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WHO releases new guidelines on preventing dementia
The guidelines evaluate 12 risk factors and are designed to help governments and healthcare providers tackle dementia prevention.
The new WHO guidelines advise that physical activity should be recommended to adults with normal cognition, and may be recommended to those with mild cognitive impairment.
According to the World Health Organization (WHO), there are nearly 10 million new cases of dementia worldwide every year, with the figure set to triple by 2050.
Meanwhile, Dementia Australia reports that there are currently an estimated 447,115 Australians living with dementia.
The WHO has now published a new set of guidelines, Risk reduction of cognitive decline and dementia.
‘We need to do everything we can to reduce our risk of dementia,’ WHO Director-General Dr Tedros Adhanom Ghebreyesus said of the new guidelines.
‘The scientific evidence gathered for these guidelines confirms what we have suspected for some time, that what is good for our heart is also good for our brain.’
While age is the strongest known risk factor for cognitive decline, the WHO notes that dementia is not a ‘natural’ nor ‘inevitable’ consequence of ageing. There are a number of other, non-modifiable risk factors for dementia, including gene polymorphisms, gender, race/ethnicity and family history.
The WHO evaluated 12 modifiable risk factors and offered advice on how to tackle them. It then provided evidence-based recommendations on lifestyle behaviours and interventions to delay or prevent cognitive decline and dementia.
The guidelines include recommendations on a number of areas.
Physical activity
The WHO advises that physical activity should be recommended to adults with normal cognition, and may be recommended to those with mild cognitive impairment (MCI), to reduce the risk of cognitive decline.
According to the guidelines, adults aged 65 and over should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week, or at least 75 minutes of vigorous-intensity aerobic physical activity, in bouts of at least 10 minutes.
Smoking
Interventions to help tobacco cessation should be offered for those who use tobacco, since they may reduce the risk of cognitive decline and dementia, along with other recognised health benefits.
Those interventions may include behavioural or psychological strategies, along with various pharmacological treatments.
Nutritional interventions
The WHO guidelines note:
- the Mediterranean-like diet may be recommended to adults with normal cognition to reduce the risk of cognitive decline and/or dementia
- a healthy, balanced diet should be recommended to all adults.
Supplementation with vitamins B and E, polyunsaturated fats and multi-complex supplements was not recommended.
Alcohol
Interventions aimed at reducing or ceasing hazardous and harmful drinking should be offered, based on ‘extensive evidence’ that alcohol is a risk factor for dementia and cognitive decline.
In terms of other risk factors, the guidelines note the following may be offered to help reduce cognitive decline and/or dementia:
- Cognitive training to older adults with normal cognition and MCI
- Weight management with interventions for overweight and/or obesity at mid-life
- Management of dyslipidaemia at mid-life
- Management of hypertension and diabetes for adults with these conditions
Not all risk factors evaluated led to recommendations.
Social participation
While the guidelines strongly connected social participation and support to good health and wellbeing, the WHO found insufficient evidence it could stave off cognitive decline and/or dementia.
The same conclusions were drawn for depression and hearing loss. The WHO advises treating both on their own merits, but found insufficient evidence to recommend treatment for cognitive risks alone.
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