Black Americans Face a Higher Risk of Dementia, But Lifestyle Changes May Help

The statistics are sobering, but there’s a silver lining: Simple lifestyle changes can offer powerful protection

Christine Richmond

Updated May 05, 2025

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Let’s get the bad news out of the way first: Cognitive decline — though not inevitable — becomes more of a risk as we get older. And for Black people, the risk is greater. Black adults age 55 and older are two to three times more likely to have dementia than white adults, and they develop the disorder an average of three years earlier, research has shown.

One explanation for these disparities is that Black communities often face barriers to high-quality health services. “In real estate, it’s all about location, location, location. In public health, it’s access, access, access: access to information, access to resources and access to health care,” says neurologist and Alzheimer’s researcher Dean Sherzai, M.D. “And those things do not exist in most communities where you see a higher prevalence of disease.”

Sherzai and his wife Ayesha Sherzai, M.D., also a neurologist and Alzheimer’s researcher, host brain health workshops at Black churches. As social gathering spaces and pillars of trust in the neighborhoods they serve, churches help the Sherzais meet people in their own communities. During their presentations, the Sherzais focus on the good news: You can do a lot to slash your dementia risk.

Dementia is an umbrella term that describes problems with memory, thinking and reasoning that interfere with daily life. The most common cause — Alzheimer’s disease — involves your genes but also your environment and lifestyle. “That’s an incredibly empowering thing to know, because while we can’t alter genes, we can alter those other factors,” Dean Sherzai says.

His brain health advice: Eat more plants, such as leafy greens, and less sugar and processed meat; take more walks; and talk with your health care provider if you have any sleep problems, such as sleep apnea. He also encourages people to keep their minds stimulated. “Your brain has 87 billion neurons, with one quadrillion connections between them. It needs to be challenged,” he says. “Whether it’s learning a new musical instrument, volunteering or running a book club, these things create new connections in the brain.”

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Here’s a closer look at three changes you can make today to help benefit your brain:

1. Eat more plants

In a study of 3,337 people age 65 and older, part of the Chicago Health and Aging Project (CHAP), Black adults who most closely followed a healthy plant-based diet had a slower rate of cognitive decline. Published in The American Journal of Clinical Nutrition in 2022, the study defined a healthy plant-based diet as being high in whole grains, fruits, vegetables, nuts, legumes, vegetable oils, tea and coffee and low in refined grains, sugary beverages and sweets.

Don’t let vascular diseases go untreated

Dementia risk and certain vascular diseases, including diabetes and high blood pressure, are more common in Black communities. “You see the correlation of those things — very strong correlation — with cognitive diseases, like stroke … like vascular dementia, like Alzheimer’s," says Dean Sherzai. "And when you see those things being treated, you see the prevalence [of dementia] going down.”

Another study of 3,390 adults from the CHAP cohort, published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association in 2022, found that Black adults whose diets were highest in vitamin D, from foods like salmon, mushrooms, almonds and fortified milk, performed better on cognitive tests over 12 years of follow-up compared with those who got the least dietary vitamin D. Your skin makes vitamin D when you’re outside in the sun. But older adults — especially those with darker skin — may not produce enough, because the pigment melanin, which makes skin dark, absorbs more of the ultraviolet rays the body needs to make vitamin D.

You’ll get plenty of fruits, veggies and other types of plants if you switch to a Mediterranean diet; many people find it easy to follow, thanks to its flexibility. But if you’re not ready for a complete diet overhaul, you can start smaller by doing Meatless Mondays or making produce-packed versions of your favorite dishes and takeout classics. The Sherzais believe in the power of making “small, meaningful changes.” For example, Dean Sherzai points to a 2018 Rush University Medical Center study that suggested that older adults who ate at least one serving of leafy greens a day showed signs of being 11 years younger cognitively.

Learn more about the essential nutrients for brain health and how to cook with brain-friendly foods.

2. Manage stress

Staying calm, cool and collected is no easy feat in these tumultuous times. Government surveys have found that Black adults are 20 percent more likely than white adults to report serious psychological distress. Here’s why de-stressing is so important: In a study of 24,448 Black and white adults with a median age of 64, the most stressed-out participants, regardless of race, performed the worst on tests designed to screen for cognitive impairment. The study was published in JAMA Network Open in 2023.

The next time you’re feeling overwhelmed, try these seven simple stress busters or check out our free guided meditation videos.

3. Get moving

Exercising on a regular basis can help protect you from a host of chronic illnesses, and it’s one of Staying Sharp’s six pillars of brain health, along with managing stress and eating right. Many types of exercise, including walking, strength training, swimming, Tai chi and cycling, can improve executive function in older adults, according to a systematic review of 91 studies involving a total of 9,482 older adults published in 2024 in Frontiers in Psychology.

The Centers for Disease Control and Prevention recommends 150 minutes a week of moderate aerobic exercise, plus two days a week of muscle-strengthening activities. According to the CDC, just 13.9 percent of all U.S. adults age 65 and older meet those guidelines, and only 10.2 percent of Black older adults do. Add more movement to your day with our no-gym workout ideas and free yoga and strength training videos. And remember: Every little bit helps. “You don’t have to do a marathon: A 25-minute brisk walk every day significantly lowers your risk of dementia,” Dean Sherzai says.