A tool to help keep dementia in check

If you worry about your risk of dementia, Lauren Sprague knows your fear. Her father had a stroke when she was in high school. What followed was a long, slow descent into memory loss and dementia. He died at just 63.

“So, since I was 16 years old, pretty much every day of my life I worry, ‘Is today the day that the same thing could happen to me that happened to my dad?'” Sprague said. “It’s an incredible fear to walk around with.

“Every day of my children’s lives up until now, I’ve worried that that could be me,” she said.

Then she went to see Dr. Jonathan Rosand, who told us, “Time and again I would get the question, ‘Doctor, what can I do to take good care of my brain so that I don’t end up like my mother, my brother, my father?'”

Rosand is a neurologist at Massachusetts General Hospital in Boston. He explained to Sprague it was possible to cut the risk of dementia by making changes to daily habits, from choices about what you eat, to the amount of physical activity you get every day. “It turns out that these modifiable risk factors probably account for at least 40% of all dementia cases,” Rostand said.

A committee of experts from around the globe has concluded that about 40 to 45% of dementia cases could be prevented or delayed by addressing 14 modifiable risk factors:

• Physical inactivity
• Smoking
• Excessive alcohol consumption
• Air pollution
• Traumatic brain injury
• Hearing loss
• Untreated vision loss
• High blood pressure
• Diabetes
• Obesity
• Low education attainment
• Social isolation
• High cholesterol
• Depression 

Rostand said that it’s a very common conception that if dementia or Alzheimer’s is in one’s family, that they are doomed. “But the truth is there’s so much we can do,” he said.

The idea that exercise and diet are important is not new, of course. But what is new is a tool from Rosand and his team to help you understand exactly how much and what kind of lifestyle changes are beneficial. It starts with a simple questionnaire free to everyone online, called the Brain Care Score.

“The Brain Care Score is a tool for any of us to use in our daily lives that lists out the modifiable risk factors for dementia, stroke and depression,” Rostand said.

The healthier your habits, the higher your score. And to improve your score, you pick which habits you want to focus on changing. Rostand said, “It’s a guide to where you can go next. And in our work with patients, it really does give a choice, and a sense of freedom.”

A groundbreaking study from June 2025 found that a five-point higher Brain Care Score is associated with a 43% lower risk of developing heart disease, and a 31% lower incidence of most common cancers (including lung, colorectal, and breast cancer).

It’s evidence that what’s good for the brain is good for the rest of the body, too.

So, where to start? For Lauren Sprague and her husband, Scott, change started in the kitchen. They doubled down on greens and cut out highly-processed foods. (This added one point to her score.) They spend more time outdoors, which helps with fitness and stress relief. (That can add 2 more points.) She also takes time to sing and create, adding meaning, more stress relief, and purpose (while adding 2 more points).

Sprague said, “The Brain Care Score really gave me the prescription that I needed. And the wonderful thing about it is, it is a recommendation, but there is nuance, and it can be customized, which is wonderful.”

And Rosand is hoping this is one prescription that we all can share. He said, “The key message we want to convey with the Brain Care Score is, it is you. It is each of our viewers. It is everyone who wants to take a step forward. It’s up to you and you’re in control.”

     
For more info:

• Take the Brain Care Score (Global Brain Care Coalition)
• Understanding your Brain Care Score
• Dr. Jonathan Rosand, McCance Center for Brain Health at Massachusetts General Hospital
• Lauren Sprague

     
Story produced by Amol Mhatre. Editor: Emanuele Secci.