Prevention must begin now, before problems emerge.
Lifestyle modifications like diet, exercise, and limiting screen time can prevent up to 90% of strokes and 30-40% of dementia cases, according to Spain's Neurology Society president. Protecting vision and hearing, engaging hands-on activities, maintaining social connections, and managing stress are critical for brain health at any age.
- Lifestyle changes could prevent 80-90% of strokes and 30-40% of dementia cases
- Hearing loss is a documented risk factor for dementia
- Repeated minor head trauma in children under 14 multiplies neurological damage risk by six times
- Chronic stress keeps the brain locked in alert mode, preventing access to more beneficial cognitive function
Spanish neurologists outline six preventive strategies that could reduce dementia risk by 30-40% and stroke risk by 80-90%, including healthy diet, exercise, sensory care, cognitive engagement, stress management, and head injury prevention.
Jesús Porta-Etessam, president of Spain's Neurology Society, has a straightforward message: the science is now overwhelming. Small, deliberate changes to how we live—what we eat, how much we move, whether we protect our hearing and eyes—could prevent between 80 and 90 percent of strokes, the leading cause of disability in the general population and the top cause of death among women. The same habits could reduce dementia risk by 30 to 40 percent. The evidence has accumulated steadily over recent years, and neurologists are no longer hedging their recommendations.
Start with the obvious: diet and movement. Not a restrictive regimen, but a genuinely healthy one—the kind that prevents metabolic diseases like obesity, diabetes, and high cholesterol. Pair that with regular physical activity, whether organized sport or a simple thirty-minute walk. These are not separate concerns. They work together to protect against cerebrovascular accidents. The catch, Porta-Etessam emphasizes, is timing. Prevention must begin now, before problems emerge. Waiting until disease appears means fighting from a position of weakness.
Screen exposure deserves serious attention, particularly for adults who often dismiss it as a children's issue. Excessive social media use damages the brain's capacity for attention, concentration, and learning across all ages. For children whose brains are still developing, the endless scroll of short-form video content delivers an immediate hit of gratification that trains the brain to seek the same rush in ordinary life—making sustained focus harder. The habit of watching television while scrolling through Instagram should be abandoned. And screens at night sabotage sleep, which is foundational to neurological health.
The senses matter more than most people realize. Vision and hearing are not peripheral to cognition; they are preneuronal organs, meaning they feed directly into how the brain processes the world. Hearing loss, in particular, is a documented risk factor for dementia, supported by recent research. The recommendation is simple but often ignored: at the first sign of auditory or visual decline, seek help. If you need hearing aids, wear them. If your vision is failing, correct it. The earlier the intervention, the better the outcome.
Keeping the mind active through reading and study is valuable, but adding hands-on work multiplies the benefit. Sewing, painting, assembling things—activities that engage both thought and hands—provide powerful reinforcement for brain health. The key is choosing something you actually enjoy. If macramé holds no appeal, attend lectures instead. Better still, do these things in groups. Isolation and loneliness damage neurons in ways that became starkly visible during the pandemic. Social engagement is not optional.
Stress and tension have a direct, measurable impact on how the brain functions. When we are chronically stressed, we activate the alert system—the brain's first gear, designed for immediate threats. If that state becomes habitual, the brain stays locked in alert mode and cannot access the second system, which is more cognitive and far more beneficial for long-term health. Managing stress is not a luxury. Neither is treating depression seriously. If you are depressed, see a doctor and get treatment. Motivational coffee-cup wisdom will not rewire your neurology.
One final caution concerns head injuries, particularly in children under fourteen. Repeated minor head trauma—the kind that accumulates through heading a soccer ball or falling off a bike—multiplies the risk of neurological damage by a factor of six, according to a 2018 study. Helmets matter. Wear one when cycling or riding a scooter, and fasten it properly. The stakes are higher than a fine.
Notable Quotes
Prevention must begin now, as primary prevention, not secondary prevention after the problem has already appeared— Jesús Porta-Etessam, president of Spain's Neurology Society
There is a clear connection between stress and how the brain functions; when we are constantly stressed, we activate the alert system and cannot access the more cognitive and beneficial second system— Jesús Porta-Etessam
The Hearth Conversation Another angle on the story
Why does the neurologist keep saying we should start prevention now, before anything goes wrong? Doesn't that feel like fear-mongering?
It's the opposite. Once damage occurs—a stroke, cognitive decline—you're managing a crisis. Prevention is about building resilience while your brain is still intact. The window for that is always now.
The hearing aid recommendation surprised me. How does hearing loss actually lead to dementia?
When you can't hear well, your brain works harder to process sound, which taxes cognitive resources. Over time, that constant strain, combined with social withdrawal from hearing difficulty, appears to accelerate decline. It's not mysterious—it's measurable.
So sewing and painting are as important as exercise?
Not instead of, but alongside. Exercise protects the vascular system. Hand-work with thought engages different neural pathways. Together they're more powerful than either alone. The specificity matters less than the combination.
What about people who are already stressed or depressed? Is it too late?
No. But you can't think your way out of it. You need actual treatment—medication, therapy, whatever works. The brain under chronic stress cannot access its own resources for healing. You have to interrupt the cycle first.
The head injury warning seems specific to children. Why?
Because a child's brain is still developing. The same impact that a teenager might recover from can derail the formation of neural architecture in a younger child. The vulnerability window is real.
If I do all of this—diet, exercise, hearing aids, sewing, stress management—am I guaranteed not to get dementia?
No guarantee exists. But you've shifted the odds substantially. You've removed preventable risk. What remains is what you cannot control. That's the honest version.