Modifiable Dementia Risk: What the Research Actually Shows

The best current evidence on dementia risk comes from the Lancet Commission on dementia prevention, intervention, and care — a standing group of dementia researchers who periodically review the global evidence and publish population-level estimates. Their 2024 update lists 14 modifiable risk factors — things like hearing loss, high blood pressure, smoking, physical inactivity, diabetes, excessive alcohol, social isolation, air pollution, untreated vision loss, high LDL cholesterol, depression, obesity, traumatic brain injury, and less education — that together are associated with an estimated 45% of dementia cases worldwide, in the sense that addressing all of them, at a population level, could theoretically prevent or delay that share of cases.¹ Notably, sleep is not on that official list — we're not going to pretend otherwise. And nothing here is a case for taking a supplement to prevent dementia; no supplement, Proco's or anyone else's, has been shown to do that. This article is about what the research actually says, and where — if anywhere — a supplement genuinely fits into a much bigger picture.

What the Lancet Commission actually found

The Lancet Commission isn't a single study — it's a standing panel of dementia researchers, led by Professor Gill Livingston at University College London, that reviews the global evidence base every few years and models how much of dementia's population-level burden is theoretically attributable to modifiable factors versus factors that can't currently be changed (age and genetics being the biggest of those). The first report, in 2020, identified 12 modifiable factors accounting for an estimated 40% of cases.⁷ The 2024 update added two more — high LDL cholesterol in midlife and untreated vision loss in later life — each independently estimated to account for about 7% and 2% of cases respectively, bringing the total estimate to 45%.¹²

That 45% figure is a population attributable fraction — a statistical estimate of how much disease burden theoretically traces back to a set of factors across an entire population, assuming those factors are causal and could be fully removed. It's not a promise that any individual who fixes their blood pressure or quits smoking cuts their personal risk by 45%, and the Commission itself is explicit that dementia has non-modifiable drivers too, starting with age and genetics, that this estimate doesn't touch.

The 14 factors, and where they sit across life

The Commission groups the factors by the stage of life where the evidence for their impact is strongest — though the general principle is that brain health accumulates across a lifetime, not just in old age.

Early life: less education.
Midlife: hearing loss, high blood pressure (hypertension), high LDL cholesterol, obesity, excessive alcohol consumption, traumatic brain injury, physical inactivity, smoking, diabetes, depression.
Later life: social isolation, air pollution, untreated vision loss.¹³

Hearing loss and high LDL cholesterol carry the largest individual estimated shares in the 2024 analysis — about 7% each — followed by less education and social isolation.² None of these are supplement targets in any direct sense: the interventions the Commission actually recommends are things like hearing aid access, blood pressure treatment, cholesterol management, smoking cessation support, corrective lenses and cataract surgery, hearing protection and head-injury prevention, cleaner air, and treatment for depression.

The single biggest modifiable factor on the entire list is hearing loss — and the intervention is a hearing aid, not a supplement.

What about sleep?

We said upfront that sleep isn't on the Commission's official list, and it genuinely isn't — not in 2020, not in the 2024 update. That's a real gap worth naming rather than glossing over, because sleep and brain health are connected in other ways.

A separate, well-known observational study — not part of the Lancet Commission's analysis — followed close to 8,000 UK civil servants over 25 years (the Whitehall II cohort) and found that people who consistently slept six hours or less per night in their 50s and 60s had roughly a 30% higher rate of later dementia diagnosis than people sleeping seven hours.⁴ That's a real, published finding — but it's an association from observational data, not a controlled trial, and it doesn't establish that poor sleep causes dementia, or that improving sleep prevents it. The Lancet Commission's own reviewers have not judged the evidence strong or consistent enough yet to add sleep to the formal factor list, and reverse causation is a live possibility — early, undiagnosed neurodegeneration can itself disrupt sleep, years before symptoms appear, which makes the causal direction genuinely hard to untangle in this kind of research.

What this has — and doesn't have — to do with supplements

Read back through the 14 factors and the honest answer is: almost nothing, directly. This is a list of things addressed by hearing aids, blood pressure medication, quitting smoking, moving more, drinking less, wearing glasses, treating depression, staying socially connected, and reducing head injury and air pollution exposure. No supplement — Proco's or any other brand's — belongs on that list, and we're not going to imply otherwise.

