• By Ian Roth

WHO releases guidelines for risk reduction of cognitive decline and dementia

May 14, 2019
a black and white photo of family members gathered around an elderly woman who is highlighted in the picture, looking a little bit sad and weak, perhaps sick and maybe having dementia or Alzheimer's

The World Health Organization (WHO) has released a comprehensive guideline for reducing the risk of cognitive decline and dementia. The guidelines are a culmination of more than two years worth of data evaluation by a panel of experts from across the globe, including Ronald Petersen, M.D., Ph.D., director of the Mayo Clinic Alzheimer's Disease Research Center.

"They looked over the literature to examine what they could say somewhat confidently to people with regard to lifestyle modifications that may impact their subsequent development of cognitive impairment, mild cognitive impairment and dementia," Dr. Petersen says.

He says the WHO will send these recommendations to all of the member countries. The guidelines are intended to help instruct health care professionals and the general population on things they can do to reduce the likelihood of developing cognitive impairment.

"In particular, the WHO is impactful with low- and middle-income countries," Dr. Petersen says. "So this, perhaps, is the first time that these countries have received this information."

Watch: Dr. Petersen discuss WHO guidelines.

Journalists: Broadcast-quality sound bites with Dr. Petersen are in the downloads at the end of the post. Please "Courtesy: Mayo Clinic News Network." 

The guidelines are extensive, providing dozens of recommendations to improve health based on available data.

"There are a few things that we can do that maybe will not, say, prevent Alzheimer's disease definitively, but may delay its onset, slow its progression if it develops," Dr. Petersen says. "And usually one of the most impactful recommendations regards physical exercise. So there is a good deal of literature out there in the world indicating that if you exercise moderately — aerobic exercise — and by that we mean maybe 150 minutes a week, so 50 minutes three times, 30 minutes five times; vigorous walking, swimming, jogging if you're up to it — that can have an effect at, again, delaying onset and slowing progression."

He says the physical activity recommendations are increasingly important as obesity continues to be a growing problem worldwide. Another WHO recommendation also addresses obesity and associated complications: diet.

"Is there a diet out there that we can engage in that will reduce our likelihood of developing cognitive impairment?" Dr. Petersen asks. "Most people now recommend the Mediterranean diet. So a diet that's generally heart healthy is probably a good idea for your overall nutrition as well as for the brain."

The WHO guidelines also address the importance of keeping the brain active to protect it from cognitive decline.

"We think from observational studies that people who stay more intellectually active may have a lower risk of developing cognitive impairment," Dr. Petersen says. "But when you get down to actual exercise, training exercises, brain games and the like, there the data are a bit weaker and we can't say that if you do this particular exercise with your mind you will not develop cognitive impairment and the like. On the other hand, we certainly do recommend that people remain intellectually active."

The WHO guidelines also strongly discourage smoking and other tobacco use to reduce the risk of cognitive decline and dementia.

Another highlight of the guidelines is the WHO's recommendations regarding alcohol use.

"The WHO committee looked at individual factors and alcohol was one of them," Dr. Petersen says. "And the recommendation came out, of course, that people should avoid hazardous use, excessive alcohol use. But as for any drinking versus no drinking, I think the data are much more equivocal there. So, in general, we don't recommend that people start drinking if they don't drink. But on the other hand, if they do drink, just be modest about it. Be mindful of the fact that a little bit of alcohol is probably OK, but don't get carried away.

Read the rest of the WHO guidelines and recommendations here.

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