New global guidance released by the World Health Organization (WHO) identifies that up to 45% of the risks can be attributed to modifiable risk factors. This strategic update, which builds upon the organization’s initial 2019 recommendations, provides evidence-based interventions for governments and health systems to manage cognitive health across the life course. With over 57 million people currently living with dementia worldwide—a figure that grows by nearly 10 million new diagnoses annually—the initiative emphasizes that early awareness and timely action are essential to reducing the long-term societal and economic burden of the condition, which costs the global economy an estimated US$ 1.3 trillion every year.
Alzheimer’s disease remains the most common form, accounting for an estimated 60–70% of cases. While there is no cure for these conditions, the WHO’s latest findings indicate that a significant portion of risk is tied to factors that can be influenced through public health policy and individual lifestyle choices. The guidance serves as a roadmap for integrating brain health into existing services for noncommunicable diseases (NCDs) and mental health care.
Addressing Modifiable Risk Factors for Cognitive Health
The WHO identifies a range of lifestyle and environmental factors that contribute to cognitive decline. Central to these recommendations is the management of cardiometabolic conditions, specifically hypertension, diabetes, and high cholesterol, all of which can help reduce dementia risk. The updated advice also highlights the importance of social engagement, noting that social activities and cognitive stimulation can support brain health in adults who have normal cognition or are experiencing mild cognitive impairment.
Beyond clinical management, the guidelines advocate for several behavioral changes:
- Physical Activity: Increasing physical activity is recommended to reduce the risk of NCDs and cognitive decline.
- Substance Use: The guidance calls for the cessation of tobacco use and the reduction of alcohol consumption.
- Dietary Choices: Adopting a healthy diet is underscored as a protective measure.
- Environmental Health: The guidance includes a recommendation to reduce exposure to air pollution, which is recognized as a factor in brain health.
- Hearing Health: The use of hearing aids is now suggested as part of risk-reduction strategies.
Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, stated, “We know more today than ever before about what drives dementia risk, and these guidelines translate that knowledge into action. Countries now have clear, evidence-based recommendations they can put into practice immediately to protect people’s cognitive health.”
Evidence-Based Interventions and Supplementation
A critical component of the new WHO report is the clarification regarding nutritional supplements. In the absence of a diagnosed deficiency, the guidelines explicitly do not recommend the use of vitamin B, vitamin E, omega-3 polyunsaturated fatty acids (PUFA), or multivitamin/mineral supplements for the specific purpose of reducing the risk of cognitive decline or dementia. The organization cites a lack of evidence of any potential benefits to outweigh unexpected harmful effects.
The Global Economic and Social Impact
The human cost of dementia extends far beyond the individual patient. With an annual economic impact estimated at US$ 1.3 trillion, the condition places a significant strain on global healthcare systems. A substantial portion of this cost—about half—is attributed to the unpaid care provided by family members and friends, which often impacts the caregivers’ own health, employment, and financial stability.
By addressing the modifiable risk factors identified in these guidelines, nations have an opportunity to improve the quality of life for millions, helping individuals remain independent and active for longer periods.
We invite readers to share their perspectives on how these public health guidelines might be implemented in their local communities in the comments section below.
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