By Tom Miles
GENEVA, May 14 (Reuters) – The World Health Organization published its first guidelines on the prevention and management of dementia on Tuesday, putting physical activity at the top of its list of recommendations for preventing cognitive decline.
Stopping smoking, a healthy diet and avoiding harmful use of alcohol were also among the recommendations of the WHO’s report, entitled “Risk reduction of cognitive decline and dementia.”
The report recommends:
- Regular physical exercise.
- Eating a healthy diet, particularly “high adherence” to a Mediterranean-style one, with simple plant-based meals, little meat and olive oil rather than animal fats.
- Eliminating use of tobacco.
- Reducing alcohol consumption.
- Treating hypertension, high cholesterol and diabetes.
It warns against:
- Use of vitamins and other dietary supplements — particularly B vitamins, antioxidants, omega-3 and ginkgo — unless prescribed for a clinical problem. They are not helpful and can be harmful in high doses, said WHO expert Neerja Chowdhary.
It said there is not enough evidence to consider these to be preventative factors:
- Adequate sleep.
- Cognitive training.
- Social activity.
- Antidepressant medicines.
- Hearing aids.
Chowdhary said that the study had not looked at smoking marijuana or environmental factors, although there was some evidence of a link with pollution.
Dementia affects around 50 million people globally, with nearly 10 million new cases annually – a figure that is set to triple by 2050, while the cost of caring for dementia patients is expected to hit $2 trillion by 2030, WHO Assistant Director General Ren Minghui wrote in the report.
“While there is no curative treatment for dementia, the proactive management of modifiable risk factors can delay or slow onset or progression of the disease,” Ren wrote.
“As many of the risk factors for dementia are shared with those of non-communicable diseases, the key recommendations can be effectively integrated into programs for tobacco cessation, cardiovascular disease risk reduction and nutrition.”
The report said that although age is the strongest known risk factor for cognitive decline, dementia is not a natural or inevitable consequence of aging.
“During the last two decades, several studies have shown a relationship between the development of cognitive impairment and dementia with educational attainment, and lifestyle-related risk factors, such as physical inactivity, tobacco use, unhealthy diets and harmful use of alcohol,” it said.
Maria C. Carrillo, chief science officer of the Alzheimer’s Association in the United States, said there was substantial evidence that there were things people could do to reduce the risks.
“Start now. It’s never too late or too early to incorporate healthy habits,” she said.
Carol Routledge, director of Research at Alzheimer’s Research UK, said dementia was the leading cause of death in Britain, but only 34 percent of adults realized they could reduce the risk, and the WHO report helped to clarify what was known and where evidence was lacking.
(Reporting by Tom Miles; Additional reporting by Kate Kelland)
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