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Prevention of cognitive decline and dementia: Current evidence on lifestyle factors and dietary patterns
Ligia Juliana Dominguez, Nicola Veronese, Francesco Saverio Ragusa, Flavia Seminara, Salvatore Maria Baio, Laura Vernuccio, Giuseppina Catanese, Mario Barbagallo. EXCLI journal, 2026-01-25
Topic: Risk, prevention and care in population studies
Cognitive decline and dementia represent major and growing global health challenges, driven largely by population aging and increased longevity. Currently, more than 55 million people worldwide live with dementia, a figure projected to rise to approximately 153 million by 2050. Alzheimer's disease accounts for the majority of cases, and despite extensive research, effective disease-modifying therapies remain limited. Consequently, increasing attention has shifted toward prevention strategies targeting modifiable risk factors. Accumulating evidence indicates that dementia is not an inevitable consequence of aging and that up to 45 % of cases may be attributable to potentially modifiable lifestyle and environmental factors operating across the life course. Lifestyle behaviors-including diet, physical activity, smoking, alcohol consumption, sleep, and social and cognitive engagement-have emerged as key targets for intervention. In particular, adherence to healthy dietary patterns such as the Mediterranean, DASH, and MIND diets has been associated with better cognitive outcomes, while unhealthy dietary patterns may increase risk. However, findings across studies remain heterogeneous, and uncertainties persist regarding causality, optimal exposure timing, and specific lifestyle components. Recent large prospective cohorts, meta-analyses, umbrella reviews, and multidomain intervention trials have advanced understanding of these associations but have also highlighted important gaps, including limited randomized evidence and underrepresentation of diverse populations. This narrative review critically synthesizes current evidence on lifestyle factors and dietary patterns associated with cognitive decline and dementia risk, focusing on recent high-quality studies. By integrating findings across domains, it aims to clarify areas of consensus and uncertainty, inform prevention strategies, and identify priorities for future research and public health action. See also the graphical abstract(Fig. 1).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Dominguez, L. J., Veronese, N., Ragusa, F. S., Seminara, F., Baio, S. M., Vernuccio, L., et al. (2026). Prevention of cognitive decline and dementia: Current evidence on lifestyle factors and dietary patterns. EXCLI journal. https://doi.org/10.17179/excli2026-9298
Vancouver
Dominguez LJ, Veronese N, Ragusa FS, Seminara F, Baio SM, Vernuccio L, et al. Prevention of cognitive decline and dementia: Current evidence on lifestyle factors and dietary patterns. EXCLI journal. 2026. doi:10.17179/excli2026-9298. PMID: 42376437.
BibTeX
@article{dominguez2026-42376437,
author = {Dominguez, Ligia Juliana and Veronese, Nicola and Ragusa, Francesco Saverio and Seminara, Flavia and Baio, Salvatore Maria and Vernuccio, Laura and Catanese, Giuseppina and Barbagallo, Mario},
title = {{Prevention of cognitive decline and dementia: Current evidence on lifestyle factors and dietary patterns}},
journal = {EXCLI journal},
year = {2026},
doi = {10.17179/excli2026-9298},
pmid = {42376437},
url = {https://doi.org/10.17179/excli2026-9298}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Accumulating evidence indicates that dementia is not an inevitable consequence of aging and that up to 45 % of cases may be attributable to potentially modifiable lifestyle and environmental factors operating across the life course.
- In particular, adherence to healthy dietary patterns such as the Mediterranean, DASH, and MIND diets has been associated with better cognitive outcomes, while unhealthy dietary patterns may increase risk.
- This narrative review critically synthesizes current evidence on lifestyle factors and dietary patterns associated with cognitive decline and dementia risk, focusing on recent high-quality studies.
Why it matters
This narrative review reports that up to 45% of dementia cases may be attributable to potentially modifiable lifestyle and environmental factors, and that healthy dietary patterns such as Mediterranean, DASH, and MIND diets have been associated with better cognitive outcomes. It notes that findings across studies remain heterogeneous and that uncertainties persist about causality and optimal timing, so prevention through lifestyle is suggested but not proven.
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Study details
- Study designmeta-analysis
- Evidence strengthHigh
How this study scored 47/100
Published in a peer-reviewed journal, and it is a meta-analysis pooling many studies. Scored zero for sample size, effect reported and studied in people because the record does not state it. We have no data on institution's track record, so that was left out: it earned 46 of the 97 points we could judge it on, which is 47 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (EXCLI journal) |
| Journal's citation record | 0 / 4 | EXCLI journal: journal h-index 62 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A meta-analysis pooling many studies |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 0 / 6 | Cited 0.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Mario Barbagallo: h-index 65 (OpenAlex, whole career) |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 42376437) |
| Free to read | 2 / 2 | Free to read |
| Points | 46 / 97 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 46 of the 97 points we could judge it on is 47 out of 100. |
| Total | 47 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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