Although there is no single cause for dementia, there are various factors which increase or reduce the likelihood of it developing. Some of these are things which it is possible to change, which means it is possible to reduce the likelihood of developing dementia or slow down its progress. This chapter reviews the main risk factors, with a focus on those which are possible to change. This includes vascular risk factors, such as high blood pressure, elevated cholesterol, and diabetes, all of which can be addressed pharmacologically. It then reviews lifestyle risk factors and how these can potentially be addressed via lifestyle changes. This includes giving up smoking, reducing alcohol consumption, taking regular exercise, modifying diet, and improving quality and quantity of sleep. Evidence is reviewed for the effectiveness of making such changes.

A healthy 38-year-old secundigravida presents for a first prenatal visit after sonography at your hospital center just dated a spontaneous intrauterine pregnancy at 12+4 weeks’ gestation. Early fetal morphology and sonographic screening markers for aneuploidy are unremarkable. You learn that she and her husband just moved to the country. Five years ago, she had gestational diabetes mellitus (GDM) and delivered vaginally. The patient has no obstetric complaints and has been taking folate-containing prenatal vitamins. She does not drink alcohol, smoke cigarettes, or use any recreational substances.

A 25-year-old G2P1 presents for prenatal care at 8+2 weeks’ gestation by menstrual dates with complaints of nausea and vomiting for the past two weeks. Your clinical nurse reassures you the patient is not in acute distress and converses well. There is no history of vaginal bleeding.