WHO updates dementia prevention guidelines, adding air pollution and hearing aids

The World Health Organization (WHO) has issued new guidelines for dementia prevention, expanding beyond lifestyle management to include environmental factors. The updated recommendations, released seven years after the initial guidelines in 2019, incorporate recent research findings and present a total of 19 suggestions.

A significant addition to the guidelines is the emphasis on the link between dementia and environmental factors. The WHO now advises reducing exposure to fine particulate matter (PM2.5) and household air pollution, stating that this can lower the risk or incidence of cognitive decline and dementia. Fine particulate matter can penetrate the blood-brain barrier, potentially causing neuroinflammation and oxidative stress, which studies suggest may increase dementia risk by approximately 1.4 times. Household air pollution refers to harmful substances released from solid fuels used in cooking.

The guidelines also highlight the importance of cognitive stimulation through engaging in new and challenging activities such as reading, games, puzzles, and playing musical instruments. This is presented as an enhancement to existing recommendations for cognitive training. For overweight or obese adults, the guidelines suggest dietary interventions like calorie restriction or intermittent fasting. However, hormone therapy is not recommended for postmenopausal women aged 65 and older for dementia prevention.

Furthermore, the WHO recommends a multi-domain approach, advocating for individuals to manage at least three risk factors concurrently, tailored to their specific circumstances. This includes physical activity, cognitive training, and a healthy diet. The guidelines also refine previous recommendations, such as specifying the use of hearing aids to manage age-related hearing loss, which can contribute to social isolation and reduced brain stimulation, both factors linked to increased dementia risk. The definition of a healthy diet has also broadened beyond the Mediterranean diet to include the DASH and MIND diets.

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We know more about the factors that increase the risk of dementia than ever before. These guidelines provide clear evidence for governments and individuals to act immediately.