Health & Well-Being

Cognitive Decline Risk Factors and Prevention

I’m Dr. Cris, a neurologist and the founder of the International Headache Center, IHaC, among other things in this life. I focus on building community around healthy brains and spreading the message about all the things we can do to improve our brain function.

While we should all be engaging in healthy lifestyle modifications to protect our brains, identifying risk factors for cognitive decline helps target preventive treatment.

Below are some risk factors we may be able to prevent or can do something about, along with some tips for boosting brain health. As a note, “mid-life” in clinical studies is defined as age 45-65.

5 Risk Factors for Cognitive Decline

1. Traumatic Brain Injury

Injury to the brain leads to disrupted brain function. This is intuitive when someone has suffered a visible injury, but it is often overlooked in those with repeated head trauma due to contact sports or military service.

2. Midlife Obesity and/or Hypertension

The link between obesity and high blood pressure with cognitive decline may be age-related. Indeed, these conditions may be predictors in mid-life, but protective in late life.

3. Smoking

Quitting smoking may decrease the risk to a level comparable to those who don’t smoke.

4. Diabetes

There is strong evidence for an increased risk of dementia in those with diabetes. However, this is not conclusive.

5. Depression

Both a diagnosis of depression and depressive symptoms independently are associated with cognitive decline. The relationship, however, is not well understood.

In general, there is evidence these conditions predispose to cognitive decline. It is thought these conditions lessen brain resilience by decreasing cognitive reserve and increasing inflammatory processes along with toxic damage to the blood vessels and the nervous system.

Healthy Habits that Can Help Inhibit Cognitive Decline

Beyond treating the conditions, above, practicing healthy lifestyle habits expand brain resilience by increasing cognitive reserve and decreasing both inflammation and toxicity to the blood vessels and brain tissue.

1. Formal Education Early in Life

In general, more formal education or greater literacy are protective against dementia and cognitive decline.

2. Physical Activity

Not only does physical activity decrease the likelihood of cognitive decline, but it also improves cognitive function. Though there is no formal recommendation on the type or duration of exercise, activity as simple as walking for 30 minutes daily, at least four times per week, can be protective.

3. Mediterranean Diet

This diet has been linked to lower rates of cognitive decline. If you’re wondering what it really means: add vegetables and/or fruits at every meal and eat fish once per week along with regular whole grains, nuts, olive oil, and small amounts of red meat.

4. Cognitive Training

Mental training improves both immediate and delayed recall. There are no set guidelines on which brain activities are best. Set a daily regimen of something challenging — but not frustrating — wherein you have to come up with the solution and work your way up in difficulty.

5. Social Engagement

Though not much literature is available, social activities at least once per week, along with larger social networks, are linked with better cognitive function and reduced cognitive decline.

Participate in volunteering activities and attend events where you can have novel conversations regularly.

Implementing healthy lifestyle habits and addressing medical concerns can happen at any age to deflect unwanted outcomes (including cognitive decline) and provide positive brain effects! 


Dr. Cristina Wohlgehagen

Cristina Wohlgehagen, MD is the founder of IHaC, a membership based clinic aimed to strengthen and protect our best brain. Dr. Cris is double board certified in Neurology and Headache Medicine. She works with Kerwin Research Center in neurodegenerative clinical research. She is an experienced speaker and educator in the community, also with a volunteer faculty appointment at UT Southwestern.

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