Nearly half of dementia cases may be influenced by modifiable factors like smoking, cardiovascular disease, and high blood pressure.
Research suggests that many dementia cases are connected to risk factors that people may be able to change. A new study from Lund University identifies several lifestyle and health conditions linked to two of the most common forms of dementia, Alzheimer’s disease and vascular dementia.
A person’s likelihood of developing dementia is shaped by both fixed and modifiable influences throughout life. Certain factors cannot be changed, including age, gender, and genetic background. However, others may be managed or improved. These include smoking, cardiovascular disease, high blood lipid levels, physical activity, alcohol consumption, hearing loss, and high blood pressure.
Dementia itself is not a single illness. Instead, it describes a group of symptoms caused by different underlying brain disorders. Because of this, the risk factors and biological changes involved can vary depending on the type of dementia. The Lund University study explored how different risk factors are connected to brain changes associated with Alzheimer’s disease and vascular dementia.
Study Reveals How Risk Factors Affect Different Dementia Mechanisms
“Much of the research available on the risk factors that we ourselves can influence does not take into account the different causes of dementia. This means that we have had limited knowledge of how individual risk factors affect the underlying disease mechanisms in the brain,” explains Sebastian Palmqvist, senior lecturer in neurology at Lund University and senior physician at the Memory Clinic at Skåne University Hospital.
The research followed nearly 500 participants with an average age of 65 who showed no signs of cognitive decline. Over four years, scientists monitored changes in the brain’s white matter, the nerve fibers that are commonly affected in vascular dementia. They also measured levels of amyloid β and tau, the proteins closely linked to Alzheimer’s disease. The goal was to understand how both modifiable and non-modifiable risk factors relate to gradual changes in the brain.
“We saw that most modifiable risk factors—smoking, cardiovascular disease, high blood lipids, and high blood pressure, among others—were linked to damage to the brain’s blood vessels and a faster accumulation of so-called white matter changes. This damage impairs the function of the blood vessels and leads to vascular brain damage—and can ultimately lead to vascular dementia,” says Isabelle Glans, doctoral student at Lund University and resident in neurology at Skåne University Hospital.
Diabetes and Body Weight Linked to Alzheimer’s Proteins
The researchers also identified factors associated with proteins involved in Alzheimer’s disease.
“Diabetes was associated with increased accumulation of amyloid β, while people with lower BMI had faster accumulation of tau. However, these findings need to be investigated further and validated in future studies,” continues Isabelle Glans.
Maintaining healthy habits and addressing modifiable risks could help delay the development of symptoms related to Alzheimer’s disease. This may be especially important because many individuals with dementia have more than one underlying cause, including both vascular damage and Alzheimer’s-related brain changes. Sebastian Palmqvist highlights that healthy lifestyle choices remain valuable even when Alzheimer’s disease is involved.
“Focusing on vascular and metabolic risk factors can still help reduce the combined effects of several brain changes that occur simultaneously,” he concludes.
Reference: “Associations of modifiable and non-modifiable risk factors with longitudinal white matter hyperintensities, amyloid-β and tau – a prospective cohort study” by Isabelle Glans, Niklas Mattsson-Carlgren, Olof Strandberg, Erik Stomrud, Rik Ossenkoppele, Danielle van Westen, Nicola Spotorno, Oskar Hansson and Sebastian Palmqvist, 1 January 2026, The Journal of Prevention of Alzheimer’s Disease.
DOI: 10.1016/j.tjpad.2025.100448
This study was funded by the National Institute on Aging, Alzheimer’s Association, European Research Council, GHR Foundation, Swedish Research Council, the Knut and Alice Wallenberg Foundation, and the Swedish Brain Foundation.
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