All factors

Excessive alcohol

Heavy drinking (more than 7 drinks per week) accelerates cognitive decline through direct neurotoxicity and vascular damage.

Population risk0.5%
Evidence gradecohort

Why it matters

Reducing alcohol intake to moderate levels or below removes the excess risk. The brain recovers some function over months.

What to ask at the checkup

Ask about current alcohol intake and whether a reduction plan would help

Screening: Self-reported weekly drinks

Sources

Dementia prevention, intervention, and care: 2024 report of the Lancet Commission

Livingston G, Huntley J, Liu KY et al.. The Lancet, 2024.

Fourteen things people can change account for nearly half of dementia cases at the population level.

Alcohol consumption and cognitive decline in early old age

Topiwala A, Allan CL, Valkanova MV et al.. JAMA Neurology, 2017.

More than about 7 drinks a week was linked to faster memory loss over decades.

Routines for this factor

One fewer drink today

Have one fewer drink than usual, or swap one for sparkling water.

1 min, difficulty 2/3