Brain damage already visible

Risk of dementia later in life?

Someone who is at risk for dementia later in life due to an unhealthy lifestyle, already has visible brain damage and cognitive problems. Research by Maastricht UMC+ shows this on the basis of questionnaires and brain scans of more than 4,000 people. These results underline the importance of lifestyle to keep the brain healthy and prevent dementia.

The results of this study, led by Dr. Sebastian Köhler, were published on August 25, 2021 in the online edition of Neurology®, the medical scientific journal of the American Academy of Neurology.

LIBRA Questionnaire

The 4,164 participants in the study completed the so-called LIBRA (Lifestyle for Brain Health) questionnaire. Subsequently, the participants were given an individual risk profile, which shows the risk of dementia. This profile is mainly based on lifestyle factors, such as diet, obesity, smoking and high blood pressure. These factors influence the development of dementia.

Brain damage already

The risk profile describes the possibility that a person will develop dementia later in life. However, this study shows that, with an increased risk of dementia, brain damage already occurs before the disease actually manifests itself. This damage consists of shrinkage of the brain and damage to vessels in the brain. In addition, people at risk of dementia have more difficulty with information processing, performing complex tasks and paying attention. Men with a poor LIBRA score also have a smaller volume of gray matter (tissue in the brain) and more problems with memory. Follow-up research should further clarify this difference between men and women.


Associate professor and researcher Sebastian Köhler: “We already knew that people with an unhealthy lifestyle have a higher risk of dementia. However, our research now also shows that the signs of dementia are already present, namely brain damage and cognitive problems. That is bad but also good news, because people can do something about those bad omens.”


There is a lot of room to work on the lifestyle factors that increase the risk of dementia. Köhler: “If you have a high risk profile at the age of 55, you can lower your dementia risk by, for example, stopping smoking or opting for a healthier diet. We expect that you can also prevent further damage to your brain and cognitive problems. Our research shows how incredibly important a healthy lifestyle is for the brain, in the short and long term.”

The Maastricht Study

This research is part of the Maastricht Study. The 4,164 participants are participating in this large-scale study in the Maastricht/Heuvelland region into the causes and consequences of type 2 diabetes and other chronic diseases.