Can Alzheimer's Be Prevented?
- 2 days ago
- 13 min read
When Alzheimer’s has walked through your own front door, the question of prevention gets real—and takes on a little more urgency.
I watched what this disease asked of my mother—and of everyone who loved her. Later, I learned that I carry one copy of APOE4, a gene variant associated with higher risk of Alzheimer’s.
But even though APOE4 raises risk, it does not write the ending in stone. Good to know. Not carrying APOE4 does not guarantee that you won’t develop Alzheimer’s; carrying it simply raises the odds.
Still, once you know it is there, it can be hard to unknow. A misplaced phone feels a little different. So does a name that refuses to come to you until three hours later.
It also makes every brain-health headline difficult to ignore.
A certain diet cuts Alzheimer’s risk in half. A supplement protects memory. Walking this many steps or sleeping exactly this many hours could save your brain. Researchers have reversed Alzheimer’s in mice—again.
I have clicked on plenty of those headlines.
But our choices matter, and I would very much like to believe that somewhere in all the research is a dependable formula for protecting my brain. But wanting something to be true is not the same as having good human evidence that it is.
So, has science found a precise formula for preventing Alzheimer’s?
No. Not yet.
But researchers have identified evidence-backed ways that may improve our odds, protect cognition and possibly delay decline.
And delay is not a consolation prize.
Five or more years of managing your own life, driving, traveling, cooking, recognizing the people you love and being fully present for the life you built would matter enormously.
The 2024 Lancet Commission estimated that 45% of dementia cases could potentially be prevented or delayed. And it identified 14 modifiable risk factors: physical inactivity, smoking, high blood pressure, diabetes, high LDL cholesterol, obesity, excessive alcohol use, social isolation, air pollution, untreated vision loss, hearing loss, depression, traumatic brain injury and limited education.
Surprisingly actionable, right?
Now to be clear, that does not mean each of us can reduce our personal Alzheimer’s risk by 45% by faithfully checking every box. It reflects a population-level estimate involving all forms of dementia, not a guarantee for any individual.
That said, Dr. Tommy Wood, M.D. who holds a PhD in neuroscience and physiology, believes that 45% may even be conservative because poor sleep and nutrient status were not included, despite growing evidence for both.
Whether the true opportunity is 45% or something higher, the important point is this: age and genetics are not the entire story.
As I dug into those risks, and the human studies behind them, a few findings stood out more than others.
What Surprised Me Most
The full list of 14 is not terribly exotic, but several findings genuinely surprised me:
The relationship between diabetes, insulin resistance and brain health is stronger than I realized.
Treating hearing loss slowed cognitive decline by 48% in a group of older adults already at higher risk.
Leg strength may be more closely connected to cognitive aging than most of us realize.
Cardio and resistance training may support the brain in somewhat different ways.
Before getting into what each of these findings means for us, a quick word about how I decided which claims deserved the most weight.
A Note on How I Sort Through the Claims
A promising study can mean very different things.
Was it conducted in hundreds or thousands of people—or six?
Did it last weeks or years?
Did it measure real cognitive function or only a laboratory marker?
And was it conducted in people at all?
I mean no disrespect to mice. They have worked very hard on our behalf.
Preclinical research, often conducted in genetically engineered mice, is an important starting point and can lead to important discoveries. But these models reproduce only selected features of a disease that unfolds over decades in complicated human bodies. It is not yet a prevention strategy for the rest of us.
So when I’m under my red-light panels, tuned in to the latest podcast by one of the doctors or neuroscientists I follow, I listen carefully for exactly those details when a study or trial is mentioned: Mice or humans? If in people, how many and for how long? Was it observational or a randomized clinical trial?
For example, Dr. Dale Bredesen promotes his ReCODE protocol with considerable confidence, including claims that Alzheimer’s is potentially preventable and often reversible. Many elements of the program are sensible, but the published studies so far have involved relatively small numbers of participants. I find the results interesting and look forward to larger, independently replicated randomized trials.
Promising is not the same as settled science.
I am not dismissing every idea that has not reached the finish line. I simply want to know where it is on the track.
So, What Actually Appears to Move the Needle?
🧠 Protect Your Blood Vessels and Metabolic Health
Some of the strongest human evidence points to something decidedly unglamorous: The brain depends on healthy blood vessels.
High blood pressure, high LDL cholesterol, diabetes, smoking and strokes are not merely heart concerns. They can damage blood vessels—and therefore the brain’s blood supply—making the brain less able to tolerate other age-related changes.
The diabetes connection initially surprised me, but it makes sense when you consider the effects of chronically elevated blood sugar, insulin resistance and vascular damage.
For brain health, metabolic care means:
Know your blood pressure, cholesterol, glucose and A1C.
