JAMA Network reported: It’s no wonder they’re concerned. There is no cure, and the 2 so-called disease-modifying therapies available for Alzheimer disease, the most common cause of dementia, are expensive and only modestly effective at best.

Every day, cardiologist Matthew Gold, MD, hears the same question in his clinic:

“What can I do to prevent dementia?” patients implore.

Meanwhile, the numbers of people with dementia are climbing as populations around the world age. According to a 2025 US estimate, the lifetime risk of dementia after age 55 years is 42%, with higher rates among women, Black adults, and carriers of the apolipoprotein ε4 (APOE ε4) allele, the primary genetic risk factor for sporadic Alzheimer disease. The authors projected that the number of people in the US who develop dementia each year will rise from the 514 000 seen in 2020 to approximately 1 million in 2060.

More than 7 million people in the US are living with Alzheimer disease, and the cost of caring for them and others with dementia is projected to reach $409 billion this year, according to the Alzheimer’s Association. Worldwide, the number of people with Alzheimer disease is expected to reach 78 million in 2030 and nearly double that in 2050, according to estimates from Alzheimer’s Disease International, a global federation of Alzheimer and dementia organizations.

Those projected case numbers aren’t a forgone conclusion, though. As many as 45% of dementia cases might be preventable if people eliminated risk factors ranging from hearing loss to high levels of low-density lipoprotein cholesterol to social isolation, the Lancet Commission on dementia estimated in its 2024 report.

“It’s so much more efficient to prevent the disease from happening in the first place,” noted Gold, an advanced heart disease fellow at Cedars-Sinai Medical Center in Los Angeles.

For now, there are no proven treatments to reduce the risk of mild cognitive impairment or dementia in people with normal cognition, although a clinical trial of lecanemab (Leqembi), currently approved only for people with Alzheimer-related mild cognitive impairment or early-stage dementia, is under way in individuals described as presymptomatic.

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