Two of the factors do sit next to areas where specific ingredients have their own, separately-established research — worth naming honestly, with the limits stated plainly:

Blood pressure. Hypertension is one of the 14 factors. Separately from any dementia research, magnesium supplementation has been studied specifically for its effect on blood pressure: a 2016 meta-analysis of 34 randomized, placebo-controlled trials found modest reductions in both systolic and diastolic blood pressure with magnesium supplementation, particularly at higher doses.⁵ Proco's Magnesium Glycinate is formulated around that separate body of blood pressure research — it may support blood pressure levels already within a normal range. That is not the same claim as "supports dementia prevention," and we're not making that claim.

Depression. Depression is also one of the 14 factors. Separately, EPA-predominant omega-3 fatty acids have their own research base as an adjunctive nutraceutical studied alongside standard treatment for depressive symptoms, summarized in a 2016 systematic review and meta-analysis in the American Journal of Psychiatry.⁶ Proco's Omega-3 EPA 180mg+DHA 120mg may support mood on that basis. It is not a treatment for clinical depression and it is not a dementia-risk product — those are two entirely separate evidence bases, and we're keeping them separate here on purpose.

Neither of these is a reason to expect a measurable change in dementia risk from taking either product. The research connecting them to blood pressure or mood is real and separately established; the research connecting either of them, or any supplement, to dementia risk reduction does not exist, and we're not going to manufacture it by association.

What actually moves the needle

Based on the Commission's own modeling, the highest-leverage actions are unglamorous and mostly outside a supplement aisle entirely: getting hearing checked and using a hearing aid if needed, managing blood pressure and LDL cholesterol with a clinician, not smoking, staying physically active, limiting alcohol, protecting the head during contact sports and high-risk activities, correcting vision problems, treating depression, staying socially engaged, and — where it's within someone's control — reducing exposure to air pollution.¹ Education earlier in life is on the list too, which is a reminder that dementia risk isn't only shaped by what someone does in their 50s and 60s — it accumulates across an entire lifetime.

Bottom line

The real, current Lancet Commission list of 14 modifiable dementia risk factors is: less education, hearing loss, high blood pressure, high LDL cholesterol, obesity, excessive alcohol, traumatic brain injury, physical inactivity, smoking, diabetes, depression, social isolation, air pollution, and untreated vision loss — together estimated to account for up to 45% of dementia cases worldwide, in a population-level, modeled sense. Sleep is not on that list, however associated it might turn out to be once more research is done. Almost none of these factors are addressed by a supplement, and none of Proco's products — or anyone's — are shown to reduce dementia risk. Where a product does connect to one of the 14 factors, it's through a separate, established evidence base for that specific factor (blood pressure, mood), not through any dementia claim, and we've tried to be exact about that distinction throughout.

This article is for informational purposes only and has not been evaluated by the FDA. It is not intended to diagnose, treat, cure, or prevent any disease. Speak with a healthcare provider before starting any new supplement, especially if you take medication or have an existing health condition. Specifically: this article is not medical advice about dementia prevention or treatment, and no claim is made anywhere in it that any Proco product, or any supplement, reduces dementia risk.

References

1. Livingston G, Huntley J, Liu KY, et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet. 2024;404(10452):572-628. pubmed.ncbi.nlm.nih.gov/39096926
2. The Lancet. Risk factors for dementia (infographic summarizing the 2024 Commission report). thelancet.com/infographics-do/dementia-risk
3. Alzheimer Europe. 2024 Lancet Commission underscores the potential for dementia risk reduction, identifying 14 modifiable risk factors across the life course. alzheimer-europe.org/news/2024-lancet-commission
4. Sabia S, Fayosse A, Dumurgier J, et al. Association of sleep duration in middle and old age with incidence of dementia. Nature Communications. 2021;12:2289. nature.com/articles/s41467-021-22354-2
5. Zhang X, Li Y, Del Gobbo LC, et al. Effects of Magnesium Supplementation on Blood Pressure: A Meta-Analysis of Randomized Double-Blind Placebo-Controlled Trials. Hypertension. 2016;68(2):324-333. ahajournals.org/doi/10.1161/hypertensionaha.116.07664
6. Sarris J, Murphy J, Mischoulon D, et al. Adjunctive Nutraceuticals for Depression: A Systematic Review and Meta-Analyses. American Journal of Psychiatry. 2016;173(6):575-587. psychiatryonline.org/doi/10.1176/appi.ajp.2016.15091228
7. Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396(10248):413-446. pubmed.ncbi.nlm.nih.gov/32738937

Related reading: Moderate Drinking and Your Brain: What New Research Actually Shows and Exercise vs Supplements for Brain Health: An Honest Comparison

Want to know what's actually in what you take? Join the list — no spam, just it straight.