You want your parents to stay active, independent and part of family life for as long as possible.
Yet memory loss can make families feel powerless. A parent may start repeating questions, missing appointments or struggling with familiar tasks. The family worries, but nobody knows what to do next.
The first thing to know is that dementia is not a normal part of ageing. Nor is it always preventable. But families can act on several risks linked to the disease.
Can dementia risk be reduced?
Yes. Dementia cannot always be prevented, but better health and daily habits may reduce or delay some cases.
The “2024 Report of the Lancet Standing Commission on Dementia Prevention, Intervention and Care” identified 14 risks that people or health systems can change. They include physical inactivity, smoking, diabetes, high blood pressure, high cholesterol, hearing loss and social isolation.
The commission estimated that these factors are linked to about 45% of dementia cases worldwide. This is a population estimate, not a promise that one person can cut their risk by exactly 45%.
For families, the message is simple: do not wait for memory problems to appear before looking after brain health.
Start with three steps.
Dementia in Pakistan: What do we know?
No reliable national count exists for dementia in Pakistan.
One article in the Journal of the Pakistan Medical Association estimated that between 150,000 and 200,000 Pakistanis live with dementia. A later editorial in the Journal of the College of Physicians and Surgeons Pakistan put the figure between 200,000 and 400,000.
The gap between these estimates tells its own story: many cases are probably missed, and Pakistan needs better data, diagnosis and public awareness.
But families do not need to wait for perfect statistics before taking sensible action.
Step one: ask their doctor about the shingles vaccine
Shingles, also called herpes zoster, is a painful illness caused when the chickenpox virus becomes active again.
The vaccine’s proven purpose is to prevent shingles and its complications. Recent research suggests that it may have another benefit.
A 2025 study in Nature, “A Natural Experiment on the Effect of Herpes Zoster Vaccination on Dementia”, studied older adults in Wales. Vaccine eligibility depended on a strict date-of-birth rule, allowing researchers to compare otherwise similar groups.
People who received the vaccine had a 3.5-percentage-point lower chance of receiving a new dementia diagnosis over seven years. This was equal to a 20% relative reduction.
Another study, “The Recombinant Shingles Vaccine Is Associated With Lower Risk of Dementia”, appeared in Nature Medicine in 2024. It found that people who received the newer recombinant vaccine were less likely to receive a dementia diagnosis during the following six years than those who received the older vaccine.
This is encouraging evidence. It is not proof that the vaccine prevents dementia, and it should not be sold as a “dementia vaccine”.
What should your family do?
Ask your parents’ doctor:
- Is the shingles vaccine suitable for them?
- Does an illness or medicine make it unsuitable?
- Which vaccine is available in Pakistan?
- How many doses do they need?
The doctor should make the recommendation after reviewing their age, health and medicines.
Step two: walk with them
“Exercise more” sounds like a lecture.
“Let us take a walk together” sounds like family time.
A large study published in JAMA Network Open in 2021 was called “Association of Physical Activity Level With Risk of Dementia in a Nationwide Cohort in Korea”. It followed 62,286 people aged 65 or older.
Compared with inactive adults, those who did some activity had a 10% lower risk of dementia. The most active group had a 28% lower risk. Even light activity was linked with a benefit.
This does not mean that every 30-minute walk cuts a person’s risk by a fixed amount. The study found an association over time, not a guarantee for each walker.
Still, walking is a useful place to start. It supports the heart, blood vessels, blood pressure, blood sugar, balance and mood. These are all relevant to healthy ageing.
How much walking is enough?
A practical aim is 30 minutes on five days each week. This adds up to the World Health Organisation’s target of at least 150 minutes of moderate activity a week.
Choose a flat and familiar route. Walk at a pace that still allows conversation. In hot weather, go early in the morning or later in the day.
A shorter walk is better than none. Parents with chest pain, dizziness, severe breathlessness, frequent falls or poor mobility should ask their doctor before starting.
Step three: stop smoking and control blood sugar
Smoking harms more than the lungs. It damages blood vessels, including those that supply the brain.
