Dementia has become Australia's leading cause of death. That does not mean dementia is an inevitable consequence of ageing. It means that as Australians live longer, more people are reaching ages where dementia is common - and that brain health deserves the same serious attention we give cardiovascular and metabolic health.
Primary source: Australian Institute of Health and Welfare, Australia's health 2026.
The Australian picture
Australia's Health 2026 reports that dementia became the leading cause of death in Australia in 2024, accounting for about 17,500 deaths - around 1 in 10 deaths - and overtaking coronary heart disease.[1]
Neurological conditions accounted for 8.4% of Australia's total disease burden in 2024. AIHW also notes that dementia was the leading cause of disease burden among males aged 85 and over and females aged 65 and over. [1]
The report links the rise in dementia deaths largely to population ageing: more Australians are reaching ages where dementia is more common. It also identifies excess weight as a risk factor for dementia alongside cardiovascular disease and type 2 diabetes.[1]
Brain health is connected to the rest of the body
Dementia Australia emphasises that dementia is not a normal part of ageing and that risk can be influenced across the life course. Brain health is connected to blood vessels, blood pressure, glucose regulation, cholesterol, hearing, vision, physical activity, sleep, smoking, alcohol, mental health and social connection.[2][3]
This matters because several dementia risk factors are also cardiovascular and metabolic risk factors. Looking after blood pressure, cholesterol, diabetes risk and physical activity may therefore support both heart and brain health.
No single lifestyle change can guarantee prevention. The goal is risk reduction, not certainty.
What can affect cognitive health?
Cognitive change can have many causes. Dementia is one possibility, but it is not the only one. Memory, attention and thinking can also be affected by sleep disorders, depression, medicines, alcohol, hearing or vision loss, acute illness, nutritional deficiency and other medical conditions.
| Area | Why it matters | Useful questions or measures |
|---|---|---|
| Cardiovascular health | High blood pressure, high LDL cholesterol, diabetes and smoking are recognised modifiable dementia risk factors. | Blood pressure, lipids, glucose/HbA1c, smoking history and overall cardiovascular risk. |
| Hearing & vision | Untreated hearing impairment and vision loss are associated with higher dementia risk and can also mimic or worsen communication and cognitive difficulties. | Hearing assessment, eye examination, use of hearing aids/glasses when prescribed. |
| Physical activity | Regular movement supports cardiovascular, metabolic and brain health. | Activity level, strength, aerobic fitness, mobility and sedentary time. |
| Sleep | Poor sleep and sleep disorders can impair memory and daytime cognition; sleep apnoea can fragment sleep repeatedly. | Sleep duration/quality, snoring, witnessed apnoeas, daytime sleepiness. |
| Mood & social connection | Depression and social isolation are recognised dementia risk factors and can themselves affect cognition. | Mood screening, social contact, loneliness, meaningful activity and support network. |
| Nutrition & alcohol | Overall diet and excessive alcohol intake can influence cardiovascular, metabolic and brain health. | Diet pattern, alcohol intake, weight/waist, targeted nutrient tests when clinically indicated. |
| Head injury | Traumatic brain injury is a recognised risk factor for dementia. | Past head injuries, fall risk, occupational/sport exposure and head protection. |
| Medicines & medical causes | Some medicines and medical problems can contribute to confusion or memory complaints. | Medication review and targeted medical investigation when symptoms are new or changing. |
Fourteen modifiable risk factors
Dementia Australia summarises 14 modifiable dementia risk factors from contemporary research: lower levels of education, hearing impairment, high blood pressure, smoking, obesity, depression, physical inactivity, diabetes, excessive alcohol consumption, traumatic brain injury, air pollution, social isolation, vision loss and high LDL cholesterol.[2][3]
These are population-level risk factors, not a personal diagnosis. Their value is that they identify areas where prevention and health monitoring may overlap with other chronic-disease strategies.
What is worth measuring?
When someone is concerned about memory or thinking, the useful question is not simply 'Do I have dementia?' A structured assessment can help distinguish normal variation, reversible contributors and conditions that need further investigation.
- Cognitive change over time: what has changed, when it started and whether it affects everyday function.
- Blood pressure, cholesterol and glucose regulation: because vascular and metabolic health are strongly connected with brain health.
- Hearing and vision: sensory loss can increase cognitive load and reduce social engagement.
- Sleep: especially snoring, apnoeas, insomnia, fragmented sleep and daytime sleepiness.
- Mood and mental health: depression and anxiety can affect concentration, memory and motivation.
- Medication and alcohol review: especially after a new medicine, dose change or new confusion.
- Targeted medical tests: based on history and clinical assessment rather than a blanket panel of tests.
- Formal cognitive assessment: when symptoms are persistent, progressive or affecting daily life.
Memory screening is not the same as diagnosis
Brief cognitive tests can identify areas that deserve closer assessment, but they do not by themselves diagnose a specific dementia. Education, language, hearing, vision, mood, fatigue and cultural background can all influence performance.
A diagnosis usually requires a clinical history, functional assessment, medication review, physical and neurological examination, cognitive testing and, when appropriate, blood tests or imaging.
Questions worth asking
A physiology-first brain-health conversation can include:
- Is this change new, progressive and affecting everyday function, or is it an isolated memory lapse?
- Have blood pressure, cholesterol, glucose, hearing, vision and sleep been reviewed?
- Could depression, anxiety, alcohol, pain, infection or a medicine be affecting cognition?
- Is there a history of stroke, cardiovascular disease or head injury?
- Are physical activity and social connection being maintained?
- Would formal cognitive assessment or referral to a specialist add useful information?
Are we looking only at memory, or are we also examining the cardiovascular, metabolic, sensory, sleep and social physiology that supports the brain?
When professional assessment matters
New or progressive memory loss, personality change, confusion, difficulty managing finances or medicines, getting lost, language problems or loss of everyday function should be assessed by a doctor.
Sudden confusion is not typical dementia progression and can signal acute illness, medication effects, infection, metabolic disturbance or another urgent medical problem.
The Physiology First takeaway
Brain health does not sit in isolation from the rest of the body. Blood vessels, metabolism, hearing, vision, sleep, movement, mood and social connection all influence the environment in which the brain ages.
Physiology First cannot promise dementia prevention. It can encourage earlier measurement, better risk-factor management, prompt assessment of cognitive change and a broader view of the systems that support cognitive health.
KNOW MEASURE UNDERSTAND CONNECT QUESTION OPTIMISE RE-MEASURE
[1] Australian Institute of Health and Welfare (2026). Australia's health 2026. Australian Government. https://www.aihw.gov.au/reports/australias-health/australias-health-2026
[2] Dementia Australia. Risk factors for developing dementia. https://www.dementia.org.au/brain-health/risk-factors-developing-dementia
[3] Dementia Australia. Reduce your risk of dementia. https://www.dementia.org.au/brain-health/reduce-your-risk-dementia
[4] Dementia Australia. Brain health. https://www.dementia.org.au/brain-health
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