World Health Organization: Let’s Prevent Dementia

Worldwide, 57 million people worldwide have dementia, and the cases are rising.

Dementia causes a tremendous financial burden on families, communities, and societies.

The individual with dementia loses memory, independence, physical functions, mobility, and dignity. These problems only get worse as the brain deteriorates. Nearly all will experience depression, agitation, aggression, and psychosis as they become unable to take in and makes sense of what is going on around them.

The loved ones and caretakers of a person with dementia face physical and emotional exhaustion. Dementia costs an estimated $1.3 trillion around the world annually. In the US, a bed in a memory care facility can cost $10,000 per month. 

Yet, dementia is not an inevitable part of growing older. Up to 45% of dementia risk is thought to be preventable according to the World Health Organization (WHO), an international association dedicated to global health goals. The WHO just released its 168 page report Risk reduction of cognitive decline and dementia: WHO guidelines, second edition, its first update since 2019.

Preventing Dementia

Dementia, a term that reforms to a number of disease of cognitive decline such as Alzheimer’s and others, is caused by many factors that are just beginning to be understood. 

Brain health is the result of many influences accumulating over decades. Some risks may be especially impactful when addressed in those 40 and over, long before memory problems appear. 

So long as there is no cure for dementia, prevention is of utmost importance.

Indeed, the risk factors for dementia are the same as those for many chronic , eventually disabling conditions that are caused by lifestyle, genetics, and the environment: cardiovascular disease, cancer, chronic respiratory disease, and diabetes. 

"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."

The broad advice sounds simple, but it is consequential: exercise, avoid tobacco, reduce harmful drinking, eat a balanced diet, and manage conditions that damage the heart and blood vessels. 

Exercise

Regular activity should include aerobic movement, muscle strengthening, and less time sitting. Introducing exercise may even help those who already have mild cognitive impairment. 

Heart Health Equals Brain Health

Managing heart disease, hypertension (high blood pressure), diabetes, obesity, and high cholesterol are crucial for reducing dementia risk. These conditions damage blood vessels and raise the likelihood of stroke, major threats to cognitive health.

A healthy lifestyle may help prevent these in some, but once they occur, managing them requires access to medical care. Treatment, especially in midlife, can be very effective in reducing dementia risk.

Keep the Brain Active and Social  

Cognitive training that targets memory and attention through repetition stimulates the brain and keeps it working and communicating within itself.

Reading, storytelling, and playing games can benefit everyone, even older adults with some cognitive impairment. Such activities encourage integrating with others and foster social connections. A sense of connection with others is necessary for brain health.

Hearing

Untreated hearing loss is a strong risk factor for dementia. Missing sounds means the brain misses out on unending stimulation from the environment. People who don’t hear well may socially isolate from the difficulty of communication and frustration, which also increases dementia risk.

Hearing aids are an essential part of dementia prevention. Eliminating hearing loss at the population level could theoretically prevent about 7% of dementia cases, a very large number worldwide.

Supplements

The WHO advises against taking supplements without having a diagnosed nutrient deficiency. Supplements cannot replace exercise, cardiovascular care, social connection and a healthy diet. Eating a healthy diet is a better approach than taking isolated nutrients like Vitamins B or E, omega-3 fatty acids, or multivitamin and minerals. 

Alcohol

WHO’s message about alcohol is blunt. It is not healthy in any amounts. Cutting down on heavy or hazardous drinking, treating alcohol dependence, lowering or stopping alcohol use may lower the risk of cognitive decline or dementia.

Air Pollution

Brain health depends partly on where people live, specifically the air they breathe. The WHO now recommends reducing exposure to outdoor air pollution, particularly fine particulate matter known as PM2.5, and household air pollution. Communities and governments should work to improve air quality.

Health Issues Not Connected to Dementia

Treating depression, sleep problems, or vision impairment remains important for health and quality of life, but evidence is not yet sufficient to recommend those treatments specifically for dementia prevention.

Make Several Changes (Not Just One)

The WHO recommends addressing at least three risk factors at once. Depending on the person, that might combine any needed, whether that is exercise, dietary changes, cognitive training, social activity, smoking cessation and medical treatment of vascular risks. Implementing several changes is much more effective than working on only one risk. 

Universal Healthcare

Dévora Kestel of the WHO argues that medical coverage for everyone is key to dementia prevention. After all, many of these risk factors cannot be managed without medical testing, medical advice, and consistent access to affordable medications and follow-up care.

“Universal health coverage provides the foundation for delivering this agenda. It ensures that people can access the services they need without financial hardship. Through strong, people-centred health systems, countries can better prevent, detect, and manage dementia and its risk factors over time, while responding to people’s evolving needs as they age,” Kestel writes in the report.