Prevention of cognitive decline and dementia: Current evidence on lifestyle factors and dietary patterns

Authors

  • Ligia J. Dominguez Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, 90133 Palermo, Italy; E-mail: ligia.dominguez@unipa.it https://orcid.org/0000-0003-1466-8610
  • Nicola Veronese Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90100 Palermo, Italy; Faculty of Medicine, Saint Camillus International University of Health Sciences, 00131 Rome, Italy https://orcid.org/0000-0002-9328-289X
  • Francesco Saverio Ragusa Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90100 Palermo, Italy https://orcid.org/0000-0001-8998-2044
  • Flavia Seminara Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90100 Palermo, Italy https://orcid.org/0009-0007-4408-0451
  • Salvatore Maria Baio Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90100 Palermo, Italy https://orcid.org/0009-0002-2549-4513
  • Laura Vernuccio Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90100 Palermo, Italy https://orcid.org/0009-0009-1444-5565
  • Giuseppina Catanese Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90100 Palermo, Italy https://orcid.org/0009-0001-9222-6538
  • Mario Barbagallo Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90100 Palermo, Italy https://orcid.org/0000-0002-1349-6530

DOI:

https://doi.org/10.17179/excli2026-9298

Keywords:

Dementia, cognitive decline, social engagement, sleep, exercise, dietary pattern

Abstract

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.

Downloads

Published

2026-05-27

How to Cite

Dominguez, L. J., Veronese, N., Ragusa, F. S., Seminara, F., Baio, S. M., Vernuccio, L., … Barbagallo, M. (2026). Prevention of cognitive decline and dementia: Current evidence on lifestyle factors and dietary patterns. EXCLI Journal, 25, 690–724. https://doi.org/10.17179/excli2026-9298

Issue

Vol. 25 (2026)

Section

Review articles

Categories

License

Copyright (c) 2026 Ligia J. Dominguez, Nicola Veronese, Francesco Saverio Ragusa, Flavia Seminara, Salvatore Maria Baio, Laura Vernuccio, Giuseppina Catanese, Mario Barbagallo

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish in this journal agree to the following terms:

  • The authors keep the copyright and grant the journal the right of first publication under the terms of the Creative Commons Attribution license, CC BY 4.0. This licencse permits unrestricted use, distribution and reproduction in any medium, provided that the original work is properly cited.
  • The use of general descriptive names, trade names, trademarks, and so forth in this publication, even if not specifically identified, does not imply that these names are not protected by the relevant laws and regulations.
  • Because the advice and information in this journal are believed to be true and accurate at the time of publication, neither the authors, the editors, nor the publisher accept any legal responsibility for any errors or omissions presented in the publication. The publisher makes no guarantee, express or implied, with respect to the material contained herein.
  • The authors can enter into additional contracts for the non-exclusive distribution of the journal's published version by citing the initial publication in this journal (e.g. publishing in an institutional repository or in a book).