Dementia haunts the imagination of aging Australians more than any other disease, yet a growing body of evidence suggests that nearly half its burden need not be inevitable. Professor Henry Brodaty, drawing on decades of research and a landmark trial of 6,000 adults, has shown that lifestyle coaching — spanning exercise, diet, education, and cardiovascular care — can meaningfully delay the disease's onset. The question Australia now faces is not whether prevention is possible, but whether the nation possesses the collective will to treat the aging brain with the same seriousness it once brough
Nearly half of dementia risk is modifiable, new evidence shows
Dementia affects two in five Australians over 55 and is the disease most feared, creating significant burden on individuals, families, and the healthcare system.
Nearly half of dementia risk can be modified through choices we make.
Mark
When you say 45 percent of dementia risk is modifiable, does that mean the other 55 percent is just bad luck—genetics, age, things we can't touch?
Mimi
Not quite. The 45 percent comes from evidence we can measure and study in populations. The remaining 55 percent includes genetics, sure, but also factors we haven't fully identified yet, or can't easily measure. It's not that they're unchangeable—it's that we don't have the same level of proof about them.
Mark
So if someone has a family history of dementia, the coaching program still helps them?
Mimi
Yes. The trial showed that even in a general population, coaching improved cognition three times more than just handing people information. Family history doesn't erase that benefit. It might mean you need to be more vigilant, but the levers still work.
Mark
Why does delaying onset by a year matter so much? That sounds almost trivial.
Mimi
Because dementia is a disease of late life. If you delay it by a year, you reduce new cases by 10 percent across a population. Delay it by five years and you've cut incidence in half. Some people will never develop it at all—they'll die first. That's not trivial. That's the whole point.
Mark
The trial cost money to run. How do we know a national program would actually save money, not just cost more?
Mimi
The trial itself showed that within three years, the health savings—fewer hospital visits, fewer prescriptions, fewer emergency department trips—completely paid for the coaching. That's not a projection. That's what happened. Scale matters, but the math works.
Mark
What stops Australia from doing this tomorrow?
Mimi
Inertia, mostly. We've proven it works with heart disease, with smoking, with skin cancer. We have the playbook. We have the evidence. We have the technology. It's a choice.
Le Pouls
- Two in five Australians over 55 will develop dementia — the disease they fear most — yet nearly half that risk is modifiable, creating a rare and urgent window for prevention.
- A rigorous three-year trial of 6,000 adults found that personalised coaching improved cognition almost three times more than information alone, equivalent to pushing dementia's onset back by at least a year.
- The economic disruption is already here: dementia strains hospitals, families, and the healthcare budget, but the trial's cost savings from reduced medical visits completely offset the program's expense.
- Professor Brodaty is calling for a two-tier national Brain Health Australia campaign — a public awareness push for those 45 and older, paired with an online coaching program backed by AI and GP education.
- Australia has rewritten the story of preventable disease before — with heart health, smoking, and 'Slip Slop Slap' — and Brodaty argues the tools, evidence, and economic case are already in place to do it again for the brain.
Dementia haunts the imagination of aging Australians more than any other disease, yet a growing body of evidence suggests that nearly half its burden need not be inevitable. Professor Henry Brodaty, drawing on decades of research and a landmark trial of 6,000 adults, has shown that lifestyle coaching — spanning exercise, diet, education, and cardiovascular care — can meaningfully delay the disease's onset. The question Australia now faces is not whether prevention is possible, but whether the nation possesses the collective will to treat the aging brain with the same seriousness it once brought to smoking, skin cancer, and HIV.
Dementia is the disease Australians fear most, and two in five people who live past 55 will develop it. But a shift in understanding is underway: nearly half of that risk is modifiable. It can be prevented, or at least delayed. The question is whether the nation is ready to act.
Professor Henry Brodaty, 2026 Senior Australian of the Year and co-director of the Centre for Healthy Brain Ageing at UNSW, has spent years identifying what actually works. The list is neither exotic nor expensive — education in childhood, regular aerobic and strength exercise, a Mediterranean-style diet, social connection, managed blood pressure and cholesterol, no smoking, limited alcohol, early treatment of hearing loss, depression, obesity, and diabetes. Individually, each factor accounts for between one and seven percent of dementia risk. Together, they account for 45 percent of the disease burden.
