WHO DEMENTIA guidelines have been updated to provide recommendations of varying strength aimed at reducing the risk of cognitive decline and dementia throughout life, with a stronger emphasis on modifiable risk factors and early preventive action.1,2
Dementia is a group of conditions caused by diseases affecting the brain, leading to problems with memory, thinking and daily functioning.
More than 57 million people were living with dementia worldwide, with nearly 10 million new diagnoses each year.1,2 Alzheimer disease remained the most common form, accounting for an estimated 60-70% of cases. Although no cure exists, WHO said up to 45% of dementia risk could be attributed to modifiable factors.1,2
The WHO dementia guidelines consolidated recommendations on tackling unhealthy behaviours such as smoking, managing medical conditions such as hypertension, diabetes and dyslipidaemia, and reducing environmental exposures that may contribute to cognitive decline.2
Recommended interventions included cognitive training, cognitive stimulation and social engagement for adults with normal cognition or mild cognitive impairment.1,2 The guidance also reinforced established interventions that reduce the risk of noncommunicable diseases, including increasing physical activity, stopping tobacco use, reducing alcohol consumption and following a healthy diet.1,2 WHO also recommended maintaining a healthy weight in line with existing obesity guidance, while noting that the evidence linking weight management directly with dementia risk remained limited.2
A new recommendation encouraged reducing exposure to air pollution as part of dementia risk reduction. WHO also highlighted the importance of managing cardiometabolic risk factors, including hypertension, diabetes and high cholesterol, while hearing aids could be offered as part of broader prevention strategies, although the certainty of evidence for the latter is low.2
The guideline also stated that psychosocial interventions for depression and anxiety may be considered in people with these conditions, although evidence for reducing dementia risk was limited.2
WHO said the second edition reflected substantial growth in the evidence base since the first dementia risk reduction guideline was published in 2019.1 It also adopted the GRADE approach to assess the certainty of evidence and strength of recommendations across interventions.2
WHO advised against routine supplementation with vitamins B and E, omega-3 polyunsaturated fatty acids or multivitamins and minerals in people without a diagnosed deficiency, citing insufficient evidence of benefit and the potential for harmful effects.1,2 It also advised against using hormone replacement therapy, acetylcholinesterase inhibitors, metformin and aspirin for dementia risk reduction solely for dementia risk reduction .2
Beyond its impact on cognition, dementia can reduce independence, dignity and safety while creating substantial demands on families and carers. WHO estimated the condition cost the global economy around US$1.3 trillion each year, with about half of that burden resulting from unpaid care provided by relatives and friends.1
The organisation said improving awareness of dementia risk factors and supporting evidence-based prevention strategies could help people maintain health, quality of life and independence for longer.1
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