So you think you don't need to worry about dementia until you are old.

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Two in five adults living beyond 55 will develop dementia.

It's the disease we fear most.

The good news is that almost half of the risk of dementia can be modified.

We can all take action to reduce our chances of developing dementia.

It sounds too obvious. A good education in childhood and challenging our brains throughout life lays the basis for a rich neural network; it builds our cognitive reserve.

Exercise regularly, preferably aerobic and strength training. Eat a healthy Mediterranean-style diet. Be socially connected.

Check your blood pressure regularly and treat if high. Ditto for cholesterol or lipids.

If possible, avoid or treat depression midlife obesity and diabetes. Don't smoke. Don't drink alcohol to excess.

Protect your noggin; avoid head injury.

For those who develop hearing loss, wear a hearing aid - earlier is better. Avoid living in an area with air pollution.

The contribution of all these risk factors ranges from 1 per cent to 7 per cent each but together they add up to 45 per cent.

The evidence comes from cohort studies which compare the habits and exposure to risk factors of populations of people who did and didn't develop dementia.

Many of these risk factors can operate in tandem such as physical inactivity, obesity, high cholesterol and diabetes. People with less education are likely to be less affluent and be unable to afford a healthy diet or have time to exercise.

While researchers can adjust statistically for these confounding factors, there may be other factors not accounted for.

A more rigorous approach is to conduct a randomised controlled trial in which risk factors are targeted proactively.

There is evidence from many prevention studies........

© The Examiner