Take prediabetes seriously & manage diabetes appropriately.
Remain active.
Preserve muscle.
Avoid smoking.
The goal is not simply to weigh less. It is to maintain a strong, well-nourished body and the healthiest metabolic profile we reasonably can.
🧠 Move Your Body—and Occasionally Make It Think at the Same Time
Physical activity appears in nearly every serious brain-health recommendation because it supports several systems at once: circulation, blood pressure, insulin sensitivity, muscle, balance, mood and sleep.
No particular workout, step count or heart-rate zone has been proven to make us Alzheimer-proof. But consistent movement remains one of the best all-purpose tools we have for supporting the brain and body.
Large trials such as FINGER and U.S. POINTER studied multidomain programs—movement combined with better nutrition, cognitive and social activity and cardiovascular-risk management. The results suggest that several improvements together may be even more useful than expecting one habit to carry the whole load. U.S. POINTER found benefits in participants both with and without APOE4.
Then there’s dual-task exercise, which means moving and thinking at the same time: following a new sequence, reacting to instructions or coordinating both sides of the body.
Sounds a lot like Pilates to me—listening, following instructions, remembering movements, coordinating arms, legs and breathing, and occasionally trying not to topple over.
And another surprise for me, leg strength.
In a long-term study of female twins, greater leg power predicted healthier cognitive aging and brain structure ten years later. That’s wild to me. The association makes sense: our legs contain some of the body’s largest muscles, and keeping them strong supports blood-sugar control, mobility, balance, fall prevention and our ability to keep participating in life.
Last but not least, there is good evidence that cardio and resistance training may support the brain in somewhat different ways.
Broadly speaking, aerobic exercise appears especially supportive of gray matter, including the hippocampus involved in memory. Resistance training has emerging evidence for supporting white matter, the wiring that allows different parts of the brain to communicate as well as abilities such as decision-making and processing speed. The practical message is simple: We need both.
However, all this said, a Pilates class, a strength training session, or a morning walk is not a permission slip to spend the next eleven hours welded to a chair. Research has found a strong association between dementia risk and spending more than ten hours a day sedentary.
The best movement plan includes cardio, strength, balance, less sitting and some cognitive challenge—and still fits into our actual lives.
🧠 Protect the Quality of Your Sleep
Sleep is not simply time when the brain switches off.
And it is not only about logging seven or eight hours in bed. Quality matters too. If sleep is repeatedly interrupted, it may provide far less restoration.
Both slow-wave deep sleep and REM sleep are important. Long-term human studies have linked fragmented sleep and reductions in these stages with later cognitive decline.
Persistent insomnia, loud snoring, pauses in breathing, restless legs, frequent waking or unexplained daytime sleepiness are worth investigating. Sleep apnea is especially important because it repeatedly disrupts both breathing and sleep.
The basics help too: a reasonably consistent schedule, a cool dark room, fewer bright screens before bed, less late alcohol and caffeine, movement and getting some daylight outdoors.
A watch or Oura Ring can provide useful clues by revealing patterns. But these devices can only estimate sleep stages; they do not directly measure brain waves as a clinical sleep study does.
So if your deep-sleep number lands in the red, pay attention—but do not assume your brain received no restorative sleep. REM sleep, sleep continuity, total sleep and how you function during the day all matter.
The goal isn’t to earn a perfect sleep score.
OK, full disclosure: I still do a tiny victory dance inside when my Oura Ring gives me a crown for sleep. Apparently, I remain highly motivated by affirmation.
But the crown is feedback, not a medical verdict. It can also show me what happens when I stay up too late or splurge on a glass of wine.
The real goal is to notice persistent problems, look for causes and adjust what we can to give the brain the most restorative sleep reasonably possible.
🧠 Don’t Ignore Hearing and Vision
Hearing and vision problems can quietly shrink our world.
Conversations become tiring. Reading, driving and group activities become harder. We may move less, go out less and gradually withdraw without fully realizing it.
That matters to the brain.
In the large ACHIEVE trial, hearing intervention slowed cognitive decline by 48% over three years among participants who entered the study at greater risk.
The result did not apply to everyone, and it does not prove that hearing aids prevent dementia. But in that higher-risk group, the result was striking.
Hearing aids also make it easier to communicate and remain connected.
And no, pretending we heard the conversation is not a brain-health strategy.
Vision deserves similar attention. Untreated vision loss was added to the Lancet Commission’s list of modifiable dementia risks in 2024. Seeing well makes it easier to read, exercise, drive, recognize faces, avoid falls and participate in life.
The takeaway is simple: Have hearing and vision checked, keep prescriptions current and treat meaningful loss or disease when appropriate.
