July 2019

New guidelines: dementia prevention

Dementia affects about 50 million people worldwide. This number is on the rise, with estimates projecting 152 million by 2050. Since there is no curative treatment for dementia, knowing which strategies have evidence for delaying its onset or progression is key for healthcare professionals. The World Health Organization (WHO) recently created guidelines for developing a public health response to dementia, which includes prevention strategies. These prevention strategies include recommendations on lifestyle changes, exercise, supplements, diets, etc. What key points should you share with patients who are worried about getting dementia?

Quitting smoking, limiting alcohol consumption, and maintaining a healthy weight are among some of the more obvious recommendations. In terms of supplements, WHO actually recommends against their use. Specifically, the guidelines recommend against B and E vitamins, polyunsaturated fatty acids such as fish oil, and multivitamins. These recommendations may be important to highlight, as your patients may have heard unsupported claims that some of these supplements are beneficial. For instance, fish oil is often touted as being a “brainfood,” but the evidence in relation to dementia doesn’t support this claim. Similarly, the use of multivitamins as a strategy for staying healthy is common, but strong evidence of benefit for dementia is lacking.

When it comes to dietary guidelines for dementia prevention, WHO recommends the Mediterranean diet, which emphasizes olive oil, fish, nut, whole grain, fruit, and vegetable intake. Research shows that a Mediterranean diet is linked to a 46% reduced risk for dementia or Alzheimer disease, but strict adherence is necessary to get these benefits. That might not be realistic for all patients, so other diet options including the DASH diet can be recommended as well.

If your patients are concerned about their dementia risk, tell them to remain physically active, maintain a healthy weight, and properly manage any existing conditions like hypertension or diabetes. When it comes to diet, sticking to a Mediterranean-like diet is a great option. If your patients want to try supplements, tell them that most evidence suggests they’re not a wise investment for dementia prevention. For now, they’re better off picking healthier food options and using that money to stay active.

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