This talk will provide a critical review progress in the field of dementia risk reduction and prevention, emphasizing a non-pharmacological perspective. I will explain concepts in population-level approaches to dementia prevention, which differ substantially from those in clinical trials. The findings from recent multi-domain trials will be critically reviewed, along with findings from some single domain trials and epidemiology. Issues to consider when evaluating the literature will be discussed. These include effect sizes of recent trials, cost and participant burden of multi-domain risk reduction approaches, duration of exposure to interventions and sample characteristics. Other factors which influence interpretation of the literature and that need to inform future research will be discussed such as times scales over the life-course, surrogate endpoints, person-centered outcomes, biomarkers of cognitive health, social determinants, and environmental risks.