These actions may preserve much more than the senses themselves.
🧠 Eat for the Whole Body, Not One Miracle Food
Nutrition matters to brain health, but no single "superfood" or rigid eating plan has been shown to prevent Alzheimer’s.
The strongest evidence supports an overall pattern similar to Mediterranean and MIND-style eating: vegetables, fruit, beans, nuts, fish, whole grains and healthier fats.
Fatty fish provide omega-3s, berries are rich in flavonoids, and beans, nuts, seeds and whole grains are good sources of fiber. Protein from fish, poultry, lean meats, eggs, dairy and beans is especially important after 60 because maintaining muscle supports strength, balance and metabolic health.
Yes, blueberries are wonderful. Olive oil is wonderful. Neither comes with an Alzheimer’s-prevention guarantee. The overall pattern matters more.
Foods to Limit
Ultra-processed foods
Added sugars and refined carbohydrates
Excess saturated fat
A quick word about nutrients: getting enough of what the brain needs matters too. Vitamin D, iron, omega-3 fats and several B vitamins (especially B12 and folate) have all been linked to cognitive health, particularly when someone is deficient. Keep in mind that nutrient needs vary, and they don’t operate in a vacuum. For example, some research suggests that the effect of B-vitamin supplementation may depend partly on a person’s omega-3 status. This is one reason giving the same supplement to everyone can produce mixed results.
This is not an invitation to megadose or build another enormous supplement stack. It is a reason to eat a nutrient-dense diet and work with a healthcare professional to identify and correct genuine deficiencies.
I prefer to test rather than guess.
I have also written previously about tricky labels, pesticide lists, microplastics and forever chemicals in our food, water, etc. Those toxin concerns are worth understanding and reducing where practical.
When it comes to protecting cognition, the overall pattern of what we eat—and how it affects our vascular health, metabolic health, nutrient status and muscle—appears to matter far more than any one superfood.
🧠 Stay Connected—and Keep Using Your Brain
Social isolation and loneliness are consistently associated with a higher risk of cognitive decline and dementia.
Cause and effect can run both ways: isolation may affect brain health, while hearing loss, illness or early cognitive changes may cause someone to withdraw.
Either way, meaningful connection is worth protecting.
Activities that combine learning, remembering, decision-making and interaction may be especially useful—think classes, volunteering, dancing, book clubs and games.
A class that makes us learn something, laugh and leave the house may be checking several brain-health boxes at once.
No hobby has been proven to prevent Alzheimer’s, but curiosity, challenge and connection may offer more than a solitary brain-training app we do not enjoy.
Depression is also worth noting as it is associated with a higher risk of later cognitive decline. The relationship is complicated, but the response is straightforward: recognize and treat depression as a real health condition that can affect sleep, motivation, movement and connection now.
🧠 Protect Your Brain From Injury
A history of traumatic brain injury is associated with a higher risk of dementia, particularly after more severe or repeated injuries—which is why it appears on the Lancet Commission’s list.
After 60, protecting the brain often means reducing our chances of falling:
Maintain leg strength and balance.
Keep vision prescriptions current.
Review medications if you feel dizzy or unsteady.
You know that rug, cord or random object you keep stumbling over? Move it.
If your shoes make you feel unsteady—or you cannot turn and react quickly in them—it may be time to let them go. Yes, even the fabulous heels.
Wear helmets for biking, e-biking and Vespa rides.
Always wear a seat belt.
The goal is not to become fearful of movement. Inactivity weakens the muscles and balance we need to remain steady. Keep moving—while protecting the brain you are trying so hard to preserve.
A Word on Brain Hacks
You have seen them on social media: brushing your teeth with your non-dominant hand, walking backward to "rewire" your brain, listening to Mozart, taking nootropic “smart drugs,” or swallowing the latest miracle “brain formula.”
Some may be interesting or support health in other ways.
None has been proven to prevent Alzheimer’s.
Period. Full stop.
Same is true for heavily marketed brain supplements. Correcting a true nutritional deficiency can be important, and a supplement may support general health or fill a genuine gap. That is different from demonstrating that it prevents dementia.
Have you seen the television commercial for the popular memory supplement marketed around a protein originally found in jellyfish? Sounds so exotic and groundbreaking.
My mother insisted on taking it. As her dementia progressed, she became thoroughly convinced it held the cure. Oy.
The Federal Trade Commission and New York Attorney General challenged claims that Prevagen was clinically shown to improve memory and provide cognitive benefits. A federal court ultimately restricted misleading claims about the product.
That experience is one reason I take this kind of marketing so seriously.
If an over-the-counter formula had prevented Alzheimer’s in large, rigorous human trials, it would be major medical news—not merely the subject of a very persistent television commercial.
