Dementia • Risk factor management and lifestyle changes – new guidelines from the World Health Organization

On July 16, 2026, the World Health Organization (WHO) published its updated guidelines on reducing the risk of cognitive decline and dementia. According to the report, Up to 45% of dementia cases worldwide can be delayed or even prevented.

The main message remains the same: Prevention is currently the most effective strategy, as there is no widely available, disease-modifying treatment for dementia.

According to the authors, the main effort focuses on changing lifestyle and treating risk factors, many years before the first symptoms appear. This includes, among other things, maintaining a healthy metabolism, regular exercise, eating in a way that balances blood sugar levels and reduces inflammation, careful sleep habits, cultivating social relationships, engaging in activities that stimulate the brain, monitoring hearing quality, reducing alcohol consumption, and reducing exposure to factors such as smoking and air pollution. Many of these are also common to a wide range of chronic diseases, such as heart disease, vascular disease, and type 2 diabetes. Therefore, dealing with them on a comprehensive level will bring significant improvements in quality of life and longevity.

Compared to the 2019 guidelines, the main difference today lies in the scientific evidence base, which has become significantly stronger and broader; the current report presents a much larger volume of findings that establish, strengthen, or update previous guidelines, while adding new recommendations.

Furthermore, the guidelines also emphasize that dementia prevention requires Multidisciplinary strategy Understanding that brain health is influenced by a network of interwoven factors.

New recommendation: Multidomain intervention

For decades, the field of dementia prevention has focused primarily on a point-based approach: reducing individual risk factors, such as smoking, diabetes, high blood pressure, physical inactivity, and excessive alcohol consumption, which are known to increase the risk of all-cause mortality, cognitive decline, and Alzheimer's. Although quitting smoking, getting regular exercise, and controlling blood pressure are as essential today as they were in the past, new research from the past decade provides strong evidence that combined treatment of vascular (blood vessel) and metabolic risk factors, along with lifestyle changes, is much more effective than focusing on one step alone.

The shift from focusing on a single risk factor to multidisciplinary interventions for maximum brain protection is now one of the *Important and new recommendations* of the WHO in the field of prevention.

Example of a multidisciplinary intervention – In practice, a multidisciplinary approach consists of simultaneous intervention at several levels: cognitive stimulation, maintaining an active social life, improving sleep quality, regular physical activity and a healthy diet, along with monitoring vascular risk factors, blood pressure and diabetes.

New recommendation: Cognitive stimulation in addition to cognitive training

A new recommendation encourages the incorporation of cognitive stimulation, beyond structured cognitive training (such as computerized training), cognitive stimulation activities are daily actions that stimulate thinking and improve overall cognitive function. The report explains that educated people who are mentally challenged in their workplace are generally at lower risk of dementia.

Examples of simple cognitive activities to adopt Activities that encourage thinking, memory, and speed of information processing: reading aloud, playing board or computer games, crossword puzzles, following new cooking recipes, challenging work, listening to the radio, or playing a musical instrument, especially if the activities are new and challenging.

Cognitive activities in society: Encourage multi-sensory stimulation (hearing, sight, smell, etc.) combined with movement and/or various props to assimilate the experience. Examples include participation in book clubs, workshops to strengthen cognition and memory, and participation in dance classes as they require memory and coordination.

These behaviors, in turn, contribute to improved mood and quality of life, and encourage increased engagement in other health-promoting activities. Furthermore, Cognitive activities help reduce feelings of loneliness Which, in itself, is a risk factor for dementia and premature mortality from any cause.

The great importance of this recommendation lies in the fact that it allows for the integration of both structured programs and simple daily activities. These activities can be adapted to the characteristics of the population, and their cost is significantly lower compared to more formal and institutional interventions (such as cognitive training courses or workshops).

What is the recommended weekly dosage?

This question is extremely relevant as the evidence is insufficient to determine the type, frequency, intensity, and duration of exercise recommended for maintaining or improving cognitive abilities.

Personally, I see this as a positive aspect. Most of us incorporate one or more brain-stimulating activities into our daily lives, whether it's taking a dance class once or twice a week, swimming, or taking a moderate walk. Are these activities any less valuable than an hour and a half of intensive cognitive training, held three times a week and for a limited period of time?

