The World Health Organization Catches Up

On May 14, the World Health Organization released their guidelines on risk reduction of cognitive decline and dementia.  Looks like they read Beating the Dementia Monster.

As a basis for the guidelines, the document acknowledged studies showing a relationship between the development of cognitive impairment and dementia with lifestyle-related risk factors.  It addressed physical inactivity, tobacco use, unhealthy diets and alcohol abuse.  It also addressed medical conditions associated with an increased risk of developing dementia, including hypertension, diabetes, high cholesterol, obesity, and depression.  Other potentially modifiable risk factors addressed included social isolation and cognitive inactivity.  They said that the existence of potentially modifiable risk factors means that prevention of dementia is possible through a public health approach, including the implementation of key interventions that delay or slow cognitive decline or dementia.

The guidelines document placed more emphasis on some areas than others.  It emphasized physical activity because the effect of physical activity on cognition is best supported by good research.  The guidelines support maintaining social connections, but the document says that the research in this area is of lower quality.  The document calls out social activity as an area of study that needs attention.  The role of diet is addressed, and the Mediterranean diet is promoted.  They don't mention the DASH diet or the MIND diet.

Supplements?  Don't waste your money.  The document says to take supplements only if your doctor directs you to.    

Cognitive training?  The quality of evidence supporting this as an intervention was said to be very low, and their recommendation was tepid at best.

One thing caught my attention.  This being the World Health Organization, they are interested in policies that will benefit countries around the world, including low and middle income countries.  However, they noted that most research on dementia is performed in upper income countries.  The obvious question is whether lifestyle differences between countries means that research conducted in upper income countries might not be valid elsewhere.  Then effective interventions would vary between countries.