A groundbreaking international study has pinpointed 17 modifiable lifestyle and health factors that can help protect the brain against aging, dementia, stroke, and late-life depression—offering hope to millions of Thais as the country faces a rapidly aging population and an expected surge in dementia cases. This new research, led by the Mass General Brigham healthcare system in the United States and recently published in the Journal of Neurology, Neurosurgery, and Psychiatry, draws on large-scale analysis to clarify which habits and medical conditions pose the greatest threats—or offer the strongest shields—for brain health as people grow older (source: Mass General Brigham).
The study’s significance is immediate for Thailand, where recent surveys suggest that as many as 18% of people over age 60 may now be living with dementia, a rate that tracks similarly with findings from Japan and Brazil and that experts warn may climb dramatically as the Thai population continues to age (Siriraj Medical Journal). Dementia already ranks among the top ten causes of death and diminished well-being for older Thai men and women, affecting not just memory and daily function but also happiness, family relationships, and caregiving burdens.
According to the Mass General Brigham review, the 17 modifiable lifestyle factors most closely linked to risk of dementia, stroke, and depression later in life include high blood pressure, severe kidney disease, high blood sugar, high cholesterol, smoking, alcohol use, poor diet, hearing loss, pain, low physical activity, lack of purpose in life, poor sleep, low social engagement, stress, and insufficient leisure activities with cognitive engagement. Notably, the two factors with the strongest negative impact were uncontrolled high blood pressure and advanced kidney disease, while regular physical and cognitive activity—such as exercise or puzzles—emerged as consistent protective factors.
Explaining the implications, the study’s lead investigator from Mass General Hospital’s Brain Care Labs underscored, “Our study identified 17 modifiable risk factors shared between stroke, dementia, and/or late-life depression, emphasizing that there are many different steps individuals can take to lower their risks for these age-related brain diseases.” Another researcher, a post-doctoral fellow at the same lab, said, “Dementia, stroke, and late-life depression are connected and intertwined, so if you develop one of them, there’s a substantial chance you may develop another one in the future… preventive efforts could lead to a reduction in the incidence of more than one of these diseases, which provides an opportunity to simultaneously reduce the burden of age-related brain diseases” (Source).
For Thai readers, these findings echo and amplify existing research from local hospitals and universities. For example, a 2021 cross-sectional study in Nonthaburi province observed that lower education, older age, diabetes, less use of digital technologies, and infrequent participation in religious or social activities were all sharply associated with greater dementia risk (Siriraj Medical Journal). In this Thai context, researchers emphasized that the prevalence of dementia could be as high as 18%, and that people with primary-school education or less were far more likely to be affected, as were people who struggled to use mobile phones or the internet, or who rarely joined in religious or communal activities.
Worldwide, dementia (including Alzheimer’s disease, vascular dementia, frontotemporal dementia, and others) leads to severe impairment in memory, thinking, language, and everyday function. The World Health Organization reports a new dementia case every three seconds globally, and Thailand is no exception (Wikipedia). The burdens are not only medical, as patients require more support and caregivers feel the strain emotionally and financially.
But what sets the Mass General Brigham study apart is its rigorous demonstration—backed by synthesizing findings from a host of large, previous meta-analyses—of how modifying common health risk factors can potentially stave off not just dementia, but also the linked risks of stroke and major depression in old age. The review led to the updating of the McCance Center Brain Care Score, a tool designed to help individuals measure and improve their brain health.
When considering the practical application, the lifestyle changes recommended are not especially novel, but the strength of evidence for their impact is now clearer than ever. The top modifiable factors include:
- Managing high blood pressure
- Preventing or treating kidney disease
- Controlling blood sugar and cholesterol
- Avoiding smoking and limiting alcohol use
- Following a healthy diet rich in fruits, vegetables, and whole grains
- Treating hearing loss
- Staying physically active
- Sleeping well
- Reducing stress
- Being socially engaged and having a strong sense of purpose
- Regular involvement in leisure activities that challenge the mind (such as reading, games, or learning new skills)
While certain aspects, like hearing health or kidney function, may require medical intervention, many of the most effective preventive strategies are lifestyle based. The study authors highlight that the simultaneous overlap of these risk factors in multiple conditions offers a “shortcut”: by tackling key habits, people can lower their personal risk for a whole range of costly and disabling brain disorders.
In the Thai setting, adapting these recommendations can build on foundational cultural strengths such as community life, Buddhist meditation practices, and intergenerational households, all of which may support social engagement, stress reduction, and cognitive stimulation (Siriraj Medical Journal). At the same time, rapid urbanization and a shift toward more sedentary lifestyles—especially in Bangkok and other large cities—present new challenges, making proactive health checks, community programs, and accessible health information more urgent than ever.
As Thailand prepares for a “silver tsunami” of aging adults, health leaders and policymakers are encouraged to support public health campaigns, routine screening for cardiovascular and kidney health, and easy-access programs promoting physical, mental, and social activity for older adults. Several Thai hospitals already offer memory clinics and health education workshops, but experts call for more widespread adoption of digital tools, such as online brain health self-assessments and telemedicine check-ins, to reach even those who are homebound or in rural areas.
Reflecting on the new research, a leading neurologist associated with the World Health Organization’s Southeast Asia region, commented: “This is compelling evidence that the same basic actions—healthy eating, activity, community contact, managing chronic illness—can pay enormous dividends for brain health, not only by reducing the risk of dementia but also decreasing stroke and depression rates in the elderly. For Thailand, implementing these recommendations can offer cost-effective, long-term health and social benefits.”
Looking ahead, the Mass General Brigham team is calling for international, randomized controlled trials using their Brain Care Score to track and improve brain health over time. In Thailand, researchers and health providers can build on this foundation by integrating the 17 modifiable factors into public health guidance and clinical practice for older adults, supported by data-informed outreach especially in rural and underserved urban communities.
For families and individuals wondering where to start, experts recommend regular health assessments for blood pressure, blood sugar, and kidney function, combined with daily habits such as stopping smoking, eating healthfully, walking or exercising most days, maintaining social ties, treating hearing issues, and seeking purpose through hobbies, volunteering, or religious practice.
As one of the study’s lead authors from Mass General Hospital summed up: “Healthcare is increasingly complex. But these findings remind us that preventing disease can be very simple. Why? Because many of the most common diseases share the same risk factors.” In Thailand, as the society faces a demographic transformation, heeding this advice could offer every family a pathway to a brain-healthy future.