David PerlmutterPresident,, Perlmutter Health Center · Board-Certified Neurologist | Functional Medicine Pioneer | #1 New York Times Best-Selling Author | International Speaker | Host of The Empowering Neurologist Podcast

Is Dementia Really Inevitable With Age? | Dr. David Perlmutter

12 Oct 2026 · 1 min

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In this excerpt, Dr. David Perlmutter critiques the common narrative that dementia is an inevitable outcome whose duration is merely shortened by risk factors such as smoking, hypertension, and diabetes. He argues that framing dementia as unavoidable is misleading and that the true goal should be to remain dementia‑free for an entire lifetime—a goal he deems absolutely achievable. Perlmutter links this perspective to his broader body of work, including his book Brain Defenders, emphasizing that the choices we make today can dramatically influence whether we develop dementia later in life, metaphorically flipping a coin at age 85 to determine the outcome.

Chapters

Dementia-free years. We're hearing a lot these days about the idea of the amount of time you may be dementia-free is reduced with smoking, hypertension, and diabetes. I don't even like the conversation. It makes it sound like dementia is inevitable, and if you smoke or have diabetes, that, that period of time is going to be shortened because it's ultimately going to happen. I think our goal should be to remain dementia-free for our entire lifetimes, and my point is that is an absolutely achievable goal. That's why I wrote Brain Defenders. And to be fair, it's why I've written the other 15 books over the past few decades, because it's all about the choices we make. We flip that coin at age 85 years right now to determine who gets dementia or not. The idea is, however, that we profoundly influence whether it's heads or tails by the choices we are making today.