When Taiwan’s former president Ma Ying-jeou was reported to be showing signs of cognitive decline, and when Lin Fang-yu, a prominent cardiac surgeon who had led three major medical centers, was diagnosed with dementia after retiring, public anxiety about the condition sharpened considerably. The cases raised a question many people quietly ask: am I at risk?
Dementia is not a single disease but a cluster of conditions that affect memory, behavior, personality, and judgment. The most familiar symptom is memory loss, but the condition also produces cognitive deterioration, personality changes, hallucinations, and delusions. In severe cases, it disrupts the lives of family members and caregivers as much as the person diagnosed.
The main types of dementia and how they are diagnosed
The most common forms include Alzheimer’s disease, Parkinson’s disease dementia, vascular dementia, and Huntington’s disease. Because symptoms overlap across types and no single test is definitive, diagnosis requires a structured process of assessment across multiple dimensions over time.
Traditional Chinese medicine approaches the condition differently. Huang Qianrui, a licensed practitioner of traditional Chinese medicine, notes that the discipline has no direct equivalent of the Western clinical term “dementia,” but classifies its symptoms under categories such as “stupor” and “forgetfulness.” The foundational Chinese medical text Huangdi Neijing, written roughly two thousand years ago and still a reference point in traditional practice, describes the kidneys as governing the production of marrow and the brain as the “sea of marrow,” establishing a conceptual link between kidney function and cognitive health. In this framework, weakened kidney function leads to insufficient marrow nourishment for the brain.
From that basis, traditional Chinese medicine approaches prevention through methods aimed at strengthening kidney essence and balancing vital energy and blood. Conditions such as heart-spleen deficiency, phlegm obstruction, and blood stasis are considered warning signs that may accelerate cognitive deterioration.
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Huang describes treatment goals in three stages. In early-stage dementia, the aim is to slow brain deterioration and preserve cognitive function. In the middle stage, the focus shifts to managing abnormal mood and reducing psychiatric symptoms. In advanced cases, treatment targets the reduction of severe complications, including impaired swallowing, restricted movement, and bedridden dependency.
An aging population is the primary driver of rising dementia rates
Taiwan’s health ministry projects that the island’s population of people over 65 living with dementia will grow from approximately 350,000 in 2024 to more than 470,000 by 2031, and approach 680,000 by 2041. As lifespans extend, the brain’s exposure to the conditions that cause neural degeneration increases, particularly when complicated by cardiovascular disease. Taiwan crossed the threshold of an “aged society” in 2018, when people over 65 exceeded 14 percent of the population, and entered “super-aged” status in 2025, when that share passed 20 percent.
Genetics plays a role, but a limited one for most people. Early-onset Alzheimer’s, which involves deterministic gene mutations, accounts for between one and five percent of all cases. Late-onset dementia, where genetic factors raise risk without guaranteeing illness, accounts for more than 95 percent.
Depression is a significant and underappreciated risk factor. Chang Yu-ling, a psychology professor at National Taiwan University, notes that long-term follow-up research shows people who have experienced depression carry roughly three times the dementia risk of those who have not. Sustained depressive states appear to reduce what researchers call “brain reserve,” the brain’s capacity to absorb damage without showing symptoms, increasing vulnerability to cognitive decline.
Regular exercise cuts dementia risk by up to 40 percent
People who perform approximately 150 minutes of moderate to vigorous exercise per week show a 25 percent lower dementia risk than those who exercise rarely. A 2006 epidemiological study by the United States National Institute on Aging, covering adults over 65, found that exercising at least three times a week for 15 minutes or more per session reduced the risk of Alzheimer’s disease by 35 to 40 percent. That threshold, three sessions a week at 15 minutes each, has become a standard benchmark in medical guidance on brain aging.
Exercise benefits the brain through two main mechanisms: it improves blood circulation, and it stimulates the release of brain-derived neurotrophic factor, a protein that supports the repair of nerve cells and the consolidation of memory.
Light to moderate activity works just as well as intense exercise. Brisk walking, cycling, swimming, and dancing all qualify, provided they sustain an elevated heart rate.
Walking alone produces measurable results. A study published in the journal Nature Medicine in November 2025, led by a research team at Harvard Medical School and tracking roughly 300 adults aged 50 to 90 over periods of two to fourteen years, found that walking 5,000 to 7,500 steps per day delayed cognitive decline by approximately seven years. Walking 3,000 to 5,000 steps per day still produced a delay of around three years.
Mental exercise matters alongside physical activity. A study led by Rush University Medical Center in Chicago tracked approximately 2,000 adults aged 53 to 100 without dementia over eight years. Participants who maintained high levels of intellectually stimulating activity throughout their lives showed significantly stronger resistance to cognitive deterioration. Post-mortem examination of the 948 participants who died during the study period found that even those whose brain tissue showed the characteristic protein deposits of Alzheimer’s disease retained better memory and thinking ability if they had remained cognitively active. Their rate of decline was also measurably slower.
Andrea Zammit, a neuropsychologist at Rush University Medical Center, attributes this to what researchers call “cognitive reserve,” the brain’s capacity to reroute function around damaged areas. Sustained intellectual activity, including reading, writing, learning a foreign language, playing chess, solving puzzles, and visiting museums, appears to build and reinforce neural connections across multiple brain regions, leaving the brain better equipped to compensate for the damage caused by aging or disease.
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Sitting for more than eight hours a day raises dementia risk by 27 percent
Prolonged sitting independently impairs brain health, regardless of whether a person exercises at other times. People who sit for more than eight hours a day show a 27 percent higher dementia risk, an effect attributed to the impact of sustained physical inactivity on cerebral circulation, metabolism, and vascular health.
The pattern is common: checking a phone immediately after waking, sitting through a workday, then returning home to watch television, with the body remaining largely static for most of the day.
Experts recommend breaking sitting time with three to five minutes of movement for every hour spent seated. Standing when possible, taking short walks during work breaks, and beginning the morning with light physical activity before starting work all help reduce the cumulative effect. Brief morning sun exposure, ten to twenty minutes, activates the hypothalamus, the brain region that regulates circadian rhythm, and improves daytime concentration.
Sleep under seven hours or over eight hours both raise dementia risk
The relationship between sleep and dementia risk follows a curve. Sleeping fewer than seven hours per night raises dementia risk by 18 percent. Sleeping more than eight hours raises it by 28 percent. Duration alone is not the only variable; sleep quality matters as well.
During sleep, the brain activates a waste-clearance mechanism that flushes metabolic byproducts, including beta-amyloid, the protein most strongly associated with Alzheimer’s disease. Disrupted sleep, irregular schedules, and chronic late nights impair this process.
Practical steps for improving sleep quality include avoiding food and alcohol close to bedtime, and stopping use of phones and other screens one to two hours before sleeping. Blue light from screens suppresses melatonin, the hormone that regulates sleep onset, and reduces the depth of sleep.
Lifestyle habits slow the rate of cognitive decline even when prevention is incomplete
Ronald Petersen, an Alzheimer’s disease specialist, has stated that a healthy lifestyle reliably slows the rate of deterioration, even if no intervention eliminates dementia risk entirely. Walking daily, exercising regularly, sleeping within the seven-to-eight-hour window, and staying intellectually active are the habits with the strongest evidence behind them. People who established these habits earlier in life and maintained them consistently showed the largest reductions in risk across the studies reviewed.
