Hearing & Cognition-Risk reduction of cognition decline and dementia

Risk reduction of cognition decline and dementia - WHO guidelines, 2nd Ed

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The World Health Organization’s 2026 second edition guidelines provide evidence-based advice for reducing cognitive decline and dementia risk among adults without dementia, including those with mild cognitive impairment. They update the 2019 guidance and recognize that risk factors accumulate across life, with some having greater effects at particular stages. WHO estimates that up to 45% of dementia risk may be attributable to modifiable factors.<br /><br />The guidelines encourage physical activity, tobacco cessation, a healthy balanced diet, and reducing hazardous or harmful alcohol use. Cognitive training may be offered to older adults, while cognitive stimulation and social activity may be encouraged. A healthy diet is recommended, but vitamin B or E, omega-3, and multivitamin supplements are not advised for dementia prevention in people without deficiencies.<br /><br />For health conditions, WHO advises managing obesity, diabetes, hypertension and midlife dyslipidaemia according to existing guidance; hearing aids may be offered for hearing loss. Tailored programmes addressing multiple risk factors together may also be offered. Reducing exposure to ambient and household air pollution may lower risk. Menopausal hormone therapy should not be started to prevent dementia in women aged 65 and older; evidence is insufficient for younger women. Evidence is also insufficient to recommend dementia-specific interventions for depression, stroke, traumatic brain injury, vision impairment, sleep problems, or particular HIV treatment regimens.<br /><br />Most dementia-specific recommendations are conditional because evidence is often limited, observational, short-term, or focused on cognitive test scores rather than dementia incidence. WHO stresses that prevention requires more than individual behaviour change: equitable access to care, supportive environments, culturally appropriate programmes and cross-sector policies are essential. Further research—especially in low- and middle-income countries—is needed to clarify long-term effects, effective approaches and policy impacts.

Keywords

World Health Organization

dementia prevention

cognitive decline

modifiable risk factors

mild cognitive impairment

physical activity

healthy diet

tobacco cessation

hypertension management

air pollution exposure