Factors damaging brain health and increasing the risk of Alzheimer’s disease

Knowing the factors that increase the risk of Alzheimer’s disease can help healthcare providers identify patients at risk and develop prevention strategies to lower the risk. Examples of such interventions, which include nutrition, exercise, sleep hygiene, and social strategies, were discussed at a satellite symposium at EAN 2021 chaired by Professor Miia Kivipelto, Stockhom, Sweden.

What is brain health?

Maintaining brain health means addressing the factors that increase the risk of Alzheimer’s disease

Brain health is a concept encompassing neural development, plasticity, functioning, and recovery throughout life. Numerous social and biologic determinants play a role in brain development and brain health from pre-conception through to the end of life.1

Professor Kivipelto explained that these determinants include the many potentially modifiable factors that increase the risk for Alzheimer’s disease (AD) including the following:2

  • Physical health factors—diabetes, midlife hypertension, hearing loss, traumatic brain injury
  • Mental health factors—depression
  • Lifestyle factors—physical inactivity, midlife obesity, smoking, high alcohol consumption, sleep disturbances3
  • Social factors—poor education, social isolation
  • Environmental factors—air pollution

It has been estimated that modifying these risk factors might prevent or delay up to 40% of dementias.2


Interventions to improve brain health

FINGER addresses nutrition, exercise, cognitive training, social activities, and vascular risk monitoring

Early public health interventions that address the factors increasing the risk of AD may lower the risk or slow the progression of the disease, said Professor Kivipelto.

The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) is an example of such an intervention targeting nutrition, exercise, cognitive training, social activities, and vascular risk monitoring.

Results from a randomized controlled trial of FINGER suggested that it could improve or maintain cognitive functioning in at-risk elderly people from the general population.4

As a result, World-Wide FINGERS (WW-FINGERS) was launched in 2017 in over 25 countries as the first global network of multidomain lifestyle intervention trials for dementia risk reduction and prevention, said Professor Kivipelto. It aims to adapt, test, and optimize the FINGER model to reduce risk across the spectrum of cognitive decline.5

Unhealthy sleep patterns are linked to beta-amyloid accumulation

A bidirectional relationship between Alzheimer’s disease and poor sleep

Impaired sleep is prevalent in patients with AD,3 and less efficient sleep and more naps correlate to increased beta-amyloid accumulation.6 Sleep hygiene strategies are therefore a further intervention (in addition to those of FINGER) to lower the risk of development and progression of AD.


This satellite symposium was sponsored by F. Hoffman-La Roche Ltd.

Our correspondent’s highlights from the symposium are meant as a fair representation of the scientific content presented. The views and opinions expressed on this page do not necessarily reflect those of Lundbeck.


  1. World Health Organization. Brain health. Available at: https://www.who.int/health-topics/brain-health#tab=tab_1. Accessed 22 Jun 21.
  2. Livingston G, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet 2020;396:413–46.
  3. Minakawa EN, et al. Sleep disturbance as a potential modifiable risk factor forAlzheimer’s disease. Int J Mol Sci 2019;20:803.
  4. Ngandu T, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet 2015;385:2255–63.
  5. Kivipelto M, et al. World-Wide FINGERS Network: A global approach to risk reduction and prevention of dementia. Alzheimer's & Dementia 2020;16:1078–94.
  6. Wang C, Holtzman DM. Bidirectional relationship between sleep and Alzheimer’s disease: role of amyloid, tau, and other factors. Neuropsychopharmacology 2020;45:104–20.