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By Maria Azzurra Volpe
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Preventing dementia should not be viewed as a matter of individual responsibility alone, according to a new study that argues greater attention must be paid to the social, environmental and economic conditions that shape brain health throughout life.
Public health messages often encourage people to lower their dementia risk by exercising regularly, eating a healthy diet, staying socially connected and managing their health. While the researchers agree these actions are important, they argue that such advice tells only part of the story.
The study examined 61 potentially modifiable dementia risk and protective factors and found that prevention efforts frequently focus on changes that individuals are expected to make through motivation and behavior. According to the researchers, this approach can overlook many factors that influence whether people are actually able to make and sustain healthy choices.
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The authors say dementia risk is affected by circumstances that are not fully within a person's control. These include the education they receive, the quality and stability of their housing, safety in their neighborhood, access to healthcare, air quality, social connections and wider social and economic conditions experienced throughout life.
Eric Stulberg, MD, assistant professor of neurology at Jefferson Health, who was not involved in the study, told Newsweek that many of these factors can have a meaningful impact on dementia risk.
"Social and environmental factors play a substantial role in shaping dementia risk," he said. He noted that educational attainment has repeatedly been linked to dementia risk, while researchers continue to investigate how factors such as housing, healthcare access, air quality and neighborhood conditions may contribute.
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Stulberg added that access to preventive healthcare during midlife may be particularly important because many dementia risk factors emerge during those years. Early identification and treatment of conditions such as high blood pressure and high cholesterol can help address risks before they become long-term health concerns.
Researchers argue that these influences often receive less attention in discussions about dementia prevention despite growing evidence that they can affect brain health. They also say such factors can shape a person's ability to follow advice intended to reduce dementia risk.
At the center of the study is a concern that prevention campaigns may place too much emphasis on personal behavior without considering whether people have the resources and opportunities needed to make healthy choices.
While Stulberg agreed that broader circumstances can influence a person's ability to protect brain health, he said he would characterize the issue as "an incomplete picture" rather than an overemphasis on individual responsibility.
"Public health messaging around dementia prevention has often focused on individual actions: exercise more, quit smoking, control your blood pressure. This messaging is important and should continue since these remain major risk factors for dementia," he said.
The researchers say it is not enough simply to advise people to exercise more, eat well, remain socially active or manage their health if they live in environments that make those goals difficult to achieve.
Lead author Dr. Jennifer Dunne said factors including where people live, the education they receive, access to healthcare, the air they breathe and their social and economic circumstances can all influence brain health.
Rather than replacing existing prevention strategies, the study calls for a broader approach that combines support for healthy individual behaviors with efforts to improve the conditions that affect health across entire populations.
Stulberg said the study's findings should not be interpreted as diminishing the role of personal responsibility. "So, the practical takeaway isn't that individual choices don't matter. They're very important, and people should continue to be encouraged to take responsibility for their own health," he said.
He added that prevention efforts may be most effective when they focus on groups facing the greatest burden of dementia risk factors and the greatest barriers to preventive care and healthy lifestyles. "Ultimately, adequate access to care, healthy environmental conditions, and individual choice all play a major role in shaping dementia risk," he said.
According to figures cited in the study, about 57 million people worldwide currently live with dementia. That number is projected to increase to 139 million by 2050.
Given those trends, the authors argue that reducing dementia risk should be seen as a shared responsibility. In their view, governments, organizations and communities all have a role to play alongside individuals.
As dementia rates continue to climb, the researchers say prevention efforts must move beyond focusing solely on individual behavior. Instead, they argue for a more comprehensive approach that addresses the social, environmental and economic conditions that help make healthy choices possible in the first place.
Reference
Dunne et al. Beyond individual-level approaches to dementia prevention: a socioecological reappraisal. The Lancet Public Health. DOI: 10.1016/S2468-2667(26)00171-4
Contact Newsweek editors on this story: Kara Dolman and Emma Lee-Sang
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