To move beyond observation, Brodaty's team ran the Maintain Your Brain trial — more than 6,000 dementia-free adults aged 55 to 77, split between personalised coaching on key risk factors and information alone. Over three years, both groups improved, but the coached group improved nearly three times as much. That gap translates to at least one year's delay in dementia onset, along with sustained gains in physical activity, diet, and mood. Crucially, the reduction in hospital visits, emergency presentations, and prescription costs over those three years fully offset what the trial cost to run.
The economic logic scales powerfully. Extend the program to hundreds of thousands or millions of Australians, and the savings reach into the billions. Australia has navigated this kind of transformation before — heart disease deaths have fallen dramatically over fifty years, smoking rates dropped, cervical cancer was nearly eradicated, and 'Slip Slop Slap' became cultural shorthand for sun safety.
Brodaty's proposal follows that model: a two-tier Brain Health Australia campaign beginning at age 45, combining a broad public awareness effort with an online coaching program offering ten weeks of personalised guidance, booster sessions, and GP education. Smartphones, computing power, and artificial intelligence make this feasible today. For every year dementia's onset is delayed, its incidence falls by ten percent. The tools exist, the evidence is solid, and the economic case is made. What remains is the will.
Dementia is the disease Australians fear most, and with good reason. Two in five people who live past 55 will develop it. But here's what changes the conversation: nearly half of that risk doesn't have to happen. It can be modified. It can be prevented or delayed. The question is whether we're willing to act on what we now know.
Professor Henry Brodaty, the 2026 Senior Australian of the Year and co-director of the Centre for Healthy Brain Ageing at the University of New South Wales, has spent years studying what actually works. The answer is not mysterious. A childhood rich in education builds cognitive reserve—a kind of neural cushion that protects the brain. Throughout life, challenging your mind matters. So does moving your body regularly, preferably through aerobic exercise and strength training. Eating in the Mediterranean style. Staying socially connected. Keeping your blood pressure in check, managing cholesterol, avoiding smoking and excessive alcohol. If you lose your hearing, getting a hearing aid early helps. Living away from air pollution helps. Treating depression, obesity, and diabetes when they appear helps. Protecting your head from injury helps. Each of these factors contributes somewhere between 1 and 7 percent to overall dementia risk, but together they account for 45 percent of the disease burden.
The evidence comes from cohort studies—long-term observations of populations that did and didn't develop dementia—but Brodaty's team wanted something more rigorous. They ran the Maintain Your Brain trial, enrolling more than 6,000 community-dwelling adults aged 55 to 77 who were dementia-free at the start. Half received coaching on how to reduce four key risk factors. The other half received information only. Over three years, both groups improved their cognition. But the coaching group improved almost three times as much as the information group. That improvement is equivalent to delaying dementia's onset by at least one year. The trial also found sustained gains in physical activity, diet quality, and mood.
Here's where the economics matter. The reduction in health costs over those three years—fewer hospital admissions, fewer emergency department visits, fewer doctor appointments, lower prescription costs—completely offset what the trial cost to run. Scale that up to 600,000 Australians, or 6 million, and the savings land in the billions. Australia has done this before. Deaths from heart disease have dropped dramatically over the past 50 years because the nation embraced prevention. Smoking rates fell. HIV spread was limited. Cervical cancer was nearly eradicated through HPV vaccination. Skin cancer prevention became a household message with "Slip Slop Slap" and Sid the Seagull.
Brodaty's proposal is straightforward: launch a two-tier Brain Health Australia campaign. The first tier would be a general public information push, ideally starting with adults aged 45 and older, encouraging people to think about their brains and take action. The second tier would be an online coaching program where people select the risk factors they want to address and receive 10 weeks of personalized coaching, plus booster sessions and education for their GPs. Technology makes this feasible now—smartphones, computing power, artificial intelligence. Australia could become a world leader in brain health prevention, seeing benefits not just in dementia rates but in overall health within a decade.
The tools exist. The evidence is solid. The economic case is made. What's missing is the will to treat brain health the way the nation has treated other preventable diseases. For every year dementia's onset can be delayed, its incidence drops by 10 percent. In a disease that mostly strikes late in life, the goal is almost poetic: delay it long enough that people die of something else first. The time to act, Brodaty argues, is now.
Citations marquantes
For every year we can delay dementia's onset, we reduce its incidence by 10 percent.— Professor Henry Brodaty
Australia could become the world leader in brain health prevention, with benefits visible within a decade.— Professor Henry Brodaty
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