still unclear whether short or long sleep raises dementia risk, or whether sleep changes are an early effect of brain changes that have already started.

Only half of U.S. adults over 40 say they get seven hours of sleep daily or on most days.

Sleep apnea is one of several conditions that can cause dementia-like symptoms. Many of these can improve with treatment.

If someone tells you that you snore loudly or stop breathing in your sleep, or you wake up tired most days, talk with your clinical provider.

People with depression have a higher risk of dementia, and this was seen whether depression started in early, middle or later adult life. New evidence suggests treating depression may lower the risk.

Depression is treatable. See the Depression: understanding it guide for signs, therapies and support.

Stress isn’t one of the 14 risks. But when life feels heavy, it can be harder to sleep, move, eat well and stay in touch with people. Social contact may help the brain partly by lowering stress.

Short daily resets help. See the Breathing basics and Coping strategies: the basics guides, and use the “Everyday stress resets” worksheet.

Excessive drinking can lead to high blood pressure and brain injuries. The CDC advises that if you drink, do so in moderation.

The CDC defines moderate drinking as two drinks or less in a day for men and one drink or less for women. Drinking less is better for health than drinking more, and if you don’t drink, there’s no reason to start.

Healthy lifestyles that included avoiding too much alcohol were linked to dementia starting later. If cutting back is hard, see the Substance Use guide.

Smoking increases the risk of dementia. Quitting also lowers other dementia risks, like stroke, type 2 diabetes and high blood pressure.

In large studies, former smokers had a lower risk of dementia than people who kept smoking, especially if they quit before 65. Quitting helps your health at any age, even after many years of smoking.

Free help to quit: call 1-800-QUIT-NOW (1-800-784-8669) to reach your state’s quitline and talk with a trained counselor.

Two in three adults over 40 want brain health advice from their provider, but few ask. Writing your questions down first makes it easier.

For what to expect at routine check-ups and screenings, see the Checkups, hormones & mood guide. Use the “Brain-health questions for my next check-up” worksheet here.

Several conditions, like sleep apnea, can cause dementia-like symptoms and improve with treatment. That’s a good reason not to wait.

See the Dementia: understanding it guide for warning signs and how a check-up works, and the Living with early dementia guide for first steps. If dementia runs in your family, see Dementia runs in my family.

Call or text 988 to reach the 988 Suicide & Crisis Lifeline and talk with a trained crisis counselor.

Text HOME to 741741 to reach a trained Crisis Text Line counselor.

findahelpline.com lists free, confidential helplines by country. If you are in danger, call your local emergency number.