Cognitive Longevity and Dementia Risk Reduction: The 4 Levers Smart People Focus on Early

If you’re healthy, proactive, and genuinely serious about longevity, there’s one area you should not leave to chance:

Your brain.

Because cognitive longevity isn’t just about avoiding dementia.

It’s about staying sharp, emotionally stable, motivated, socially engaged, and independent as you age.

It’s the ability to remember names, keep learning, make good decisions, and still feel like yourself at 60, 70, 80 and beyond.

And here’s the good news:

Dementia risk is not just “bad luck”.

Yes, genetics plays a role. But it’s not the full story. In fact, for most people, dementia risk is heavily influenced by long-term lifestyle patterns, inflammation, metabolic health, and nervous system resilience.

In this post, I want to break down four of the most important and evidence-backed levers for cognitive longevity:

• APOE-related risk and lifestyle levers

• Neuroinflammation and brain ageing

• Insulin resistance and Alzheimer’s risk

• Hearing loss and dementia risk (the big new one most people still ignore)

Let’s get into it.

---

1) APOE and Dementia Risk: Genetics Loads the Gun, Lifestyle Pulls the Trigger

If you’ve been anywhere near the longevity space, you’ve heard of APOE.

APOE is a gene involved in lipid transport and brain repair. There are different versions (alleles), and the one that gets the most attention is APOE ε4.

Carrying APOE4 is associated with a higher lifetime risk of Alzheimer’s disease.

But here’s the key point I always emphasise:

APOE4 is not a diagnosis. It’s a susceptibility.

Some APOE4 carriers develop dementia.

Many never do.

And this is where I think the whole conversation needs to mature.

Because what APOE really represents is:

A brain that is more vulnerable to inflammation, oxidative stress, metabolic dysfunction, and poor recovery.

So what do you do with that information?

You don’t panic.

You optimise.

The lifestyle levers that matter most for APOE4 carriers

If you carry APOE4, the highest-return levers tend to be:

• Keeping inflammation low

• Prioritising deep, stable sleep

• Maintaining insulin sensitivity

• Avoiding chronic high ApoB and poor lipid profiles

• Building and maintaining lean muscle

• Avoiding smoking and minimising alcohol

• Maintaining cardiovascular fitness

In other words, APOE4 doesn’t mean you’re doomed.

It means you have more incentive to live like someone who values brain longevity.

And honestly, that’s a good thing.

Because the habits that reduce dementia risk are the same habits that improve energy, mood, metabolic health, and long-term performance.

---

2) Neuroinflammation: The Slow Burn That Ages the Brain

One of the most important concepts in cognitive longevity is neuroinflammation.

This is not the kind of inflammation you “feel” like a sore ankle.

This is low-grade, chronic inflammatory signalling that slowly alters brain function over years.

And it matters because the brain is highly sensitive tissue.

Inflammation affects:

• synaptic function (how brain cells communicate)

• neurotransmitter balance

• blood brain barrier integrity

• microglial activation (immune cells in the brain)

• mitochondrial function

• neuroplasticity

This is why chronic inflammation often shows up as:

• brain fog

• low motivation

• anxiety

• low mood

• poor sleep

• poor memory

• slower processing speed

Even in otherwise healthy people.

What drives neuroinflammation?

In my experience, the biggest drivers are:

• Poor sleep quality and fragmentation

• Insulin resistance and high glucose variability

• Gut inflammation and dysbiosis

• Chronic stress and cortisol dysregulation

• Environmental toxins (mould, heavy metals, endocrine disruptors)

• Sedentary lifestyle

• Unresolved nutrient deficiencies

And here’s the uncomfortable truth:

Many people are inflamed and don’t know it.

Because they look “healthy” on the outside.

This is why I’m such a believer in using biomarkers alongside genetics. You need to see what’s happening under the hood.

Markers like hsCRP, fasting insulin, homocysteine, triglycerides, ApoB, omega-3 index, and vitamin D can be incredibly informative.

---

3) Insulin Resistance: Alzheimer’s Is Increasingly a Metabolic Disease

This is one of the most important shifts in modern longevity science.

We are seeing stronger and stronger links between:

insulin resistance
and
cognitive decline / Alzheimer’s risk

In fact, you’ll often hear Alzheimer’s referred to as “type 3 diabetes” in some research circles.

Now, that’s not a perfect term, but it points to something very real:

The brain is an energy-hungry organ.

It needs stable fuel.

And when glucose metabolism becomes dysfunctional, the brain suffers.

