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Official advice on reducing the risk of dementia

Guidelines for reducing the risk of dementia

There isn’t a cure for dementia, yet.

But the World Health Organisation (WHO) has drawn up guidelines to help us reduce our risk of dementia.

Focusing on those who are not showing any or little sign of congnitive decline, the organisation has taken a look at the evidence of what may or may not help.

As a result, the WHO advises that we can reduce our risk by getting regular exercise, not smoking, avoiding harmful use of alcohol, controlling our weight, eating a healthy diet, and maintaining healthy blood pressure, cholesterol and blood sugar levels.

If this advice look familiar, that’s because the research shows that what’s good for our hearts is also good for our brains.

Physical activity

The WHO guidelines are aimed at helping people improve their overall health.

For those aged 65+, the WHO advises at least 15 minutes of moderate intensity physical activity a week, or at least 75 minutes of vigorous intensity activity, or a mix.

Each bout of exercise should last at least 10 minutes.

For even more health benefits, the recommendation is to increase moderate intensity activity to 300 minutes of week, or 150 minutes of vigorous activity.

Recognising that not everyone can physically manage robust exercise, the WHO suggests that those with poor mobility should focus on physical activity that enhances balance and prevents falls, on three or more days per week. They should also look at carrying out muscle strengthening exercises involving the major muscle groups, on at least two days a week.

If health conditions make even this difficult, then any amount of physical activity is good.

Giving up smoking

If you smoke, you’ve probably already heard a few times that tobacco dependence is the leading cause of preventable death globally. It’s a major risk factor for a number of conditions, including many types of cancers, cardiovascular diseases and risk factors, and respiratory disorders. Cutting out smoking has been demonstrated to reduce these risks significantly.

According to the WHO cited research, giving up tobacco is also associated with reduced depression, anxiety and stress, as well as improved mood and quality of life.

A healthy diet

A healthy diet with Mediterranean-like overtones seems to be the order of the day. Interestingly, the guidelines have not found evidence that Vitamin B and E, polyunsaturated fatty acids and multi-complex supplementation can reduce risk.

So what’s a healthy diet? The usual suspects:

  • Fruits, vegetables, legumes (e.g. lentils, beans), nuts and whole grains (e.g. unprocessed maize, millet, oats, wheat, brown rice)
  • At least 400 g (five portions) of fruits and vegetables a day. Sadly, potatoes, sweet potatoes, cassava and other starchy roots are not classified as fruits or vegetables
  • Less than 10% of total energy intake from “free” sugars, which are mostly the sugars that manufacturers, cooks and consumers add to their food. They can also be found naturally in sweet stuff such as honey, syrups, fruit juices and fruit juice concentrates. The 10% is roughly 50g (around 12 level teaspoons) for someone of healthy body weight consuming about 2000 calories a day. Going down to 5% is even better
  • Less than 30% of total energy intake from fats. When we do eat fats, then unsaturated fats (found in fish, avocado, nuts, sunflower and olive oils) are preferable to saturated fats (found in fatty meat, butter, palm and coconut oil, cream, cheese, ghee and lard) and trans-fats of all kinds. Trans-fats are described as including both industrially produced trans-fats (found in the oh so wicked processed food, fast food, snack food, fried food, frozen pizza, pies, cookies, biscuits, wafers, margarines and spreads), as well as ruminant trans-fats (found in meat and dairy foods from ruminant animals, such as cows, sheep, goats, camels and others). We are advised to reduce the intake of saturated fats to less than 10% of total energy intake and trans-fats to less than 1% of total energy intake. In particular, industrially produced trans-fats are not part of a healthy diet and should be avoided
  • Less than 5 g of salt (equivalent to approximately 1 teaspoon) per day and use iodized salt

Watching the alcohol intake

Stopping or at least reducing drinking of alcohol is recommended to reduce risk.

Weight management

It’s always there on the list. The overweight should reduce weight by:

  • Following a balanced diet
  • Opting for foods with a low glycaemic index (beans, lentils, oats and unsweetened fruit) as the source of carbohydrates in their diet
  • Taking exercise

What hasn’t necessarily been proven to help

While there does appear to be a link between social isolation, poor hearing, high blood pressure, depression and diabetes, the review of research hasn’t found that treating these areas can help reduce risk of cognitive decline. But these are still important to a healthy life and should be managed well.

Read the full report Risk reduction of cognitive decline and dementia: WHO guidelines. Geneva: World Health Organization; 2019.

By Kathy Lawrence, editor of When They Get Older.

Photo by Gabriele bartoletti stella on Unsplash

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