The Dementia Tsunami Is Coming: Know Your Risk Factors and Prevention Opportunities

"The mind is everything. What you think, you become. What you feel, you attract. What you imagine, you create." — Buddha

In our medical practice, we’ve seen an increase in the expression of cognitive decline. Historically those who came in specifically for cognition felt they were beginning to lose their once extraordinary executive skill set. Their goal was to restore and even go beyond where they once had been.

Since covid there has been more frequently reported symptoms of brain fog and the brain shutting down where it once had been able to keep going or that word finding was not as easy, memory less sharp. There is also a more consistent, active focus on ensuring they maintain sharp cognition for life. This was usually confirmed by finding a peak alpha frequency that dropped from previous levels.

The mainstream statistics are sobering: by 2050, approximately 13 million Americans aged 65+ may have Alzheimer's disease, up from 7 million in 2025. Projections indicate that over 42% of Americans aged 55+ will develop some form of dementia in their lifetime, with annual U.S. cases expected to double to 1 million by 2060.

While this sounds alarming, there is an empowering truth: this isn't simply an inevitable fate. This is an opportunity to create a new expression, one that values and demonstrates the importance of focusing on the wholeness of the complex system we are.

Recent research reveals that a significant portion of dementia cases could be prevented or potentially reversed through targeted interventions. Here I share why understanding dementia risk factors is important for extending not just your lifespan, but your healthspan.

The Multidimensional Nature of Dementia Risk

Dementia isn't a single condition but rather a collection of symptoms affecting memory, thinking, and social abilities significantly enough to interfere with daily functioning. While Alzheimer's disease accounts for 60-80% of cases, there are several types including vascular dementia, Lewy body dementia, frontotemporal dementia, and mixed dementia.

The conventional approach to dementia has long focused on isolated symptoms or genetic predisposition, yet this perspective is dangerously incomplete. For decades, many health conditions have been treated as singular, quantifiable entities measured by specific biomarkers. As our understanding evolves, it becomes increasingly clear that complex conditions like dementia emerge from the intricate interplay of physiological, cognitive, social, environmental, and even spiritual factors.

To make meaningful progress, we can shift from a fragmented, symptom-focused model to a more nuanced, systems-based approach that identifies and addresses root causes.

Metabolic Factors: The Brain-Body Connection

The metabolic foundations of dementia are far reaching. Key factors include:

• Insulin resistance and glucose dysregulation - Sometimes called "type 3 diabetes"

• Mitochondrial dysfunction affecting cellular energy production

• Inflammation and oxidative stress damaging neural tissue

Think of your brain as an energy-hungry organ. When metabolic processes go awry, your neural networks suffer. Many clients in my practice show early signs of insulin resistance years before cognitive symptoms appear. Regular monitoring of fasting glucose, insulin, fructosamine, and HbA1c identifies these issues before they compromise brain health.

Nutritional Considerations: You Are What You Eat

Red meat consumption has been linked to cognitive decline and ever growing research has many considering positions on the ideal reccommended intake. Recent research published in 2024 found that eating just two weekly servings of processed red meat, like bacon, sausage, or hot dogs, raised dementia risk by 14% compared to people eating less than three servings per month. Each daily serving was associated with nearly two years of accelerated cognitive aging. Interestingly, swapping a serving of processed meat for nuts, beans, fish, avocado, or berries lowered dementia risk by 20%.

Micronutrient deficiencies and gut health also play crucial roles in cognitive function. The gut-brain axis, the biochemical signaling between your gastrointestinal tract and nervous system, can profoundly influence cognitive health. I will be doing an entire newsletter on this topic in the near future.

Questions for you:

• How often do I consume processed meats weekly?

• Am I getting adequate omega-3 fatty acids through my diet?

• Have I checked my vitamin B12, vitamin D, and folate levels recently?

Infectious Factors: Hidden Triggers

Several infectious agents have been associated with increased dementia risk:

• Herpes viruses - Recent large-scale studies and systematic reviews confirm that herpes simplex virus type 1 (HSV-1) - the common cause of oral herpes-is associated with a significantly increased risk of developing dementia, including Alzheimer’s disease. Learn what can be done to significantly diminish this risk in Part 3.

