Dementia Prevention: what we can control
Dementia Prevention in Midlife: What You Can Do Now
Written by: Dr. Madeleine Clark, ND MSCP
For many patients in midlife it is a critical window for protecting your brain health long-term. What you do now can lower your risk of developing dementia later in life.
Why Prevention Matters in Midlife
Research shows that dementia develops over decades, often beginning with small, silent changes in brain health during midlife.
Factors that increase lifetime dementia risk include:
Cardiovascular disease (high blood pressure, high cholesterol, atherosclerosis)
Metabolic disease (diabetes, obesity, insulin resistance)
Traumatic brain injuries (including mild concussions)
Sleep disorders
Smoking and heavy alcohol use
The menopause transition adds another layer, since fluctuating estrogen levels can affect memory, sleep, and mood. A woman’s lifetime exposure to estrogen is thought to be protective for the brain — which is why early menopause, hysterectomy, or chemotherapy may raise risk.
Lifestyle Strategies That Protect the Brain
1. Eat for Your Brain: The MIND Diet
The MIND diet (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay) combines two evidence-based patterns of eating: the Mediterranean diet and the DASH diet. It emphasizes:
Green leafy vegetables and other vegetables
Berries (especially blueberries and strawberries)
Nuts and legumes
Whole grains
Fish and poultry
Olive oil as the main fat source
The MIND diet limits red meat, butter, cheese, pastries, and fried or fast foods. Research has shown that closely following the MIND diet is associated with a significantly lower risk of cognitive changes - with brains that function up to 9.5 years younger than those who don’t follow it as closely. When we begin to follow the diet to a closer degree, we see improvement in cognitive function. We even see that younger populations that follow this style of diet have improve cognitive processing abilities and speed.
2. Move Your Body: Exercise and Brain Health
Regular exercise supports brain health in several ways:
Aerobic exercise increases blood flow to the brain and stimulates production of brain-derived neurotrophic factor (BDNF), a protein that promotes memory and learning.
Strength training improves insulin sensitivity and vascular health, reducing risk factors for dementia.
Balance and mobility work helps prevent falls and injuries that could lead to concussions or head trauma.
Even brisk walking for 30 minutes, most days of the week, can make a measurable difference.
3. Prioritize Sleep
Sleep isn’t just rest — it’s when the brain does critical housekeeping. During deep sleep, the glymphatic system clears waste products like beta-amyloid, which accumulates in Alzheimer’s disease.
Chronic sleep disruption in midlife is linked to higher risk of dementia. Establishing good sleep hygiene — consistent bedtimes, cool dark environments, limiting alcohol and screens before bed — is one of the most powerful tools for brain health.
4. Protect Against Concussions
Traumatic brain injuries, even mild concussions, increase lifetime risk of dementia. For women active in sports or with a history of concussion, midlife is an important time to minimize further head injuries and support recovery. Protective equipment, safe sport practices, and prompt care for any head injury are essential.
5. Manage Chronic Health Conditions
Brain health is closely tied to cardiovascular and metabolic health. Preventing or managing conditions such as high blood pressure, high cholesterol, and diabetes significantly reduces dementia risk.
Regular screenings, appropriate treatment (and medication adherence!), and lifestyle changes — including nutrition, exercise, and stress management — all play a role in reducing these risks.
Hormones and Dementia Risk
Menopause hormone therapy (MHT) does not reverse dementia risk, but timing matters. Starting MHT early in menopause does not worsen cognitive health, and in some cases may support sleep and mood — both important for brain function. However, starting MHT after age 65 has been associated with increased dementia risk.
The Bottom Line
Midlife is the best time to take action for your future brain health. Eating a brain-friendly diet, staying active, protecting sleep, managing chronic diseases, and reducing head trauma all reduce risk of dementia in later life.
These habits not only support long-term brain health — they also improve energy, focus, and quality of life right now.
I’m Dr. Madeleine Clark, ND and Menopause Society Certified Practitioner. I help women navigate PMS, PMDD, perimenopause, and menopause with evidence-based, compassionate care.
Book an appointment today to create your personalized plan for brain health and healthy aging.