June 3, 2026, 3:12 pm | Read time: 4 minutes
Most people still associate dementia with old age. However, we can reduce our risk of dementia even at a young age. A recent German study shows that lifestyle from the age of 20 not only affects mental performance but also influences the risk of dementia.
Alzheimer Trend Rising in Germany
In Germany alone, over 1.8 million people live with dementia. Most of them suffer from Alzheimer’s, and the trend is rising. Due to the aging population, the number of affected individuals is expected to exceed two million in the coming years, according to forecasts.1 Until now, risk factors for dementia have mostly been studied from middle age onward. Researchers from the Medical Faculty of the University of Leipzig now show in their study that an established dementia risk index can identify differences in mental performance among young adults aged 20 to 39.2
What Did the Researchers Investigate?
The LIBRA Index (Lifestyle for Brain Health) assesses modifiable dementia risk, especially in middle-aged and older adults. The Leipzig researchers wanted to find out if the index is also applicable to young people. They examined the prevalence of LIBRA factors and their individual and combined relationships with cognitive performance in adults aged 20 to 75, considering age, gender, and socioeconomic status.
The data came from the population-based health study NAKO. With nearly 150,000 participants aged 20 to 75, it is Germany’s largest long-term study on common diseases.3 For each person, the LIBRA score was calculated based on health and lifestyle factors. The main risk factors of the LIBRA score include:
- Smoking
- Lack of exercise
- Depression
- Cardiovascular diseases
The higher the LIBRA score, the higher the risk of dementia.
What the Study Found
The data analysis clearly showed: A higher LIBRA score, indicating a higher risk of dementia, was associated with poorer mental performance across all age groups. However, the researchers wanted to break it down further and analyzed the relationships between risk values and cognitive performance.
It became apparent that younger adults had different dominant risk factors than seniors. Those aged 20 to 39 more frequently exhibited behavioral and psychosocial risk factors, such as smoking, lack of exercise, and depressive symptoms. In older individuals, cardiovascular risks like high blood pressure, coronary heart disease, and elevated cholesterol levels were more prevalent.
“It is clear that the type of risk factors for dementia changes over the lifespan. Risk reduction should not start at 40 or 60 years but should begin in young adulthood,” says Professor Steffi G. Riedel-Heller, director of the Institute for Social Medicine, Occupational Medicine, and Public Health (ISAP), in a press release from the University of Leipzig.4 If young adults focus early on lifestyle factors such as exercise, nutrition, or mental health, they can likely do much for brain health in old age, explains Professor Riedel-Heller.
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Further Interesting Insights into Dementia Risk and Factors
The data analysis revealed additional interesting correlations.
- People with a lower socioeconomic status had less favorable LIBRA scores.
- Differences between women and men were evident: On average, men had higher dementia risk factors (LIBRA values) than women.
- Negative correlations between the LIBRA score and cognitive performance were particularly pronounced in women with low socioeconomic status.
The researchers conclude from the results that certain groups may be disadvantaged multiple times throughout their lives. “Our results clearly show that dementia risk is not only linked to individual factors. If we do not focus more on social inequalities, we risk as a society that the most vulnerable groups benefit the least from important risk reduction,” explains lead author Felix Wittmann.
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Conclusion of the Study
As the researchers emphasize, the current study fills a scientific gap. Until now, the LIBRA Index had only been well-studied for individuals aged 40 and older. The study results show that it is also meaningful for those aged 20 to 39. Thus, the LIBRA Index can be applied to younger age groups as an established tool for assessing dementia risk factors.
At the same time, the study shows that dementia risk factors must be weighted differently across age groups. Behavioral and psychosocial risks are more common among younger adults, while cardiovascular risks dominate among older adults. Overall, higher LIBRA values were consistently associated with lower cognitive performance in adulthood.
Additionally, gender-specific and socioeconomic inequalities have shown that tailored strategies are needed for different risk groups. For example, young adults can support their brain health into old age through regular exercise and healthy lifestyle habits. People with lower socioeconomic status could also be targeted and supported with specific strategies.