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Dementia Guidelines 2019: WHO Releases Recommendation For Reduced Risk

The World Health Organization (WHO) on Tuesday issued a very informative 78-page report spelling out activities that will and won’t help reduce the risk of dementia, a condition mostly affecting the elderly and for which there is no effective treatment.

These guidelines cover both the physical and mental aspects of mitigating dementia, but especially focuses on the physical side of the equation because “what is good for our heart, is also good for our brain.” Surprisingly, the recommendation also debunks several beliefs that have come to be regarded as conventional wisdom.

Among these, the evidence linking cognitive training (which is quite popular today) to a lower risk of dementia is "very low to low."

WHO described dementia as the biggest health challenge of this generation.

The organization explained that dementia is an illness marked by a deterioration in cognitive function beyond what might be expected from normal aging. Dementia affects memory, thinking, orientation, comprehension, calculation, learning capacity, language and judgment. It results from a variety of diseases and injuries that affect the brain, such as Alzheimer’s disease or stroke.

“In the next 30 years, the number of people with dementia is expected to triple,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “We need to do everything we can to reduce our risk of dementia. The scientific evidence gathered for these Guidelines confirm what we have suspected for some time; that what is good for our heart, is also good for our brain.”

WHO said there are 10 million new cases of dementia every year, and this figure will likely triple by 2050. The disease is a major cause of disability and dependency among older people. "[Dementia] can devastate the lives of affected individuals, their careers and families," according to WHO.

Dementia affects more than 50 million people globally. The disease inflicts a heavy economic burden on societies, with the costs of caring for people with dementia estimated to increase to $2 trillion annually by 2030.

To counteract dementia, WHO recommended physical activity, stopping smoking, drinking less alcohol and eating a healthy, balanced diet. The organization said committing to a Mediterranean diet (simple plant-based cooking, little meat and a heavy emphasis on olive oil) might help.

"The Mediterranean diet is the most extensively studied dietary approach, in general as well as in relation to cognitive function," said the report. "Several systematic reviews of observational studies have concluded that high adherence to the Mediterranean diet is associated with decreased risk of mild cognitive impairment and Alzheimer's disease, but modest adherence is not."

The report also recommended proper management of weight, hypertension, diabetes and dyslipidemia (unhealthy or unbalanced cholesterol levels) as measures that might reduce the risk of dementia and cognitive decline.

"While some people are unlucky and inherit a combination of genes that makes it highly likely they will develop dementia, many people have the opportunity to substantially reduce their risk by living a healthy lifestyle," said Prof. Tara Spires-Jones, UK Dementia Research Institute program lead and deputy director of the Centre for Discovery Brain Sciences at the University of Edinburgh.

Below are the more surprising factoids highlighted in the report:

  • WHO warns against taking dietary supplements such as vitamins B and E, antioxidants, omega-3 and ginkgo to combat cognitive decline and dementia. "The negative recommendation, advocating that people do not use vitamin or dietary supplements (unless they are needed for a clinical problem) is welcome, and it is to be hoped that it saves lots of people from wasting their money," said Prof. Tom Dening, director of the Center for Old Age and Dementia, Institute of Mental Health at the University of Nottingham.
  • There is insufficient evidence linking social activity with a reduced of risk of dementia. The report did emphasize that social participation and social support are strongly connected to good health and individual well-being, however.
  • Cognitive training can be offered to older adults but evidence linking it to a lower risk of dementia is "very low to low."

dementia Dementia affects around 47 million people worldwide, according to the World Health Organization. Photo courtesy of Pixabay

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