The World Health Organization (WHO) has released updated guidelines on reducing the risk of cognitive decline and dementia, adding seven new health conditions and exposures to its recommendations. The second edition of the 2019 report was revised to "reflect the latest evidence and advances in dementia risk reduction."

New additions to the list of risk factors include stroke, traumatic brain injury, vision impairment, sleep problems, HIV, air pollution, and menopausal hormone therapy. These factors now join the 12 previously identified risks, bringing the total to 19.

Expanded List of Dementia Risk Factors

The seven newly recognized risk factors are:

  • Stroke: Occurs when blood flow to the brain is interrupted or a blood vessel ruptures. Conditions affecting cardiovascular health, such as heart disease and hypertension, are associated with a higher risk of dementia.
  • Traumatic brain injury (TBI): Can range from mild concussions to severe injuries and is noted as a significant factor that can impact brain health long-term.
  • Vision impairment: A substantial portion of the brain is dedicated to processing visual information, suggesting that vision problems may place additional demands on the brain.
  • Sleep problems: Challenges such as sleep apnea can lead to brain changes resembling those seen in Alzheimer's disease. Research suggests sleep plays a role in the brain's waste-clearing processes.
  • HIV: Untreated human immunodeficiency virus can affect the central nervous system and is linked to cognitive impairment. Effective antiretroviral therapy has significantly reduced the incidence of severe HIV-associated dementia.
  • Air pollution: Exposure to toxins, including fine particulate matter in outdoor and household air, has been linked to a higher risk of cognitive decline and dementia, though the evidence certainty is considered low to very low.
  • Menopausal hormone therapy (MHT): While not recommended specifically for dementia prevention in postmenopausal women over 65, hormonal changes during menopause can affect mood and memory. The WHO indicates insufficient evidence for younger women regarding MHT's effect on dementia risk.

Previously Identified Risks

The original 12 risk factors that remain on the WHO's list include:

  • Cognitive activity
  • Social activity
  • Physical inactivity
  • Harmful alcohol use
  • Tobacco use
  • Unhealthy diet/nutrition
  • Obesity
  • Diabetes
  • Hypertension
  • Dyslipidemia (abnormal lipid levels)
  • Hearing loss
  • Depression

Dr. Daniel Amen, a psychiatrist and founder of Amen Clinics, noted that the WHO's updated guidelines align with his own recommendations for reducing dementia risk, which include focusing on blood flow, inflammation, genetics, head trauma, toxins, mental health, immunity, neurohormones, diabesity, and sleep, under the acronym BRIGHT MINDS.

Dementia risk increases with age, with an estimated one in five people aged 85 and older developing the condition. While genetics can play a role, lifestyle factors are significant contributors to risk for anyone. Experts emphasize that dementia prevention should be a lifelong pursuit, starting well before old age. Making conscious decisions about daily habits and prioritizing social connection and continuous learning are key strategies for brain health. The WHO's updated guidelines provide a comprehensive framework for individuals seeking to reduce their risk of cognitive decline throughout their lives.