Defining healthy longevity and dementia prevention campaigns have been tied to the ability to work.

Contemporary dementia-prevention campaigns inherit a century-old coupling of health with economic productivity. By framing "healthy longevity" as the capacity to sustain waged labor, they cast risk reduction as a personal duty to insure future workforce participation and overlook the structural inequities-precarious work, environmental hazards, racialized stressors-that shape brain health. We trace this genealogy, critique the individualized cognitive-reserve paradigm, and argue for prevention strategies co-created with cultural interlocutors and paired with material reforms such as fair wages, housing, and caregiver support. Decoupling health from productivity is essential for an ethically coherent dementia-prevention agenda.