What insulin resistance does to the brain

Chronic insulin resistance is associated with:

• increased inflammation

• increased oxidative stress

• impaired blood flow

• reduced glucose uptake in brain tissue

• increased amyloid accumulation

• impaired mitochondrial function

In plain English:

If your metabolism is unstable, your brain becomes more vulnerable over time.

And this is why cognitive longevity is not just a brain topic.

It’s a whole-body topic.

The best insulin-sensitivity levers (for healthy optimisers)

If you’re already reasonably healthy, the best “big rocks” are:

• resistance training (non-negotiable)

• daily movement (walking is underrated)

• protein adequacy

• keeping visceral fat low

• stable sleep timing

• reducing ultra-processed foods

• minimising frequent glucose spikes

• prioritising fibre and micronutrients

And if someone wants to go deeper:

• CGM tracking can be useful

• fasting insulin and HOMA-IR testing is valuable

• triglyceride to HDL ratio is a good proxy

Most people wait until their glucose is high.

That’s far too late.

Insulin resistance begins years earlier, and that’s where the prevention window lives.

---

4) Hearing Loss: The Dementia Risk Factor No One Talks About (But Everyone Should)

Now for the big one.

This is the part of the dementia conversation that still shocks people.

Hearing loss is now considered one of the strongest modifiable risk factors for dementia.

And it’s one of the most ignored.

Why?

Because hearing loss feels “normal”.

People shrug it off.

They delay testing.

They delay hearing aids.

They pretend it’s not happening.

And that’s a mistake.

Why hearing loss increases dementia risk

There are a few mechanisms at play:

1) Cognitive load increases

When you can’t hear properly, your brain has to work harder just to decode sound.

That steals energy from memory, processing, and executive function.

2) Social withdrawal increases

People with hearing loss often stop engaging socially.

They avoid noisy environments.

They talk less.

They isolate.

And social isolation is a known dementia risk factor.

3) Brain stimulation decreases

The auditory system provides constant stimulation to the brain.

When that input reduces, brain regions can shrink or become underused over time.

This is a huge deal.

Because brain health is a “use it or lose it” situation.

The simple takeaway

If you care about brain longevity, you should:

• test your hearing earlier than you think you need to

• treat hearing loss as a health issue, not an ageing inconvenience

• use hearing aids sooner rather than later if needed

This is one of the easiest high-impact interventions in modern preventive health.

And it’s wildly underutilised.

---

Where Genetics Fits In (And Why It’s Useful, Not Scary)

People often ask me:

“Is it worth doing genetic testing for dementia risk?”

My answer is:

Yes, if you’re the kind of person who will use the information intelligently.

Because genetics is not a crystal ball.

It’s a blueprint.

And the real value is not just APOE.

It’s the broader landscape of:

• inflammation susceptibility

• detoxification pathways

• methylation efficiency

• neurotransmitter balance

• oxidative stress handling

• cardiovascular risk markers

• metabolic predisposition

This is one of the reasons I like Life X DNA®’s Ultimate Pro Kit for longevity-focused clients.

Not because it tells you your future.

But because it gives you clarity on where your weak points are likely to be.

So you can build a prevention strategy that’s personalised, not generic.

---

The 4-Part Brain Longevity Strategy I Like Most

If I had to simplify everything into a practical approach, it would look like this:

1) Keep inflammation low

Sleep well. Eat clean. Fix gut issues. Reduce toxin exposure. Move daily.

2) Keep insulin sensitivity high

Strength train. Maintain lean muscle. Avoid constant glucose spikes. Keep visceral fat down.

3) Keep cardiovascular health excellent

A healthy brain requires blood flow.

ApoB, blood pressure, omega-3 index, fitness and endothelial function matter.

4) Protect sensory input and social connection

Test hearing early.

Stay socially engaged.

Keep learning.

Keep your brain challenged.

---

Final Thoughts: Cognitive Longevity Is Built Decades Before It’s Needed

Here’s the truth:

Most dementia prevention happens in your 30s, 40s, and 50s.

Not in your 70s.

By the time someone is showing early cognitive decline, the biology has often been building for years.

That’s why I’m so passionate about this topic.

Because for healthy, proactive people, dementia risk reduction is one of the highest-value investments you can make.

It’s not about fear.

It’s about ownership.

Your brain is the control centre for your entire life.

And if you want to live longer, healthier, sharper, and more independent, then cognitive longevity deserves a permanent place in your health optimisation strategy.

Stay healthy, stay informed
Robert Van der Moigg
Founder – Life X DNA®