A new book is set to challenge the conventional view of Alzheimer’s, claiming that for the vast majority of people, the disease is not an inevitable part of ageing but something that can be prevented. Alzheimer’s: Prevention is the Cure argues that less than one per cent of cases are due to genetics and that current drug targets, such as amyloid plaques, are neither the cause nor the solution.
The book’s author, Patrick Holford, Chair of the Alzheimer’s Prevention Expert Group and founder of the charity Food for the Brain, suggests that Alzheimer’s is largely the result of lifestyle, dietary and environmental factors.
“Becoming an Alzheimer’s patient is almost always a choice,” says neurologist Dr David Perlmutter, a member of the Expert Group, who adds that lifestyle, not genes, is what’s truly driving the rise in dementia.
According to Holford, cognitive decline is the outcome of a “perfect storm” of negative influences that impair the brain’s structure, function or energy supply. “Every known risk factor affects one or more of these areas, and it’s the combination—many of which we can control—that leads to cognitive decline,” he says.
The book is the result of a global Alzheimer’s prevention initiative launched by Food for the Brain. The project tested the cognitive function of over 400,000 people through a free online tool, which included a follow-up assessment of diet and lifestyle. This generates a personal Dementia Risk Index score and practical advice to reduce risk, with users encouraged to retest and track their progress over time.
Holford (right) notes that signs of decline are being detected from as early as age 18, with most people experiencing noticeable impairment by their 70s or 80s. However, he insists that decline can be halted—and even reversed—through the right nutrition and lifestyle adjustments.
The book outlines modifiable risk factors and the impact of addressing them. Central to its message are what Holford calls “the four horsemen of the brain health apocalypse”: insufficient intake of omega-3 fats, B vitamins, antioxidants, and overconsumption of sugar and refined carbohydrates.
Increasing omega-3 intake through fish or supplements can cut dementia risk by 20%, as can optimising vitamin D levels. Supplementing with vitamin D alone has been associated with a one-third reduction in risk.
One of the most crucial—and often overlooked—risk factors is elevated homocysteine, a harmful amino acid in the blood linked to low levels of B vitamins. Rutgers University Professor Joshua Miller supports the book’s emphasis on B vitamin supplementation and omega-3 as key strategies.
Professor David Smith of Oxford University, a long-standing advocate of nutritional intervention in dementia, calls for urgent adoption of the book’s prevention model, saying, “The potential benefits are huge, both personally and economically.”
In fact, a recent analysis by Dr Apostolos Tsiachristas, Associate Professor in Health Economics at Oxford, found that reducing homocysteine through inexpensive B vitamin supplementation could save the UK economy £60 million annually and extend life expectancy by an estimated 14 years.
Despite the compelling evidence, mainstream healthcare has been slow to respond. “We’ve spent over two decades urging the health service to prioritise prevention,” says Holford. “This book is my way of giving individuals the information and tools to take charge of their brain health.”
Food for the Brain now offers a home test kit that measures homocysteine, vitamin D, omega-3 levels, blood sugar (HbA1c), and antioxidant status—important markers rarely tested by GPs. Alarmingly, most people fall below the recommended omega-3 index of 8%, with those under 5% at significantly greater risk of dementia and brain shrinkage. Only one in five achieve the government’s recommendation to eat oily fish once a week, which is insufficient to prevent dementia.
Research from the Netherlands supports the connection, showing that people with low levels of omega-3, B vitamins, and vitamin D have over four times the risk of developing dementia. Reducing sugar and processed food intake can lower Alzheimer’s risk by 20% while increasing antioxidant-rich fruits and vegetables and vitamin C intake also offers protection. One study involving 2,716 over-60s found that those with the highest antioxidant intake had half the risk of cognitive decline.
Beyond nutrition, the book highlights the importance of lifestyle factors such as minimising alcohol, not smoking, regular exercise, social engagement, quality sleep, stress management and sensory health—including hearing and vision. Addressing menopause-related hormonal shifts can also be key for women, with natural HRT showing promise in reducing risk.
Holford’s mission is simple: empower people with science-based tools to take control of their future. The book, available from foodforthebrain.org/books, also supports the ongoing prevention research of the Food for the Brain Foundation.
Alzheimer’s: Prevention is the Cure, by Patrick Holford, will be available on 1 May 2025 from Amazon and all good bookshops.
More information can be found here: https://foodforthebrain.org/apic/.
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