Dementia Prevention — Clinician Information

Dementia risk reduction refers to clinical and public health strategies that address modifiable risk factors across the life course to prevent or delay the onset of dementia. Unlike disease modifying therapies, which act on established pathology in patients already diagnosed, prevention strategies are aimed at reducing incident dementia in the broader population- including patients presenting with subjective or mild cognitive concerns, and those with no current symptoms.

Clinicians — and general practitioners in particular — are central to translating this evidence into practice. As the health professionals most patients see regularly across their lives, GPs are uniquely placed to identify and manage modifiable risk factors early, initiate brain health conversations, and support patients to make sustained changes.

In 2026, the World Health Organization released its first major update to global dementia risk reduction guideline in seven years, confirming that up to 45% of dementia cases may be attributable to modifiable risk factors. This has significant implications for primary care and specialist practice, positioning brain health alongside cardiovascular and metabolic risk reduction as a core component of preventative care.

The Australian Government of Health, Disability and Ageing in July and August, sent out a letter to all Australian newly turned 50 regarding modifiable risk factors. This may see an uptick of patients visiting their GP to discuss how to implement changes. 

Clinical trials and cohort evidence – including Australia’s Maintain Your Brain Trial– has demonstrated that structured, multi-domain risk factor intervention can improve cognitive outcomes in at-risk populations, and that these approaches are cost-effective at a health-system level.

Modifiable risk factors and clinical relevance

Current evidence-based guidelines identify the following modifiable risk factor domains as relevant to dementia risk reduction:

  • hypertension,
  • diabetes and metabolic health,
  • midlife obesity,
  • physical inactivity,
  • smoking and excessive alcohol use,
  • high cholesterol
  • hearing loss (uncorrected),
  • vision impairment
  • untreated depression,
  • social isolation,
  • low cognitive engagement/education,
  • traumatic brain injury,
  • Elevated LDL cholesterol levels,
  • air pollution exposure.

Guidelines do not currently support the use of vitamin/ mineral supplementation (including vitamin B, vitamin E, omega-3 fatty acids or mulivitamins) or menopausal hormone therapy specifically for dementia risk reduction, and these should not be recommended to patients for this indication.

Patient identification and assessment

Dementia risk reduction conversations are relevant for patients:

  • presenting for routine midlife health checks (from approximately age 45),
  • with a family history of dementia,
  • with vascular risk factors (hypertension, diabetes, dyslipidaemiea),
  • with subjective cognitive concerns but normal objective assessment,
  • identified through population screening or public health initiatives (e.g., correspondence to Australians turning 50).

Assessment may include:

  • cardiovascular and metabolic risk review,
  • hearing and vision screening,
  • depression and mental health screening,
  • lifestyle factor assessment (diet, physical activity, alcohol, smoking, sleep),
  • cognitive screening where clinically indicated.

Safety and practical considerations

Dementia risk reduction conversations should be approached as part of routine preventive care, similar to cardiovascular risk assessment. Considerations include:

  • Consultation length – meaningful risk factor discussion typically requires longer, structured consultations rather than being addressed within a standard short appointment.
  • Multidisciplinary referral – dietitians, exercise physiologists, audiologists and mental health professionals may support comprehensive risk factor management.
  • Health equity – access to healthy food, safe exercise environments, hearing aids and social participation varies significantly by socioeconomic circumstance and geography, and should be considered when developing a management plan.
  • Life-course framing – while midlife is a critical window, risk reduction conversations remain relevant across the life course, including in older patients.

Implementation considerations in Australia

The introduction of population-level dementia prevention guidance has implications for General Practitioners, where new blood and diagnostic tests become increasingly available in clinical practice in the future. It has further implications for:

  • general practice and preventive health consultations,
  • MBS-funded health assessments (e.g., 45–49 year old health check, 75+ health assessment),
  • referral pathways to allied health and specialist services,
  • public health messaging and consumer-facing campaigns,
  • workforce training in brain health and prevention communication.

ADNeT Registry

The Australian Dementia Network Registry is a clinical quality registry established by Monash University, School of Public Health and Preventative Medicine, as one of three key ADNeT initiatives.

The primary aim of the ADNeT Registry is to collect and analyse real-world data from clinicians to monitor and enhance the quality of care and patient outcomes for people diagnosed with either dementia or mild cognitive impairment (MCI) in Australia. The secondary aim of the ADNeT Registry is to facilitate the recruitment of participants into research, and to establish a publicly available resource to researchers to assist further study into the risk factors for, and trajectory of, dementia and MCI in Australia.

Find out more about the ADNeT Registry here.

Clinician Resources

Clinicians can access the following resources to support dementia prevention in practice:

For Further Reading

Community of Practice

ADNeT hosts a Community of Practice for clinicians involved in dementia risk reduction, diagnosis and treatment.

For further information — including how to join regular meetings and education sessions — please email adnet.cop@monash.edu