Save You have reached your maximum number of saved items. Remove items from your saved list to add more. TOTOTO Avoiding air pollution from smokestacks and vehicle emissions is among a set of new dementia prevention recommendations from the World Health Organization (WHO), which has not endorsed supplements or menopausal hormone therapy to reduce the
Avoiding air pollution from smokestacks and vehicle emissions is among a set of new dementia prevention recommendations from the World Health Organization (WHO), which has not endorsed supplements or menopausal hormone therapy to reduce the risk of cognitive decline.
Up to 45 percent of the risk of dementia could be prevented or delayed by eliminating modifiable risk factors such as tobacco, alcohol, lack of exercise, diabetes and high blood pressure, according to the first update of WHO’s dementia prevention guidelines in seven years.
But the WHO dementia expert panel, drawing on the latest evidence on dementia risk and effective treatments, emphasized that individuals alone will not make a dent in dementia prevalence without government action.
“Today we know more than ever about the factors that drive dementia risk, and these guidelines translate that knowledge into action,” said WHO Director-General Dr. Tedros Adhanom Ghebreyesus.
“Countries now have clear, evidence-based recommendations that they can put into practice immediately to protect people’s cognitive health.”
A healthy diet rich in leafy green vegetables, berries, nuts and olive oil, and low in processed and ultra-processed foods, along with daily physical activity and cognitive stimulation, are among the most important dementia prevention strategies.
The latter could be taking a course, learning a language, attending public lectures, reading and playing games – “things that really challenge your brain. It’s not just doing the same crossword puzzle every day,” said Scientia Professor Kaarin Anstey, director of UNSW’s Aging Futures Institute and the only Australian on the WHO dementia panel.
Anstey also emphasized that reducing exposure to ambient and household air pollution, such as PM2.5 particles from vehicle emissions, was important and justified new conditional recommendations.
“What many people don’t realize is that the risk is not just for those who live next to a polluting factory. Many of us are exposed to air pollution by living in cities,” he said. “The smoke produced by lighting a fire in the fireplace can have negative health effects.”
In contrast, the guidelines strongly advise against vitamin and mineral supplements to reduce the risk of cognitive decline and dementia, specifically vitamins B and E, omega-3 polyunsaturated fatty acids, and multivitamins and minerals.
One potentially controversial update to the guidelines, Anstey said, was a conditional recommendation against menopausal hormone therapy (MHT) specifically to reduce the risk of cognitive decline or dementia in postmenopausal women aged 65 and older.
There was also insufficient evidence for or against MHT for women experiencing premature ovarian failure, early menopause, or perimenopause for the specific purpose of reducing cognitive decline or the risk of dementia.
The International Menopause Society does not recommend the initiation of MHT for the primary prevention of [Alzheimer’s Dementia] in naturally menopausal women, but observed that estrogen therapy was associated with a reduced risk of Alzheimer’s disease in women with premature ovarian failure.
“The evidence base for this is very confusing,” Anstey said. “We are basing these guidelines on evidence through a very rigorous process. We look at all the literature, their methodologies, and synthesize it all.”
The new guidelines also found insufficient evidence to recommend interventions for depression, sleep, stroke, traumatic brain injury, visual impairment and HIV with the specific purpose of reducing the risk of dementia.
Other key updates supported interventions to combat obesity and overweight in midlife, hearing aids for people with hearing loss, and social participation interventions to protect against loneliness and isolation.
More than 57 million people live with dementia worldwide and almost 10 million people receive a new diagnosis each year. Alzheimer’s disease is the most common form of dementia and is estimated to account for 60 to 70 percent of cases.
Dementia, including Alzheimer’s disease, is the leading cause of death in Australia, surpassing cardiovascular disease. An estimated 446,500 Australians will have dementia by 2026, according to the Australian Institute of Health and Welfare.
“To achieve the reduction [of 45 per cent] We would have to eliminate the risk factors. [obesity, insufficient activity]which is not going to happen,” Anstey said.
“I think we can achieve significant mitigation, but there needs to be population-wide interventions to really reduce it,” he said. “It has to be a whole-of-government response.”
“We have to look for solutions at a societal level. Not all of this depends on the individual because there are social and commercial determinants of health, such as access and affordability of healthy foods and exercise.”
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