Experts agree that the continued adoption of a healthy lifestyle has a cumulative effect, which will show its positive signs decades later. Engaging in thought-provoking activities or challenging occupations, along with cognitive training, helps build reserve cognitive (the brain's ability to recruit alternative pathways to compensate for damage or wear and tear), which may delay brain deterioration. Furthermore, these activities contribute to reducing social isolation, a factor that in itself constitutes a significant risk for the development of dementia.

New recommendation: Reducing exposure to air pollution

For the first time, the World Health Organization (WHO) recommends reducing exposure to environmental and household air pollution as a potential strategy for lowering the risk of dementia.

Scientific evidence from recent years links long-term exposure to air pollution, especially fine particles (2.5-10 µm or smaller), to an increased risk of cognitive decline and dementia. These fine particles can enter the bloodstream and contribute to inflammation, oxidative stress, and blood vessel damage. These processes can directly damage brain health.

Although no individual can fully control air quality, there are practical ways to reduce exposure, such as exercising away from busy roads, monitoring air quality reports on days when pollution levels are high, and supporting policies that promote cleaner air.

The inclusion of air pollution in the latest dementia prevention guidelines reflects an important conceptual shift: brain health is shaped not only by our lifestyle choices, but also by the environment we live in. Therefore, maintaining brain health is both a personal responsibility and a national public health challenge.

Updated recommendation: Social engagement

Social isolation and loneliness are increasingly recognized as modifiable risk factors for cognitive decline. According to the report's authors, one in four adults experiences loneliness. They estimate that addressing this problem could prevent about 5% of dementia cases, as social interaction builds cognitive reserve and slows mental decline.

Maintaining social connections is now recognized as a vital component of maintaining brain health. Research shows that people who maintain social and community connections tend to have a lower risk of cognitive decline and dementia. Regular interactions with family, friends, community groups, or volunteer activities stimulate the brain, enhance mental well-being, and may reduce stress and depression, factors that also directly affect cognitive health.

It is important to note that social engagement is much more than just “being around people.” The greatest benefits come from meaningful interactions that involve conversation, learning, problem-solving, laughter, and a sense of purpose. It is not for nothing that social activity is one of the interventions in multidisciplinary research: it challenges the brain, often encourages physical movement, improves mood, and fosters a sense of belonging.

Managing existing diseases

The researchers emphasize the importance of managing existing conditions associated with dementia and cognitive decline. The specific conditions and diseases are:

• Obesity– Dietary restriction is recommended for overweight adults.
• diabetes mellitus – People with type 2 diabetes have a 50% to 100% higher risk of developing dementia compared to those without it.
• Hypertension – High blood pressure is a long-known and proven risk factor for dementia.
• Dyslipidemia (imbalance in blood fats) – The report also suggests reducing the consumption of cholesterol and animal products.
• Hearing loss – Especially in old age. Loss of any level has been linked to cognitive decline and dementia. Studies report that a sharp reduction in the number of people with hearing loss could reduce dementia cases worldwide by 7%. Therefore, the use of hearing aids may be associated with a reduced risk of dementia.

Factors for which the evidence is insufficient

The authors also investigated other factors for their impact on dementia and cognitive decline, including depression, stroke, traumatic brain injury, visual impairment, chronic sleep deprivation, and HIV. Despite the large number of studies on the conditions mentioned, the amount of evidence is insufficient to justify their inclusion in the report.

Further clinical studies in the future, which will focus on long-term follow-up and examination of medical interventions, will contribute to establishing the causal relationship of these factors with dementia.

In conclusion

The classic recommendations, such as quitting smoking, exercising, a healthy diet, and balancing cardiometabolic risk factors, remain as essential as ever. However, the report also gives prominence to factors such as Social engagement, cognitive stimulation, and air pollution. This change Reflects the growing understanding that brain health is influenced by a combination of lifestyle and the environment in which we live.

Accordingly, the authors encourage the implementation of a multidisciplinary approach, which simultaneously integrates several lifestyle and risk factors, which helps preserve cognitive function.

 The future of dementia prevention does not lie in one magic pillA synergistic and comprehensive combination of all these elements will allow the brain to derive maximum benefit and maintain cognitive function over time.