Dementia: WHO guidelines on minimising risk

According to the World Health Organisation (WHO), there are nearly 10 million new cases of dementia worldwide every year, with the figure set to triple by 2050.

The WHO evaluated 12 modifiable risk factors and offered advice on how to tackle them. It provides evidence-based recommendations on lifestyle behaviours and interventions to delay or prevent cognitive decline and dementia.

 

What is dementia?

Dementia is not a single disease, but rather an umbrella term that describes a group disorders. It’s a term used to describe a progressive deterioration of intellect and social functioning as a consequence of brain disease. Dementia is usually progressive and eventually severe.

There are over 100 different types of dementia, and any progressive brain disease (including e.g. multiple sclerosis) can include dementia later.

Alzheimer’s accounts for 70% of all dementias, affecting 20% of individuals over 85.

In practice, the term dementia is usually used for patients presenting with symptoms such as problems with memory, speech and understanding, where a general medical cause such as infection or a metabolic disturbance can’t be identified.

 

Who’s at risk?

Dementia can develop at any age from adolescence onwards, but is strongly age related, rare under the age of 60, and very rare under the age of 45.

The incidence increases from 6.7 per 1,000 persons, years 65–69, to 68.5 per 1,000 persons at age 85 years and above. About 5% of the population over 65 has dementia at any one time, and around 163,000 new cases of dementia occur in England and Wales each year.

Thus, as people get older and live longer, it is increasingly common and not unusual for patients to know others who have suffered, or have a family history of the condition. Although there are some genetic types of dementia, these usually present at a younger age.

 

Reducing risk

The WHO has launched its first ever guidelines on how people can reduce their risk of getting dementia.

The main takeaways in the guidelines are to exercise more and maintain a healthy diet, with an emphasis on the benefits of the Mediterranean diet – simple plant-based cooking, little or no meat and a healthy dose of olive oil.

Interestingly, supplementation with vitamins B and E, polyunsaturated fats and multi-complex supplements did not make a difference.

People should be looking for these nutrients through food; not through supplements.

 

Other notable factors

There is now ‘extensive evidence’ that smoking and alcohol are risk factors for dementia and cognitive decline.

In terms of other risk factors, the guidelines note the following may be offered to help reduce cognitive decline or dementia:

  • Cognitive training to older adults with normal cognition and mild cognitive impairment.
  • Weight management with interventions for overweight and/or obesity at mid-life
  • Management of dyslipidaemia at mid-life
  • Management of hypertension and diabetes for adults with these conditions

The WHO did not endorse games and other activities aimed at boosting thinking skills. These can be considered for people with normal capacities or mild impairment, but there’s little evidence of benefit.

 

Conclusion

While there is no cure for dementia, there is hope that having better overall health could help prevent it.

In summary, the WHO recommends staying away from tobacco, limiting your alcohol consumption, and maintaining a healthy blood pressure through a good diet and exercise.

It seems that what’s good for your heart is probably good for your brain too.

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