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Quiz: Risk Factors and Prevention Strategies

Test your understanding of dementia risk factors and evidence-based prevention strategies with these 10 review questions. Click "Show Answer" to check your work.

1. According to the Lancet Commission, approximately what percentage of dementia cases worldwide may be prevented or delayed through addressing modifiable risk factors?

  1. Up to 5%
  2. Up to 15%
  3. Up to 40%
  4. Up to 90%
Show Answer

The correct answer is C. The 2020 Lancet Commission on Dementia Prevention identified 12 modifiable risk factors that, if addressed across the lifespan, could prevent or delay up to 40% of dementia cases. This is a hopeful finding because it means lifestyle changes throughout life can make a substantial difference, even though we cannot yet cure or fully prevent dementia.

Concept Tested: Modifiable Risk Factors

2. Which of the following is a non-modifiable risk factor for dementia?

  1. Blood pressure
  2. Age
  3. Physical activity level
  4. Diet
Show Answer

The correct answer is B. Age is the strongest known risk factor for Alzheimer's disease and most other dementias, and it cannot be changed. After age 65, the risk of Alzheimer's doubles roughly every five years. Blood pressure, physical activity, and diet are all modifiable lifestyle factors that can be influenced through choices and medical care.

Concept Tested: Non-Modifiable Risk Factors

3. How does the APOE epsilon 4 (ε4) variant affect a person's risk of Alzheimer's disease?

  1. It guarantees the person will develop Alzheimer's disease
  2. It protects completely against Alzheimer's disease
  3. It increases risk but does not guarantee the person will develop Alzheimer's
  4. It has no effect on Alzheimer's risk
Show Answer

The correct answer is C. APOE ε4 is the most important genetic risk factor for late-onset Alzheimer's. One copy raises risk 2 to 3 times; two copies raise it 8 to 12 times. However, many carriers never develop dementia, and many non-carriers do. It influences risk and timing, not certainty, which is why routine testing of healthy adults is generally not recommended.

Concept Tested: APOE Gene

4. Why do doctors say "what's good for your heart is good for your brain"?

  1. The heart and brain share the same nerves
  2. Cardiovascular risk factors damage blood vessels and reduce blood flow to the brain, increasing dementia risk
  3. Heart medicines also treat dementia directly
  4. The brain only receives blood from arteries in the heart
Show Answer

The correct answer is B. The brain uses 20% of the body's blood flow. Conditions such as high blood pressure, diabetes, high cholesterol, and obesity damage blood vessels and reduce oxygen and nutrient delivery to brain cells. They also cause microinfarcts, inflammation, and small vessel disease. Protecting cardiovascular health therefore protects brain health, especially when started in midlife.

Concept Tested: Cardiovascular Risk

5. A 50-year-old man has just been diagnosed with high blood pressure. Why is treating his hypertension NOW especially important for future brain health?

  1. Midlife hypertension strongly increases dementia risk in later life, and treatment in midlife is most protective
  2. High blood pressure only matters after age 75
  3. Blood pressure has no connection to brain health
  4. He should wait until he has symptoms before starting treatment
Show Answer

The correct answer is A. Untreated midlife hypertension (ages 40 to 64) increases dementia risk by 60 to 80%. High blood pressure damages small vessels, causes microinfarcts, and creates white matter lesions that accumulate silently for decades. Controlling blood pressure through lifestyle and medication during midlife is the critical window for maximum brain protection, even though benefits continue into later life.

Concept Tested: Hypertension

6. A caregiver asks which diet has the strongest research evidence for reducing dementia risk. What is the best answer?

  1. A strict vegan diet with no animal products
  2. A low-carbohydrate ketogenic diet
  3. A high-protein, red-meat-based diet
  4. The Mediterranean diet, which emphasizes vegetables, fruits, whole grains, fish, olive oil, and nuts
Show Answer

The correct answer is D. The Mediterranean diet and its MIND diet variation have the strongest evidence, with studies showing 30 to 40% reduction in dementia risk. It is rich in anti-inflammatory foods, healthy fats, antioxidants, and fiber, and it supports cardiovascular and brain health through multiple pathways. No other dietary pattern has comparable evidence for protecting cognition as people age.

Concept Tested: Mediterranean Diet

  1. At least 150 minutes of moderate-intensity aerobic activity
  2. About 10 minutes once a week
  3. At least 12 hours per day
  4. No specific amount; any movement is equally beneficial
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The correct answer is A. Guidelines recommend at least 150 minutes per week of moderate aerobic activity (such as brisk walking) or 75 minutes of vigorous activity, plus strength training twice weekly. Regular exercise reduces dementia risk by 30 to 40% through increased blood flow, neurogenesis, higher BDNF, reduced inflammation, and stronger cognitive reserve. It's never too late to start.

Concept Tested: Physical Exercise

8. What is cognitive reserve, and how is it built?

  1. A special brain region that stores extra memories
  2. A vitamin supplement proven to prevent dementia
  3. The brain's resilience built through education, mentally stimulating work, lifelong learning, and novel challenging activities
  4. A backup copy of the brain created during sleep
Show Answer

The correct answer is C. Cognitive reserve is the brain's ability to compensate for damage by using alternative neural pathways and more efficient networks. It is built across life through education, complex occupations, learning new skills, multilingualism, and engaging in novel mentally stimulating activities. People with higher reserve can tolerate more brain pathology before symptoms appear, which is why lifelong learning matters.

Concept Tested: Cognitive Reserve

9. Research shows that social isolation and loneliness increase dementia risk by roughly 50 to 60%. Which is the BEST strategy for a recently widowed 72-year-old to maintain social engagement?

  1. Stay home and avoid the stress of new people
  2. Join a local senior center, volunteer group, or interest-based club to build regular contact with others
  3. Rely only on short text messages for all contact
  4. Wait for family to initiate all social interactions
Show Answer

The correct answer is B. Active social engagement through clubs, faith communities, volunteering, classes, or senior centers provides cognitive stimulation, emotional support, purpose, and often physical activity. Quality matters more than quantity, and small steps like joining one regular group can make a meaningful difference. Isolation is as damaging to brain health as physical inactivity, so rebuilding connections is a priority.

Concept Tested: Social Engagement

10. A 55-year-old woman whose mother developed Alzheimer's disease at age 70 asks what she should do. Which response best balances the evidence?

  1. "Family history guarantees you will develop dementia, so don't bother with lifestyle changes."
  2. "Get tested for APOE immediately; the results will tell you exactly what will happen."
  3. "Only medications can prevent dementia; lifestyle doesn't matter if it runs in families."
  4. "Family history raises risk but is not destiny. Focus on modifiable factors such as blood pressure, exercise, diet, social engagement, and hearing care."
Show Answer

The correct answer is D. A first-degree relative with dementia increases risk 2 to 4 times, but most people with family history never develop dementia, especially when they address modifiable factors. Controlling cardiovascular risk, staying physically active, eating a Mediterranean-style diet, maintaining social and mental engagement, treating hearing loss, and avoiding smoking all reduce risk even in those with genetic susceptibility.

Concept Tested: Family History