rewrite this title Want to Protect Your Brain Health? Study Identifies 17 Risk Factors You Can Actually Control

Researchers have identified 17 modifiable factors—things within your control—that can influence your risk of developing three major brain diseases: stroke, dementia, and late-life depression.

In a new review, published on April 3 in the BMJ’s Journal of Neurology, Neurosurgery, and Psychiatry, researchers analyzed existing research that determined risk factors associated with stroke, dementia, and depression. From the data, they identified 17 modifiable factors shared by at least two of the three diseases.

The risk factors range from lifestyle choices such as smoking and alcohol use to social factors such as stress and engaging with others.

But they can all be mitigated with behavioral changes or treatment. “This means there are real opportunities for prevention,” study author Sanjula Singh, MD, PhD, MSc, principal investigator with the Brain Care Labs at Massachusetts General Hospital and Harvard Medical School, told Health.

After examining 59 different meta-analyses, Singh and her colleagues found 17 risk factors for dementia, late-life depression, and stroke that overlapped with one another. They also measured how significant each risk factor was, estimating how each affected quality of life and risk of early death.

They identified the following 17 risk factors:

AlcoholBlood pressureBody mass indexFasting plasma glucose (blood sugar levels)Total cholesterolCognitive activity during leisure timeDepressive symptomsDietHearing lossKidney functionPainPhysical activityPurpose in lifeSleepSmokingSocial engagementStress

Though depression, stroke, and dementia are mental health, cardiovascular, and neurological conditions, respectively, researchers have long known that the three are connected.

While various parts of the brain are responsible for different functions—thinking and memory, balance and motor control, mood, and physical functions such as breathing and heart rate—if one area of the brain is impacted, others may be affected too, said Douglas Scharre, MD, professor of clinical neurology and psychiatry at The Ohio State University Wexner Medical Center.

This is due to neural networks that connect different parts of the brain.

“A stroke or dementia in one place of the brain can also affect those networks that go to your root centers,” he told Health. “It [depends] where the damage is, and the connections between the areas of the neural circuits and [the extent of the] stroke and dementia damage.”

This, in part, explains why it’s common for people to experience depression after they have a stroke or develop dementia, for example, said Scharre.

Because these three conditions are linked, it makes sense that they would share risk factors, too. However, the way that risk factors affect brain health can vary, said Gregory Cooper, MD, PhD, chief of adult neurology and director of the Memory Center at Norton Healthcare Neuroscience Institute.

“For example, high blood pressure could affect vascular health, which can lead to stroke and/or more gradual damage to individual neurons (brain cells), which could then lead to cognitive impairment (dementia) and depression,” Cooper told Health in a statement.

Similarly, risk factors such as smoking and cholesterol can lead to conditions such as cerebral small vessel disease (CSVD), which involves damage to brain’s small blood vessels, Singh said.

“CSVD can lead to disruptions in brain areas responsible for cognitive function, mood regulation, and motor control, potentially increasing the risk for all three conditions,” she said.

Singh hopes her research helps the public and other researchers shift from thinking of stroke, dementia, and late-life depression as separate, inevitable conditions to recognizing them as both interconnected and, in many cases, partially preventable. 

“We hope these findings can add to ongoing efforts to build a clearer roadmap for the prevention of brain diseases,” she said. 

The 17 modifiable risk factors identified by Singh and her team span a wide range—from chronic conditions such as high cholesterol to more subjective factors like strong life purpose.

And perfecting every single one likely isn’t possible. Rather, Singh advised, think of them as a menu of options—pick three to start with.

“You don’t have to address them all at once, and many are interconnected. For example, becoming more active may help improve sleep or lower blood pressure,” said Singh. “The key is to start somewhere—and know that progress in one area can often support progress in others.” 

But if there’s one risk factor that stands out among the 17, it’s high blood pressure. It was the strongest and most consistent risk factor across stroke, dementia, and late-life depression, so Singh recommended managing that first.

“It’s something you can’t feel—but you can measure, and that’s a crucial first step,” she said. “We recommend that adults check their blood pressure regularly, starting as early as their 20s, and talk to their doctor if it’s elevated.”

Even small reductions in blood pressure—whether with medication, diet, physical activity, or stress management—can make a meaningful difference, she noted.

Managing blood sugar levels and high cholesterol are also critical, Scharre added.

“Even if you have a genetic risk factor for diabetes or high triglycerides or high cholesterol, there are pretty good medications to control these. Or, you can make changes to your diet,” he said.

Cutting down on alcohol and quitting smoking are also important for lowering dementia and stroke risk.

“Alcohol can also cause a dementia condition and destroy brain cells, particularly in the memory circuits at times,” said Scharre.

Finally, seeing your doctor regularly for checkups is also a key part of keeping these risk factors in check. Your healthcare provider can identify which of the 17 factors you should prioritize, and can prescribe treatments for things you may not be able to tackle on your own, such as hearing loss and high blood sugar levels.

“Hearing about multiple risk factors can feel overwhelming, but our goal is to make prevention feel accessible and actionable,” said Singh. “Even small, consistent changes can help you take better care of your brain over time.”