A study called “Effect of Smoking Cessation on the Risk of Dementia” followed a large group of adults over time. It found that people who had stopped smoking for a sustained period had a lower risk of dementia than those who continued.
The World Health Organisation’s “Risk Reduction of Cognitive Decline and Dementia” guidelines also advise people not to smoke and to manage weight, blood pressure, cholesterol and blood sugar.
Does sugar cause dementia?
Not by itself.
An occasional sweet does not cause dementia. The greater concern is a long-term pattern of sugary drinks, weight gain, diabetes and poorly controlled blood sugar.
Diabetes is one of the risks identified by the Lancet Commission. This is why families should focus on blood-sugar control rather than frightening parents with claims that a spoonful of sugar will damage the brain.
A sensible plan is to:
- Cut down on sugary drinks and packaged juices
- Serve smaller portions of mithai
- Follow the treatment prescribed for diabetes
- Check blood sugar as the doctor advises
- Monitor blood pressure and cholesterol
- Help smokers get support to quit
Small changes that last are better than strict rules that last a week.
What about memory supplements?
No pill sold as a “memory booster” has been shown to prevent dementia.
A doctor may prescribe a supplement when a blood test finds a deficiency. But vitamins and herbal products should not replace medical care, exercise, sleep, healthy food or treatment for diabetes and high blood pressure.
Be especially careful when an older person already takes several medicines. Supplements can cause side-effects or interact with prescribed drugs.
Your three-step family plan:
Do not hand your parents a long list of rules. Give them support.
First, arrange a doctor’s visit. Ask about the shingles vaccine, blood pressure, diabetes, cholesterol, hearing and medicines.
Second, walk together. Aim for about 30 minutes on most days, but begin with what they can manage safely.
Third, improve household habits. Support smoking cessation, reduce sugary drinks and keep diabetes under control.
The family is the guide in this story. Your job is not to frighten or command your parents. It is to make the healthy choice easier.
Frequently Asked Questions:
1. Can dementia be completely prevented?
No. Age, genes and some illnesses cannot be changed. But addressing smoking, inactivity, diabetes, high blood pressure, high cholesterol, hearing loss and other risks may prevent or delay some cases.
2. Does the shingles vaccine prevent dementia?
It has not yet been proved to prevent dementia. Recent studies found fewer dementia diagnoses among vaccinated adults, but more research is needed. The vaccine’s established purpose is to prevent shingles.
3. Which studies link the shingles vaccine with dementia risk?
The main studies discussed here are:
- “A Natural Experiment on the Effect of Herpes Zoster Vaccination on Dementia”, published in Nature in 2025
- “The Recombinant Shingles Vaccine Is Associated With Lower Risk of Dementia”, published in Nature Medicine in 2024
Both found an association between vaccination and fewer dementia diagnoses. Neither proves that vaccination will prevent dementia in every person.
4. How much should an older adult walk?
A useful aim is 30 minutes on five days a week, provided walking is safe for that person. Shorter walks also count. Even light physical activity has been linked with a lower risk than complete inactivity.
5. Does quitting smoking reduce dementia risk?
Research suggests that sustained smoking cessation is linked with a lower dementia risk than continued smoking. Quitting also protects the heart, lungs and circulation.
6. Does eating sugar cause dementia?
No single food causes every case of dementia. But diabetes and poor blood-sugar control are recognised risks. Reduce excess sugar as part of a broader plan to manage diabetes, weight and cardiovascular health.
7. When should memory problems be checked?
Speak to a doctor when memory problems begin to affect medicine, money, cooking, communication, safety or familiar daily tasks.
Seek urgent help for sudden confusion. An infection, stroke, medicine or another illness may be responsible.
Start with one action:
No miracle food, pill or vaccine can guarantee protection from dementia.
But one medical appointment, one walk and one healthier household habit are a sound start.
For more practical advice on healthy ageing and supporting an older family member at home, read the family-care resources from ConsidraCare Pakistan.
Medical disclaimer: This article provides general information. It does not replace advice, diagnosis or treatment from a qualified healthcare professional.
