Perth Audiology & Dizziness

Midlife Matters: Reducing Dementia Risk Before It Starts

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Hopefully the title has caught your attention. In all seriousness, Dementia and Loneliness are killing people. And there's something you can do about it to stop it.

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In recent years, evidence emerging from longitudinal and population-based journal studies has begun to reshape how we think about dementia risk. One of the most compelling insights is this: what happens in midlife matters deeply for brain health later on. Even more encouraging, many of the risk factors identified are modifiable—meaning there are steps people can take to reduce their risk.

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To set the scene, let’s clarify a few key terms.

Midlife typically refers to adults aged 40 to 60 years. This period is increasingly recognised as a critical window during which long-term brain health trajectories are shaped. Changes occurring in these decades may not cause immediate symptoms, but they can quietly influence dementia risk many years later.

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Risk factors are characteristics or conditions that increase the likelihood of developing dementia. Some risk factors are non‑modifiable, such as family history or genetic susceptibility. However, a growing body of evidence highlights several modifiable risk factors in midlife that are strongly linked to future dementia risk.

Notable midlife risk factors include:

• High cholesterol, which is associated with vascular changes that affect blood flow to the brain

• Hearing loss, increasingly recognised as a significant and independent risk factor

• Cardiovascular risk factors such as high blood pressure, diabetes, and obesity​

 

Hearing loss is of particular interest. Untreated hearing difficulties may contribute to social withdrawal, increased cognitive load, and structural brain changes over time—all mechanisms linked to cognitive decline. Importantly, hearing loss is measurable and treatable, making it a powerful target for prevention strategies.

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The emerging message from the research is hopeful: dementia risk is not fixed in midlife. By identifying and addressing modifiable risk factors earlier, individuals have the opportunity to meaningfully influence their cognitive health later in life. 

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Don't be the person who waits on average 9 years to do something about their hearing loss. You'll be 9 years older and your body and brain will have changed too. Being proactive and managing your health in mid life is a great place to ensure the foundations are carried through, and for some, improved as we age.

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Reassuringly, I am seeing and treating more and more client's in mid-life. As a healthcare professional who believes and tries and strives to practice preventative healthcare, supporting individuals in their 30's, 40's and 50s is energising.

 

Not to say that supporting those in later life is not. Mid-life brings a different set of challenges and a different spirit and energy. Yes, uptake to hearing aids and all the features they have is fun, however what I thorough have enjoyed and observed is the change in the skeptism of 'wow do I really need hearing aids' and 'are they actually going to work for me?' change. A few phrases from my 35-65yo clients that make me smile and really bring purpose to my role as an audiologist:

"game changer (for listening to speech in noise, like a pub)"

"less headaches from straining to listen hard all day, but still get headaches from my work, Kat"

"it wasn't immediately a wow factor, but when I heard the indicator on in the car (after forgetting to turn it off, and the typing on my smartphone..... I knew I was missing more than I thought."

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The brain and mind has it's own ways of dealing with change. For hearing loss, it deals with it by reorganising the neural pathways to area's that will use that energy. For example, your visual cortex and tactile cortex may take over. People often comment they are 'good lip readers' and I always wonder if they know this may come at a cost to their auditory processing, working memory and more.

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In short, midlife isn’t too early to think about dementia prevention and brain health —it may be the most important time to do so.

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​Longitudinal studies to review:

ACHIEVE Study

Baltimore Study

Health ABC Study (Healthy Aging and Body Composition)

TILDA Study

World Health Organisation / Lancet Commission on Dementia Prevention

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References:

• Livingston G, et al. (2024). Dementia prevention, intervention, and care: 2024 report of the Lancet Commission. The Lancet.
  Highlights midlife (≈40–60 years) as a critical window for intervention and identifies hearing loss and high LDL cholesterol as leading modifiable risk factors, estimating that up to ~45% of dementias may be preventable.
  [thelancet.com], [chronicdisease.org]

• Alzheimer Europe (2024). Lancet Commission underscores the potential for dementia risk reduction.
  Summarises major population‑attributable risk calculations derived from large cohort studies.

• Machado‑Fragua M, et al. (2025). Association of midlife hearing impairment and hearing aid use with incident dementia. Nature Aging.
  Longitudinal UK cohort analysis demonstrating that hearing impairment measured in midlife is associated with later dementia risk. [nature.com]

• Livingston G, et al. (2024). Lancet Commission (hearing loss meta‑analyses).
  Identifies hearing loss as one of the largest modifiable contributors to dementia risk globally.
  [hearingpra...ews.com.au]

• Satheesan L, et al. (2025). Hearing loss in young and middle‑aged adults as a modifiable risk factor for late‑life dementia. Audiology Research (Systematic Review & Meta‑analysis).
  Demonstrates measurable cognitive vulnerability in adults aged <65 with untreated hearing loss. [mdpi.com]