Millions of Americans are at risk of developing dementia, but early detection and targeted interventions could significantly delay its onset and alleviate its impact, according to a new report by the nonprofit research organization RAND. The report highlights how cognitive ability, lifestyle factors, and physical health can predict dementia risk as early as two decades before symptoms emerge.

The findings reveal that certain conditions, including diabetes, lack of physical exercise, and limited work history, are strongly linked to an elevated risk of dementia. By addressing these risk factors early, individuals can take proactive steps to mitigate their chances of developing the condition.

Despite the importance of early detection, current uptake of cognitive assessments remains alarmingly low. Only about 16% of Americans aged 65 and older undergo routine cognitive testing during visits with their primary care providers. This gap underscores the need for more accessible and affordable diagnostic tools to connect at-risk individuals to timely treatments and resources.

Early intervention is particularly crucial for the 58 million Americans aged 65 and above. Existing disease-modifying treatments for Alzheimer’s disease and related dementias are most effective in the early stages. However, barriers such as cost, limited access, and the absence of robust treatment options deter many from seeking early diagnosis.

The RAND report suggests that removing these barriers—by offering free and easily accessible cognitive testing—could encourage greater participation and better prepare individuals for managing the disease. The report also emphasizes the need for improved public health strategies to expand awareness and integrate routine cognitive assessments into standard care for older adults.

With dementia poised to affect a growing portion of the population, the call for early detection and comprehensive prevention strategies is more urgent than ever. By identifying at-risk individuals and addressing modifiable factors, the healthcare system can better equip millions of Americans to confront the challenges of dementia.