WHO dementia prevention guidelines: what they mean for aged care leaders

The conversation around dementia prevention is changing.

The World Health Organisation (WHO) has updated its dementia prevention guidelines for the first time since 2019, expanding the number of recognised risk factors from 12 to 20 and introducing new recommendations around areas including air pollution, hearing loss, social connection and cognitive stimulation.

For aged care leaders, the update reinforces something many providers already know: brain health does not sit within one program, one team or one stage of life.

It’s shaped by the environments people live in, the healthcare they can access, the opportunities they have to stay active and connected, and the systems that support healthy ageing.

Professor Kaarin Anstey, Director of the UNSW Ageing Futures Institute and Senior Principal Research Scientist at Neuroscience Research Australia, was the only Australian researcher involved in the WHO’s Guideline Development Group.

“These recommendations offer real-life actions that will reduce dementia risk and promote brain health,” Professor Anstey said.

“They’re both practical and evidence-based, but require the buy-in of governments and public health systems to be truly effective.”

Nearly half a million Australians live with dementia, with that number expected to exceed one million without significant action. Globally, more than 57 million people are living with dementia, with around 10 million new diagnoses each year.

What has changed in the WHO dementia prevention guidelines?

The updated guidelines broaden the understanding of what influences dementia risk.

While the previous guidelines considered 12 risk factors, the new version considers 20 and includes several additional recommendations.

The WHO now highlights the potential role of reducing exposure to outdoor and indoor air pollution, supporting people experiencing hearing loss through interventions such as hearing aids, and increasing opportunities for social engagement and cognitive stimulation.

The guidelines also recommend against using menopausal hormone therapy in women aged 65 and over as a strategy to prevent cognitive decline.

However, Professor Anstey said many established prevention approaches remain important – particularly addressing vascular risk factors earlier in life.

“Managing midlife vascular risk factors such as hypertension, diabetes and midlife obesity — these can be worked on with a person’s GP,” she said.

“Then increase physical activity and adopt a healthy diet, as well as keep mentally active.”

Why brain health needs a lifelong approach

One of the key messages in the updated guidance is that dementia prevention cannot be left until later life.

“Many factors impact brain health a small amount,” Professor Anstey said.

“Over a long time, these small effects accumulate, so it is important to have a healthy lifestyle over a long period of time, to optimise your brain health in old age.”

That lifelong approach also means prevention cannot rely on individuals alone.

Professor Anstey said governments, organisations and health systems all have a role in creating conditions that support better brain health.

“Dementia prevention involves so many factors that this can’t be only the responsibility of individuals,” she said.

“We need governments and other organisations to implement policies that will reduce risk factors that impact across society.”

What this means for aged care leaders

For providers, many of the strategies highlighted in the guidelines are already part of everyday practice.

Physical activity programs, cognitive stimulation, social connection, chronic disease management and access to healthcare all contribute to supporting brain health.

The opportunity is to recognise this work as part of dementia risk reduction – rather than viewing it as a collection of separate wellbeing activities.

“Brain health impacts all of us and requires a holistic approach,” Professor Anstey said.

“Staff and residents in the aged care sector will benefit from taking a proactive approach to brain health through improving access to healthy food and physical and cognitive activity, ensuring good access to health care, and reducing exposure to air pollution.”

Three areas to review

Recognise the role of existing programs

Review how physical, social and cognitive programs are supported and measured.

Are they recorded as activities, or are you capturing their contribution to brain health and dementia risk reduction?

Keep prevention messaging current

The new guidance provides an opportunity to review resident resources, family communications and wellbeing information.

This includes ensuring teams have accurate information about strategies that may support brain health, as well as approaches that are not supported by evidence.

Strengthen partnerships

Many dementia risk factors extend beyond the walls of aged care.

Working alongside GPs, health services and community organisations will continue to be important in supporting access to prevention-focused care.

The updated WHO dementia prevention guidelines do not change the need for specialist dementia support.

Instead, they provide a stronger evidence base for recognising the work already happening across aged care – and identifying where organisations can continue to strengthen their approach to brain health.