Risk Reduction of Cognitive Decline and Dementia
Publication Date: March 1, 2019
Last Updated: March 14, 2022
RECOMMENDATIONS
Physical activity interventions
Physical activity should be recommended to adults with normal cognition to reduce the risk of cognitive decline. (Moderate, Strong)
612
Physical activity may be recommended to adults with mild cognitive impairment to reduce the risk of cognitive decline. (Low, Conditional (weak))
612
Tobacco cessation interventions
Interventions for tobacco cessation should be offered to adults who use tobacco since they may reduce the risk of cognitive decline and dementia in addition to other health benefits. (Low, Strong)
612
Nutritional interventions
The Mediterranean-like diet may be recommended to adults with normal cognition and mild cognitive impairment to reduce the risk of cognitive decline and/or dementia. (Moderate, Conditional (weak))
612
A healthy, balanced diet should be recommended to all adults based on WHO recommendations on healthy diet.
(L-H for different dietary components)
612
Vitamins B and E, polyunsaturated fatty acids and multi-complex supplementation should not be recommended to reduce the risk of cognitive decline and/or dementia. (Moderate, Strong)
612
Interventions for alcohol use disorders
Interventions aimed at reducing or ceasing hazardous and harmful drinking should be offered to adults with normal cognition and mild cognitive impairment to reduce the risk of cognitive decline and/or dementia in addition to other health benefits. (Moderate, Conditional (weak))
(for observational evidence)
612
Cognitive interventions
Cognitive training may be offered to older adults with normal cognition and with mild cognitive impairment to reduce the risk of cognitive decline and/or dementia.
(Very Low-Low)
612
Social activity
There is insufficient evidence for social activity and reduction of risk of cognitive decline/dementia. (Evidence Gap, No recommendation)
612
Social participation and social support are strongly connected to good health and wellbeing throughout life and social inclusion should be supported over the life-course. (Evidence Gap, No recommendation)
612
Weight management
Interventions for mid-life overweight and/or obesity may be offered to reduce the risk of cognitive decline and/or dementia.
(low to moderate)
612
Management of hypertension
Management of hypertension should be offered to adults with hypertension according to existing WHO guidelines.
(Low-High for different interventions)
612
Management of hypertension may be offered to adults with hypertension to reduce the risk of cognitive decline and/or dementia.
(Very Low in relation to dementia outcomes)
612
Management of diabetes mellitus
The management of diabetes in the form of medications and/or lifestyle interventions should be offered to adults with diabetes according to existing WHO guidelines. (Low, Conditional (weak))
(Very Low to Moderate for different interventions)
612
The management of diabetes may be offered to adults with diabetes to reduce the risk of cognitive decline and/or dementia. (Very Low, Conditional (weak))
(very low)
612
Management of dyslipidaemia
Management of dyslipidaemia at mid-life may be offered to reduce the risk of cognitive decline and dementia. (W, L)
612
Management of depression
There is currently insufficient evidence to recommend the use of antidepressant medicines for reducing the risk of cognitive decline and/or dementia. (Evidence Gap, No recommendation)
612
The management of depression in the form of antidepressants and/or psychological interventions should be provided to adults with depression according to existing WHO mhGAP guidelines. (Evidence Gap, No recommendation)
612
Management of hearing loss
There is insufficient evidence to recommend use of hearing aids to reduce the risk of cognitive decline and/or dementia. (Evidence Gap, No recommendation)
612
Screening followed by provision of hearing aids should be offered to older people for timely identification and management of hearing loss as recommended in the WHO ICOPE guidelines.
612
Recommendation Grading
Overview
Title
Risk Reduction of Cognitive Decline and Dementia
Authoring Organization
World Health Organization
Endorsing Organizations
Centers for Disease Control and Prevention
National Institute for Health and Care Excellence
Publication Month/Year
March 1, 2019
Last Updated Month/Year
June 13, 2023
Supplemental Implementation Tools
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Older adult
Health Care Settings
Ambulatory, Home health, Long term care
Intended Users
Social worker, nurse, nurse practitioner, physician, physician assistant
Scope
Prevention, Management
Diseases/Conditions (MeSH)
D003704 - Dementia, D060825 - Cognitive Dysfunction
Keywords
dementia, cognitive decline
Source Citation
Risk reduction of cognitive decline and dementia: WHO guidelines. Geneva: World Health Organization; 2019. Licence: CC BY-NC-SA 3.0 IGO.