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

Endorsing Organizations

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.