• Lyme disease

• COVID-19 - Increasingly linked to both short-term cognitive impairment and long-term dementia risk, particularly in older adults. Emerging evidence highlights multiple mechanisms connecting SARS-CoV-2 to neurodegeneration: https://www.perplexity.ai/search/there-seems-to-be-quite-a-bit-ux.bxvKcQxij6QAl3L0DVQ#13

Periodontal disease (gum infection)

This is one of the essential areas the medical establishment seems to have missed. A comprehensive health screening must include a periodontal health assessment and monitoring for chronic viral activation. There are several oral microbiome tests that I find valuable (Bristle Health). The inflammatory response to these microbes can impact brain health years before cognitive symptoms emerge.

Recent studies are finding pathogenic oral bacteria in arterial plaques and in brain tissue.

Genetic Risk Factors for Dementia

While lifestyle factors offer significant opportunities for prevention, our genetic makeup also influences dementia risk. Understanding your genetic profile can provide valuable insights into personalized prevention strategies. Let's look at some key genetic markers associated with cognitive decline.

The APOe4 Gene: The Most Well-Known Genetic Risk Factor

The Apolipoprotein E (APOe) gene comes in several variants, with APOe4 being the most significant genetic risk factor for Alzheimer's disease:

• Risk impact: Carrying one copy of APOe4 increases Alzheimer's risk 2-3 fold, while two copies elevate risk 8-12 fold

• Population prevalence: Approximately 25% of people carry at least one copy of APOe4

• Mechanism: APOe4 affects amyloid beta clearance and increases inflammation in the brain

• Important nuance: Having APOe4 doesn't guarantee you'll develop dementia—it simply increases susceptibility

An important finding from my clinical practice: APOe4 carriers often respond differently to dietary interventions. While standard dietary advice recommends limiting saturated fat, some APOe4 carriers actually show improved cognitive markers on more targeted ketogenic-style diets that address their unique metabolic needs.

Beyond APOe4: Other Genetic Markers of Concern

I was greater to discover I did not have an APOe4 expression yet as I did a deep dive it turns out, I have a combination of other variants that significantly increase my risk. While many do not want to know this, many of these genetic risks can be modified by lifestyle and supplementation.

Several other genetic variants have been associated with increased dementia risk:

TOMM40

• Function: Regulates mitochondrial protein transport

• Impact: Variants can affect brain energy metabolism, accelerating cognitive decline

• Relationship: Often works in tandem with APOe4 to influence dementia onset timing. Also increases risk without APOe4.

Inflammatory Gene Variants

Variants in genes regulating inflammation can significantly impact neurodegeneration:

• TNF-alpha (Tumor Necrosis Factor): Governs inflammatory responses, with certain variants associated with increased neuroinflammation and faster progression of cognitive symptoms

• NLRP3: Variants have been significantly associated with dementia risk, particularly Alzheimer's disease (AD) and mild cognitive impairment (MCI), through mechanisms involving neuroinflammation and gene regulation.

• IL-6 (Interleukin-6): Regulates inflammatory and immune reactions, with specific polymorphisms linked to heightened neuroinflammation

• CRP (C-Reactive Protein): Certain variants can increase baseline inflammation levels, potentially accelerating neurodegeneration

• Blood clotting gene variants: Certain variants of Protein C and Factor 5.

IntellXXDNA offers testing options that cover all of these. That is where I discovered my significant risks and have instituted mitigation.

Lifestyle Elements: Daily Choices, Lifelong Impact

Lifestyle factors profoundly affect brain health:

• Sleep quality and duration represents the brain's critical cleanup mechanism

• Physical activity patterns offer neuroprotective effects

• Chronic stress acts as a silent accelerator of cognitive decline

Poor sleep prevents your brain from clearing harmful proteins like beta-amyloid and metabolic waste, while regular exercise increases blood flow and neurotrophic factors that support brain health. And chronic stress? It literally shrinks key memory centers in your brain over time.

Environmental Exposures: The Invisible Influence

Environmental factors can significantly impact neurological health:

• Heavy metals, air pollution, and other neurotoxins

• EMF exposure considerations

• Household chemicals and their potential neurological impacts

I advise all my clients with cognitive concerns to assess their home and work environments for toxin exposure and air quality (see my post on assessing indoor air quality HERE). Simple changes like using HEPA air filters, choosing natural cleaning products, minimizing plastics, and filtering drinking water can reduce neurotoxic burden.

Social & Psychological Dimensions: Connection as Protection

The social and psychological aspects of cognitive health are also key:

• Social isolation and loneliness profoundly impact brain health

• Chronic psychological stress disrupts HPA axis regulation

• Meaning, purpose, and cognitive stimulation offer protective effects

We are wired for connection. Social bonds serve as one of the most powerful regulators of stress physiology, buffering against the effects of adversity. Conversely, social isolation, relationship conflict, and community breakdown can amplify stress reactivity.

