New WHO guidelines: up to 45% of dementia risk could be prevented or delayed

The World Health Organization (WHO) today released updated guidelines on reducing the risk of cognitive decline and dementia, providing countries with evidence-based recommendations to help prevent or delay the onset of dementia across the life course.

Dementia is a condition caused by brain diseases and affects memory, thinking and the ability to function. More than 57 million people live with dementia worldwide and nearly 10 million people get newly diagnosed every year. Alzheimer disease is the most common form of dementia and is estimated to account for 60–70% of cases.

While there is no cure for dementia, up to 45% of the risks can be attributed to modifiable risk factors such as tobacco, alcohol use, social isolation, physical inactivity, air pollution and noncommunicable diseases (NCDs), including high blood pressure and diabetes. Beyond health, dementia affects a person’s independence, dignity and safety.

"We know more today than ever before about what drives dementia risk, and these guidelines translate that knowledge into action," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. "Countries now have clear, evidence-based recommendations they can put into practice immediately to protect people's cognitive health."

WHO’s new guidelines reflect the latest evidence and innovations in dementia risk reduction providing proven interventions that can effectively lower dementia risk through early awareness and timely action. They represent an important opportunity to reduce the burden of dementia in the coming decades through stronger integration of services for noncommunicable diseases, mental health and brain health.

Reducing risk, preventing illness

The updated guidelines reflect significant growth in the evidence base since WHO first issued recommendations on dementia risk reduction in 2019. They provide consolidated recommendations on addressing unhealthy behaviours, managing medical conditions, and reducing exposure to environmental factors that may contribute to cognitive decline and dementia.

The guidelines recommend several healthy behaviours and lifestyle interventions to reduce dementia risk, including cognitive training and cognitive stimulation and engagement in social activities for adults who have normal cognition or are experiencing mild cognitive impairment.

The updated advice also includes interventions that reduce risk of NCDs, including increasing physical activity, stopping tobacco use, reducing alcohol consumption, adopting a healthy diet, and a new recommendation to reduce exposure to air pollution.

Management of cardiometabolic conditions such as hypertension, diabetes, and high cholesterol can also help reduce dementia risk. Further, hearing aids may be offered as part of risk-reduction strategies.

As an intervention to reduce the risk of cognitive decline and/or dementia, the guidelines do not recommend supplementation with vitamins B and E, omega-3 polyunsaturated fatty acids (PUFA) and multivitamins/minerals in the absence of a diagnosed deficiency, due to the lack of evidence of any potential benefits to outweigh unexpected harmful effects. 

Human and economic cost

Dementia affects an individual’s ability to live independently, work and function, while placing substantial burdens on families and carers. It carries a major economic loss, costing the global economy an estimated US$ 1.3 trillion annually. About half of this cost is driven by unpaid care provided by families and friends. Understanding risk factors and taking action to prevent dementia can improve health and quality of life, helping people live longer, healthier and more independent lives.