The World Health Organization, WHO, has released the second edition of its Guidelines on Risk Reduction of Cognitive Decline and Dementia. The guidelines provide evidence-based recommendations to reduce the risk of cognitive decline and dementia through a public health approach.
The new edition includes multidomain interventions supporting healthy lifestyles and optimal management of cardiometabolic disorders as effective strategies to reduce the risk of dementia in older age.
Dementia is a chronic disorder and one of the leading causes of disability and dependency among older people. Recent estimates indicate that up to 45% of dementia cases worldwide are associated with modifiable risk factors, which means they could potentially be prevented or delayed. Since there is no cure, proactive management of risk factors across the life course remains the most effective strategy to reduce the risk of cognitive decline and dementia.
The first edition of the WHO Guidelines for the risk reduction of cognitive decline and dementia was launched in 2019 and included twelve modifiable factors – physical activity, smoking, nutrition, harmful alcohol use, cognitive activity, social activity, overweight/obesity, hypertension, diabetes, dyslipidaemia, depression, and hearing loss.
The updated Guidelines incorporate new evidence that has become available since 2019. Recommendations have been updated in the fields of diet and nutrition, cognitive activity, social activity, and the management of hearing loss, obesity, hypertension, and diabetes, while recommendations for other existing factors were reaffirmed. Among the new factors and interventions, recommendations have been issued on reducing exposure to air pollution and on implementing tailored multidomain interventions. For sleep, HIV, traumatic brain injury, vision impairment, and stroke, there was not enough evidence to make particular recommendations for the specific purpose of reducing the risk of cognitive decline and dementia. However, existing general guidelines relevant to the management of these factors remain applicable, although they are not specific to dementia risk reduction.
As many of the risk factors for dementia are shared with those of chronic non-communicable diseases, the key recommendations may be effectively integrated into other programs in the fields of cardiovascular disease risk reduction and nutrition. Also, it is emphasized that dementia risk factors should be addressed holistically, because multiple factors often coexist and accumulate over the life course.
“The WHO Guidelines provide an important evidence-based framework for healthcare providers and policymakers worldwide”, says Miia Kivipelto, professor of clinical geriatrics at Karolinska Institutet and a member of WHO’s Guideline Development Group. “Here in Sweden, for example, the National Dementia Strategy, updated by the government in 2025, is closely aligned with the WHO Guidelines and recommends promoting healthy lifestyles and optimizing cardiometabolic health to reduce the population burden of cognitive decline. The growing FINGER network of municipalities, healthcare regions, and decision-makers supports the implementation of these approaches at both the municipal and regional levels across Sweden.
The WHO Guidelines are based on a rigorous scientific methodology which synthesizes evidence from intervention studies (i.e., randomized controlled trials, considered the gold standard in clinical research) when available, or data from observational studies (e.g., tobacco use). Also, the guidelines adopt a global perspective, with recommendations that are adaptable and relevant in different socioeconomic and cultural contexts.
Researchers in our network have played key roles in the development of the original Guidelines edition as well as the 2026 update. Professor Miia Kivipelto served as a clinical expert member of the Guideline Development Group, and Dr. Francesca Mangialasche led the Karolinska Institutet evidence review team, which also includes researchers from the University of Eastern Finland and the Finnish Institute for Health and Welfare (THL).
Dementia has a severe impact on the lives of affected individuals, their carers, and families, and imposes heavy economic and societal burdens. With over 57 million people affected worldwide, a number projected to triple by 2050, dementia is a rapidly growing public health emergency.
WHO Guidelines on Risk Reduction of Cognitive Decline and Dementias
For more information, please contact
Miia Kivipelto, Professor, Director of Research & Development, miia.kivipelto(a)ki.se
Francesca Mangialasche, Principal Researcher, francesca.mangialasche(a)ki.se
Links
WHO Guidelines on Risk Reduction of Cognitive Decline and Dementias
(Second edition, released 15 July, 2026)
