The World Health Organization has published the second edition of its guidelines on reducing the risk of cognitive decline and dementia, marking the first major update since 2019. The new guidance reflects substantial advances in the evidence base and provides countries with practical, evidence-based recommendations to help prevent or delay dementia across the life course.

Read: WHO Guidelines on Risk Reduction of Cognitive Decline and Dementia (Second Edition)

More than 57 million people worldwide are living with dementia, with almost 10 million new cases diagnosed each year. While there is currently no cure, WHO estimates that up to 45% of dementia cases may be linked to modifiable risk factors, including physical inactivity, smoking, alcohol use, social isolation, air pollution, hypertension, and diabetes.

The updated guidelines reinforce the importance of healthy lifestyles and effective management of long-term conditions. Recommendations include increasing physical activity, reducing tobacco and alcohol use, maintaining a healthy diet, managing cardiometabolic conditions, promoting social and cognitive engagement, and reducing exposure to air pollution. The guidance also notes that vitamin B and E supplements, omega-3 fatty acids, and multivitamins should not be used specifically for dementia prevention in the absence of a diagnosed deficiency.

Several members of the SPIN-D Network+ contributed to the development and review of the new WHO guidelines, including Georgina Charlesworth, Chris Fox, Huw Williams, and Aimee Spector.

Their contributions included reviewing evidence in areas where uncertainty remains. Key findings highlighted that:

• Menopause Hormone Therapy is not recommended specifically to reduce the risk of cognitive decline or dementia in postmenopausal women aged 65 and over. For women under 65, including those experiencing premature ovarian insufficiency, early menopause, or perimenopause, there is currently insufficient evidence to recommend for or against its use for dementia risk reduction.
• There is insufficient evidence to recommend one antiretroviral therapy (ART) combination over another for reducing the risk of cognitive decline or dementia. Treatment decisions should continue to prioritise disease control and patient preference.
• There is insufficient evidence to recommend specific interventions following traumatic brain injury solely for the purpose of reducing the risk of cognitive decline or dementia.

The publication of these updated guidelines represents an important milestone for global brain health. By translating emerging evidence into actionable recommendations, WHO aims to support governments, healthcare systems, and communities in reducing the future burden of dementia while enabling people to live longer, healthier, and more independent lives.