Hope is important and powerful, especially when memory is already slipping.
It should not be packaged and sold as a proven prevention tool—or a cure.
Why I’m Optimistic
Being cautious about today’s claims does not mean I am pessimistic about tomorrow.
An estimated 7.4 million Americans age 65 and older are living with Alzheimer’s dementia in 2026. Without major breakthroughs, that number is projected to reach 13.8 million by 2060. Nearly double!
Those numbers are frightening—but they are also creating urgency.
The 2026 drug-development pipeline includes 192 trials studying 158 agents, while the National Institute on Aging reports supporting hundreds of active Alzheimer’s and related-dementia trials across treatment, prevention, diagnosis and care.
Researchers are looking beyond amyloid to tau, inflammation, immune function, metabolism, vascular pathways, repurposed drugs and treatment combinations.
Alzheimer’s is not a simple disease. It may not have one simple solution.
And I have to say, I have real hope for artificial intelligence.
AI is not going to create a cure simply because someone asks it the right question. But it can examine enormous amounts of genetic, imaging, laboratory and clinical information far faster than any individual research team.
It may help researchers recognize different forms of the disease, uncover patterns humans have missed, identify promising drug targets and match the right people with the right clinical trials.
Every finding still requires scientific validation and human trials—but the tool itself is real, not science fiction.
Alzheimer’s is an extraordinarily complicated puzzle. I find it hopeful that AI can rapidly examine more pieces and possible connections than any one human research team could manage alone.
That is exciting to me.
I do not know whether the breakthrough will come from AI, one of today’s trials or an idea no one has had yet.
But the field no longer feels entirely stuck.
So, Can We Prevent Alzheimer’s?
Not with the certainty any of us would like—yet.
But the human evidence does not support helplessness either.
There is much we can do to reduce risk or preserve cognition longer—especially when we address several factors together.
I often say to my sisters:
“Hey, even if I just kick the can down the road five or ten years, that is very worth my time and energy.”
And it is.
That is extending healthspan, not just lifespan.
That is five or ten more years of independence, clarity, travel, conversations, relationships and being fully present in my own life.
That is choosing to be proactive rather than reactive—and to have some fun doing it.
Planning and taking a trip. Learning a new skill or language. Building stronger legs. Playing games with friends. Eating food that nourishes us. Sleeping better.
Doing all of that in the name of living well for as long as possible sounds pretty good to me.
Stay curious friends.
Sources & Further Reading
Dementia Prevention, Intervention, and Care: 2024 Report of the Lancet Standing Commission. The source of the 45% estimate and the 14 potentially modifiable dementia-risk factors. Read the report
Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia and Mild Cognitive Impairment: The SPRINT MIND Randomized Clinical Trial. The major human trial examining blood-pressure treatment and cognitive outcomes. Read the study
Multidomain Lifestyle Intervention Trials. FINGER: A 2-Year Multidomain Intervention of Diet, Exercise, Cognitive Training, and Vascular Risk Monitoring Versus Control to Prevent Cognitive Decline in At-Risk Older Adults Read the FINGER study
U.S. POINTER: Structured vs Self-Guided Multidomain Lifestyle Interventions for Global Cognitive Function Read the U.S. POINTER study
Hearing Intervention Versus Health Education Control to Reduce Cognitive Decline in Older Adults With Hearing Loss: The ACHIEVE Trial. The hearing-intervention study discussed in the article, including the finding among participants at greater risk for cognitive decline. Read the study
Movement, Muscle and Sedentary Time.
Kicking Back Cognitive Ageing: Leg Power Predicts Cognitive Ageing After Ten Years in Older Female Twins Read the leg-power study
Sedentary Behavior and Incident Dementia Among Older Adults Read the sedentary-time study
Association Between Slow-Wave Sleep Loss and Incident Dementia. A long-term human study supporting the discussion of deep sleep and cognitive health.
Quincy Bioscience Holding Company—Prevagen Case. The Federal Trade Commission’s official case page covering the challenged memory and cognitive-benefit claims. Read the FTC case summary
Current Alzheimer’s Research and Artificial Intelligence. Alzheimer’s Disease Drug Development Pipeline: 2026 Read the pipeline report
AI-Guided Patient Stratification Improves Outcomes and Efficiency in the AMARANTH Alzheimer’s Disease Clinical Trial Read the AI study
Further Listening
Huberman Lab: “Accelerate Learning & Increase Cognitive Capacity” with Dr. Tommy Wood — July 20, 2026. Includes discussion of exercise, nutrient sufficiency, cognitive aging and potentially modifiable dementia risks, with supporting studies linked in the show notes. Listen and view the show notes
Comments