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By Daniella Gray
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The factors that raise the risk of Alzheimer's disease and other forms of dementia may not be the same across all populations—and for South Asian Americans, the picture could look particularly distinct, according to new research.
A review published in Alzheimer's & Dementia examined 25 years of studies on dementia prevalence and risk factors in India, finding growing evidence that South Asians may face a different mix of genetic, lifestyle and health-related risks than populations of predominantly European ancestry.
Researchers from Rutgers University's Krieger Klein Alzheimer's Research Center said South Asians remain underrepresented in Alzheimer's research, creating significant gaps in understanding how the disease develops within the community.
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"In the United States, there has never been a study specifically focused on brain health in aging South Asians," study leader Michal Schnaider Beeri told Newsweek.
"As a result, the evidence we have is limited, and can only be partially compared with studies from India and other South Asian countries, given the impact of immigration, acculturation, changes in diet, and the loneliness that often accompanies migration."
Despite those gaps, Beeri said South Asian Americans may achieve the greatest reduction in dementia risk by aggressively managing cardiometabolic health—particularly diabetes and hypertension—while also addressing vision and hearing loss, staying physically and mentally active and maintaining strong social connections.
The team reviewed research conducted in India between 2000 and 2025, comparing findings with 14 modifiable dementia risk factors identified by the 2024 Lancet Commission.
Those factors—including diabetes, hearing loss, vision impairment, physical inactivity and lower educational attainment—are thought to account for up to 45 percent of dementia cases worldwide if effectively addressed.
Diabetes and metabolic disorders appear especially important for South Asians. The researchers noted that South Asians often develop diabetes at younger ages and at lower body weights than other populations.
"Our review indicates that, in South Asian populations, the most important targets for dementia prevention are well-established vascular and metabolic risk factors," Beeri said. "These factors tend to emerge earlier in life and may have a greater impact on dementia risk than is typically appreciated."
Because diabetes is known to substantially increase dementia risk, this could have important implications for prevention efforts.
Beeri noted that diabetes may affect South Asians differently than other groups. Unlike populations where type 2 diabetes is often driven by insulin resistance linked to overweight and obesity, South Asians appear more likely to develop a form characterized by relative insulin deficiency, often at younger ages and lower body weights.
They also tend to progress more quickly from prediabetes to overt disease and may see less benefit from lifestyle interventions such as exercise, even when obesity is not present.
However, the implications of these differences for brain aging and dementia risk remain poorly understood, according to the researchers.
Education also appeared to play a larger role. Limited education was estimated to account for 22 percent of modifiable dementia risk in India, compared with 8 percent globally.
One study included in the review found dementia was more than three times as common among adults with no formal schooling than among those with a primary education.
The review also highlighted widespread vision and hearing impairment. Researchers reported that untreated vision loss may account for around 14 percent of dementia cases in India, while hearing loss was linked to a 59 percent higher dementia risk and approximately double the risk of Alzheimer's disease.
Another notable finding involved genetics. Variants known to increase dementia risk in people of European ancestry appeared to have a more limited impact among South Asians.
The findings have laid the groundwork for the South Asian Middle Age Risk Tracking for Brain Health (SAMARTH) study at Rutgers, which is following South Asian adults in the U.S. to identify risk and protective factors for Alzheimer's disease and related dementias.
"The SAMARTH study is designed to address these gaps by characterizing dementia risk and protective profiles specific to South Asian populations, with the goal of informing more precise and relevant prevention and treatment strategies," Beeri said.
Reference
Oberoi, A., Cai, K., West, R., Wadhawan, A., Willette, A., Simon, S.S., Tsao, J., Gu, Y., Fonseca, L.M., Patel, T. and Beeri, M.S. (2026). The landscape of dementia in India: Prevalence, risk factors, and opportunities ahead. Alzheimer’s & Dementia, 22(6). doi:10.1002/alz.71526.
Contact Newsweek editors on this story: Kara Dolman and Emma Lee-Sang
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