WHO publishes dementia risk reduction guidelines

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By Alex Smith | Tuesday 14 May 2019

The World Health Organisation (WHO) has today (Tuesday 14 May) published a report containing updated guidance on the latest evidence around dementia risk reduction. While the report highlights several risk factors that require further research to strengthen the evidence base, it strongly recommends not smoking, physical exercise, controlling blood pressure and managing diabetes as ways to maintain brain health into later in life.

To develop the guidelines, the WHO formed an international group of experts, who met in July 2018 to discuss and review the latest evidence into dementia risk.

The panel gave a ‘strong recommendation’ for those risk factors where they believed that positive benefits of an intervention outweighed any negatives, and a ‘conditional recommendation’ where the balance was less clear cut. They also rated the quality of evidence behind each recommendation, identifying risk factors where the evidence base should be strengthened.

Strongly recommended interventions included those that help people stop smoking, increase physical activity, treat high blood pressure and manage diabetes. The panel also concluded that vitamins B and E, fatty acids (including fish oils) and complex dietary supplements should not be recommended to reduce the risk of dementia.

Conditionally recommended interventions included management of cholesterol, hearing loss, depression, weight and diet, as well as interventions that reduce harmful drinking, enable social activity and provide cognitive training.

The evidence for these interventions varied in quality, suggesting that the value of such approaches should be assessed on an individual basis with support from a health professional. While many of these risk factors for dementia have been highlighted in previous studies, the panel felt there was currently not enough high-quality evidence to suggest that an intervention to address them could have a direct impact on the number of people developing dementia.

The guidelines will now be translated into different WHO official languages and shared with government health ministries across the world, who will be supported in sharing them with the communities they serve.

Dr Carol Routledge, Director of Research at Alzheimer’s Research UK, said:

“With a rapidly ageing population in the UK and across the world, many people are keen to know the steps they can take to enjoy their later years in good health. Dementia is now the UK’s leading cause of death, yet only 34% of adults recognise there is anything they can do to reduce their risk of the condition.

“The findings clarify what we already know about dementia risk, including the value of physical activity and not smoking. While observational studies have identified a link between dementia risk and factors like depression and hearing loss, the report highlights a lack of sufficient evidence that treating these conditions effectively reduces the risk of cognitive decline.

“Sadly, there will always be individuals who address many or all of these risk factors and still develop dementia. Genetic predisposition plays an important role in many people’s risk of diseases like Alzheimer’s, and while we cannot change the genes we inherit, taking the steps outlined in this report can still help to stack the odds in our favour.

“This valuable resource, which has been reviewed and developed by leading experts based on high-quality evidence, represents the best possible source of information. We now need to see these recommendations shared through NHS Health Checks in midlife, as well as through government-led risk reduction campaigns to reach as many people as possible.”

Andy Morris, 56, who lost his mother to vascular dementia in 2017, takes part in regular physical activity through his local parkrun.

He said:

“Dementia is a terrible condition where you slowly witness a loss in a loved one’s memories and personality – it’s like they drift away from you and become harder and harder to recognise. Having witnessed the effects of dementia on my mum, I know how important it is to spread the message that there are things people can do to reduce their risk of dementia. Running helped me cope with the stress and heartbreak of losing my mum to dementia and keeping my brain healthy through exercise and diet is definitely something that motivates me now.

“Alzheimer’s Research UK’s partnership with parkrun is great for spreading this message and I’m proud as a parkrun event director to be doing my bit to help people become more physically active. parkrun is a fantastic example of how people of any age and ability can enjoy regular exercise, while getting the chance to socialise in a safe and very friendly environment.”


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Alex Smith