Dementia risks: Mediterranean diet and exercise can help stave off condition, WHO says

A World Health Organisation report sets out 12 areas where evidence is strongest for cutting dementia risk – and warns that using supplements meant to mimic a healthy diet are a waste of money

Moving more, eating better but binning cigarettes and health supplements are some of the best ways to lower your odds of dementia, according to the first global guidelines on preventing the condition.

After a major review of current evidence on the impact of lifestyle on dementia, the World Health Organisation (WHO) has concluded that the condition is “not a natural or inevitable consequence of ageing”.

Dementia affects 50 million people worldwide, costs $818bn (£633 billion) annually to treat and diagnoses are likely to triple by 2050, the review said.

While the WHO has issued guidelines on dementia before, this is the first time it has produced a report on what can be done to reduce the risk.

It sets out 12 areas where action can make the biggest difference and shows that, while advanced age is the biggest risk factors for the decline in thinking and memory, improving overall health is key.

“The vision of the action plan is a world in which dementia is prevented and people with dementia and their carers live well and receive the care and support they need to fulfil their potential with dignity, respect, autonomy and equality,” the WHO authors said.

The review found the best evidence to date is for a balanced diet and exercise in healthy adults, and those with some cognitive decline.

In particular, maintaining a “Mediterranean-like” diet – with high levels of fish, fruit and vegetables, nuts and olive oils, all of which have been associated with dementia protection – has been linked to better cognitive health.

But multivitamins, omega-3 and other supplements aimed at replicating this diet were explicitly recommended against – something that was welcomed by experts.

Other key recommendations were that support to reduce high blood pressure, quit smoking and cut out “hazardous or harmful” drinking could help healthy adults and those with mild impairment avoid dementia.

It also suggests interventions to help people lose weight, and to ensure diabetes is kept under control will help.

Strength of the evidence was more limited in many other areas, with popular initiatives like “brain training” having little good evidence to back them up.

Social isolation, hearing loss and depression are other areas where support might be helpful but where the evidence base is currently too limited to make recommendations.

In these cases, the authors recommended treatment based on existing WHO guidelines to improve the quality of life of the individual.

Robert Howard, professor of old age psychiatry at University College London, said the findings were “sensible but unsurprising”.

“Like many colleagues, I already tell my patients that what is good for their hearts is probably good for their brains,” he added.

But Professor Howard and others said there was much more needed to be done to understand the risks of dementia if we are to cope with a growing health crisis.

Professor Tom Dening from the University of Nottingham said that the recommendation to avoid dietary supplements was “welcome” and could save “a lot of people from wasting their money”.

However he warned many of the steps to reducing dementia risk were easier to achieve if you’re financially well-off.

“Like most of the research on dementia risk factors, it is difficult to see clearly the effects of social inequality, but nearly everything that is modifiable tends to favour people in better socio-economic circumstances – diet, access to facilities for physical activity, social interactions,” he said.