Abstract
With population ageing worldwide, dementia poses one of the greatest global challenges for health and social care in the 21st century. In 2019, around 55 million people were affected by dementia, with the majority living in low- and middle-income countries. Dementia leads to increased costs for governments, communities, families and individuals. Dementia is overwhelming for the family and caregivers of the person with dementia, who are the cornerstone of care and support systems throughout the world. To assist countries in addressing the global burden of dementia, the World Health Organisation (WHO) developed the Global Action Plan on the Public Health Response to Dementia 2017–2025. It proposes actions to be taken by governments, civil society, and other global and regional partners across seven action areas, one of which is dementia risk reduction. This paper is based on WHO Guidelines on risk reduction of cognitive decline and dementia and presents recommendations on evidence-based, multisectoral interventions for reducing dementia risks, considerations for their implementation and policy actions. These global evidence-informed recommendations were developed by WHO, following a rigorous guideline development methodology and involved a panel of academicians and clinicians with multidisciplinary expertise and representing geographical diversity. The recommendations are considered under three broad headings: lifestyle and behaviour interventions, interventions for physical health conditions and specific interventions. By supporting health and social care professionals, particularly by improving their capacity to provide gender and culturally appropriate interventions to the general population, the risk of developing dementia can be potentially reduced, or its progression delayed.
Highlights
With population ageing worldwide, dementia poses one of the greatest global challenges for health and social care in the 21st century
The 12 risk factors and interventions presented in the guidelines were selected based on reports from two recent systematic reviews [10, 11] and those summarised in existing World Health Organisation (WHO) guidelines, i.e., the Prevention and control of non-communicable diseases [12] and Integrated care for older people (ICOPE) guidelines [13]
A review of evidence was conducted for interventions related to the 12 risk factors of focus to evaluate their efficacy in reducing risk of cognitive decline and/or dementia for adults with normal cognition or mild cognitive impairment (MCI), and took into consideration the study design—randomised controlled trials (RCT) or observational studies, risk of bias, inconsistency, indirectness, imprecision and risk of reporting bias
Summary
Dementia poses one of the greatest global challenges for health and social care in the 21st century. In 2019, around 55 million people were affected by dementia, with the majority living in low- and middle-income countries (LMIC). The total number of people with dementia is projected to reach 78 million in 2030 and 139 million in 2050 [1]. Dementia leads to increased costs for governments, communities, families and individuals. In 2019, the total global societal cost of dementia was estimated to be US$1.3 trillion, equivalent to 1.5% of global gross domestic product (GDP). This number is expected to more than double by 2030, reaching US$2.8 trillion [1]
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