Studies have shown that people with robust social networks have significantly lower risk of cognitive decline compared to those who are isolated. This isn't just about having friends, it's about meaningful connections that provide purpose and mental stimulation.

The Bredesen Approach: Subtypes and Personalized Intervention

Dr. Dale Bredesen's groundbreaking research suggests that Alzheimer's and cognitive decline can be categorized into several subtypes, each requiring different intervention strategies:

His clinical trials have shown promising results, with a 2022 trial involving 100 patients reporting 84% showing objective cognitive improvement, including those with advanced decline. The approach targets 36+ contributors to neuroplasticity imbalance, including insulin resistance, inflammation, and nutrient deficiencies.

The key insight from Bredesen's work is that addressing modifiable factors like chronic inflammation, vascular issues, and toxin exposure can potentially impact up to 40% of dementia cases.

Identifying your specific subtype of risk or early-stage cognitive change allows for personalized intervention that addresses the unique factors driving your situation, this is personalized precision medicine. This is why comprehensive testing is so critical; it reveals your individual risk profile rather than applying a one-size-fits-all approach.

Action Items: Your Brain Protection Plan

Starting today, here are specific steps you can take to protect your cognitive health:

1. Get Baseline Testing

• Comprehensive metabolic panel with insulin and inflammatory markers

• Vitamin D, B12, folate, and homocysteine levels

• Sleep study if you have poor sleep quality

• Cognitive assessment (even if you have no symptoms) - i.e. CNS Vital Signs

2. Optimize Your Diet

• Limit processed red meat to fewer than three servings monthly

• Increase plant protein sources like legumes and nuts

• Ensure adequate omega-3 fatty acid intake (wild-caught fish or supplements)

• Focus on colorful vegetables and berries for antioxidants

3. Enhance Your Lifestyle

• Prioritize 7-8 hours of quality sleep

• Exercise at least 30 minutes daily (even walking counts!)

• Practice stress management through meditation, breathwork, or other techniques

• Create regular social engagement opportunities

4. Reduce Environmental Toxins

• Test your home for mold and heavy metals

• Use natural cleaning products

• Install a quality water filter

• Consider HEPA air filtration

5. Build Cognitive Reserve

• Learn new skills (language, instrument, craft)

• Engage in challenging mental activities

• Maintain meaningful social connections

• Practice mindfulness to improve attention

Conclusion: Prevention Is Possible

The truth is that up to 40% of dementia cases could be prevented or delayed by addressing 14 risk factors across the lifespan. The key is understanding that cognitive decline doesn't happen overnight, it develops gradually over decades, giving us multiple opportunities for intervention.

I've witnessed remarkable improvements in clients who implement comprehensive preventive strategies early. Even those with mild cognitive impairment often see significant stabilization or improvement when addressing the multidimensional factors we've discussed. I believe that these interventions will slow progression or reverse it in most of this population.

The rising tide of dementia is real. By understanding your personal risk profile and implementing targeted interventions, you can significantly reduce your risk and protect your most precious asset - your mind.

In Part 2 of this series, I'll dive deep into specific biomarkers to monitor. In Part 3, I will outline the most effective prevention strategies based on your personal risk factors. Until then, remember that small, consistent steps toward brain health today can have profound effects on your cognitive future.

References:

Fang M, et al. Lifetime risk and projected burden of dementia. Nature Medicine. 2025 Jan 13. doi: 10.1038/s41591-024-03340-9.

Quan, M., Wang, X., Gong, M., Wang, Q., Li, Y., & Jia, J. (2023). Post-COVID cognitive dysfunction: Current status and research recommendations for high-risk population. The Lancet Regional Health – Western Pacific, 38, 100836.

Araya K, Watson R, Khanipov K, Golovko G, Taglialatela G. Increased risk of dementia associated with herpes simplex virus infections: Evidence from a retrospective cohort study using U.S. electronic health records. J Alzheimers Dis. 2025 Mar;104(2):393-402.

Kulkarni MS, Miller BC, Mahani M, Mhaskar R, Tsalatsanis A, Jain S, Yadav H. Poor Oral Health Linked with Higher Risk of Alzheimer's Disease. Brain Sci. 2023 Nov 7;13(11):1555.

Eke PI, Thornton-Evans GO, Wei L, Borgnakke WS, Dye BA, Genco RJ. Periodontitis in US Adults: National Health and Nutrition Examination Survey 2009-2014. J Am Dent Assoc. 2018 Jul;149(7):576-588.e6.

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