There are many candidates for modifiable—perhaps preventative—risk factors, but we have to be careful about getting carried away with trying to modify them ahead of the science.

It does look as if it’s not good to be depressed in middle age from the perspective of Alzheimer’s risk, nor obese, nor to have high cholesterol or hypertension. It is probably wise to maintain physical fitness in middle years and later, and to nurture social relationships, and community involvement. Maybe, one should eat a good diet, relatively free of fast food, and richer in fish and vegetables and peanuts.

Certain experiences in early life may affect risk for Alzheimer’s disease, too. It looks as if it is important to get a good education, and to establish the habit of using your brain in a continuum of new learning experiences through life. It may be wise to prepare yourself for an intellectually stimulating occupation, and to stay with that occupation through life, whatever your baseline cognitive abilities may be.

We have no good reason to believe that vitamins, supplements, herbs, health foods, or any related substances prevent or even affect Alzheimer’s disease, so people should be careful about spending money on these things. The desire to take pills is strong in humans, but it must be resisted and balanced against the present limitations of our knowledge. Dr. Randolph Schiffer, Director of the Cleveland Clinic Lou Ruvo Center for Brain Health, says he himself buys what is on sale at the health food store, and rotates substances from time to time to hedge the bets about what might actually work.

The problem with the summary of “risk factors” outlined above is that it starts to sound suspiciously like the aphorisms of the ancient physicians and philosophers: that one should lead a good life in the Greek ideal—well rounded, without excesses, and with altruism to the community, courage and loyalty to family and friends. Perhaps this is so. Perhaps the ancients were right. We do not presently know better than they did.