240719 SUMMARY OF RECOMMENDATIONS[1]

240719 SUMMARY OF RECOMMENDATIONS[1]

Physical activity interventions Physical activity should be recommended to adults with normal cognition to reduce the risk of cognitive decline. Quality of evidence: moderate Strength of the recommendation: strong Physical activity may be recommended to adults with mild cognitive impairment to reduce the risk of cognitive decline. Quality of evidence: low Strength of the recommendation: conditional

Tobacco cessation interventions

Interventions for tobacco cessation should be offered to adults who use tobacco since they may reduce the risk of cognitive decline and dementia in addition to other health benefits.

  • Quality of evidence: low
  • Strength of the recommendation: strong

Nutritional interventions

The Mediterranean-like diet may be recommended to adults with normal cognition and mild cognitive impairment to reduce the risk of cognitive decline and/or dementia.

  • Quality of evidence: moderate
  • Strength of the recommendation: conditional

A healthy, balanced diet should be recommended to all adults based on WHO recommendations on healthy diet.

  • Quality of evidence: low to high (for different dietary components)
  • Strength of the recommendation: conditional

Vitamins B and E, polyunsaturated fatty acids and multi-complex supplementation should not be recommended to reduce the risk of cognitive decline and/or dementia.

  • Quality of evidence: moderate
  • Strength of the recommendation: strong

Interventions for alcohol use disorders

Interventions aimed at reducing or ceasing hazardous and harmful drinking should be offered to adults with normal cognition and mild cognitive impairment to reduce the risk of cognitive decline and/or dementia in addition to other health benefits.

  • Quality of evidence: moderate (for observational evidence)
  • Strength of the recommendation: conditional

Cognitive interventions Cognitive training may be offered to older adults with normal cognition and with mild cognitive impairment to reduce the risk of cognitive decline and/or dementia.

  • Quality of evidence: very low to low
  • Strength of the recommendation: conditional

Social activity There is insufficient evidence for social activity and reduction of risk of cognitive decline/dementia.

Social participation and social support are strongly connected to good health and wellbeing throughout life and social inclusion should be supported over the life-course.

Weight management Interventions for mid-life overweight and/or obesity may be offered to reduce the risk of cognitive decline and/or dementia.

  • Quality of evidence: low to moderate
  • Strength of the recommendation: conditional

Management of hypertension Management of hypertension should be offered to adults with hypertension according to existing WHO guidelines.

  • Quality of evidence: low to high (for different interventions)
  • Strength of the recommendation: strong

Management of hypertension may be offered to adults with hypertension to reduce the risk of cognitive decline and/or dementia.

  • Quality of evidence: very low (in relation to dementia outcomes)
  • Strength of the recommendation: conditional

Management of diabetes mellitus The management of diabetes in the form of medications and/or lifestyle interventions should be offered to adults with diabetes according to existing WHO guidelines.

  • Quality of evidence: very low to moderate (for different interventions)
  • Strength of the recommendation: strong

The management of diabetes may be offered to adults with diabetes to reduce the risk of cognitive decline and/or dementia.

  • Quality of evidence: very low
  • Strength of the recommendation: conditional

Management of dyslipidaemia Management of dyslipidaemia at mid-life may be offered to reduce the risk of cognitive decline and dementia.

  • Quality of evidence: low
  • Strength of the recommendation: conditional

Management of depression There is currently insufficient evidence to recommend the use of antidepressant medicines for reducing the risk of cognitive decline and/or dementia. The management of depression in the form of antidepressants and/or psychological interventions should be provided to adults with depression according to existing WHO mhGAP guidelines.

Management of hearing loss There is insufficient evidence to recommend use of hearing aids to reduce the risk of cognitive decline and/or dementia. Screening followed by provision of hearing aids should be offered to older people for timely identification and management of hearing loss as recommended in the WHO ICOPE


[1] [1] Risk reduction of cognitive decline and dementia: WHO guidelines. Geneva: World Health Organization; 2019. License: CC BY-NC-SA 3.0 IGO.

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