On July 15, 2026, the World Health Organization (WHO) released its updated guidance on reducing the risk of cognitive decline and dementia. The report updates and adds to the first of these guidelines published in 2019.
“We know more today than ever before about what drives dementia risk, and these guidelines translate that knowledge into action,” Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, said in a press release.
“Countries now have clear, evidence-based recommendations they can put into practice immediately to protect people’s cognitive health,” added Dr. Tedros.
Globally, dementia affects more than 57 million people. Due to a range of factors, each year, that number climbs higher, especially in low-and middle-income countries.
The search for a cure for dementia is ongoing, but, according to the WHO, almost half — up to 45% — of all dementia cases are linked to modifiable risk factors; in other words, factors under our individual control.
Importantly, many of these factors are also shared with a wide range of chronic conditions, such as cardiovascular disease and type 2 diabetes. Tackling these on a global level would, therefore, bring more healthy years to billions of people.
The WHO guidelines group the interventions into four groups:
Healthy behaviors refer to cognitive, social, and physical activity, alcohol use, tobacco use, and nutrition.
New WHO recommendation:“To reduce the risk of cognitive decline and/or dementia specifically, engagement in cognitive stimulation may be encouraged.”
The report explains that people who have achieved higher levels of education and have more complex jobs generally have a lower risk of dementia. This is likely due to the protective effects of “enhanced cognitive reserve.”
The report recommends:
Medical News Today spoke to Ryuta Kawashima, MD a professor in the Department of Functional Brain Imaging at Tohoku University, Japan, who was not involved in the WHO report.
Kawashima explained that the new “guidelines confirm that keeping the brain actively engaged is not optional, something my colleagues and I have long argued.”
What might this mean in practical terms? According to the expert: “Everyday activities like reading aloud, storytelling, and playing games can accomplish this. You do not need a laboratory or a device. You merely need consistency, challenge, and curiosity to keep your brain sharp.”
Updated WHO recommendation:“To reduce the risk of cognitive decline and/or dementia specifically, engagement in social activity interventions may be recommended to adults with normal cognition or mild cognitive impairment.”
The report authors write that around one in four older people feel isolated.
If we could eliminate loneliness, they estimate that about 5% of dementia cases could be prevented. They write that engaging in social interactions can slow cognitive decline by building a greater cognitive reserve.
This might simply mean phoning friends, meeting friends for lunch, engaging in community-based activities, or joining clubs.
Validated WHO recommendation:“To reduce the risk of cognitive decline specifically, physical activity should be recommended to adults with normal cognition.”
The guidelines explain that staying active is linked to a lower risk of Alzheimer’s disease, cognitive decline, and all-cause dementia. This effect is most pronounced, they explain, when continued for long durations at high intensity.
Being active both reduces risk and helps reduce symptoms in people who already have cognitive decline or dementia.
Validated WHO recommendation: “To reduce the risk of cognitive decline and/or dementia specifically, interventions aimed at reducing or ceasing hazardous and harmful drinking (including providing support to people with alcohol dependence) may be offered to adults with normal cognition or mild cognitive impairment.”
The report explains how alcohol use is responsible for 2.6 million deaths globally each year, and is causally linked to more than 200 health conditions, including cognitive decline and dementia.
If alcohol were removed from society, they estimate that it would prevent 1% of total dementia cases.
Additionally, they provide evidence that abstaining from alcohol for 6–12 months can improve cognitive function and that “reducing alcohol consumption from heavy to moderate levels may be associated with a decreased risk of dementia.”
Validated WHO recommendation:“To reduce the risk of cognitive decline and dementia specifically, interventions for tobacco cessation should be offered to adults who use tobacco.”
The authors write that tobacco use is still a leading cause of preventable death, and smoking during middle life is more closely associated with dementia risk than smoking during old age.
Updated WHO recommendation:“To reduce the risk of cognitive decline and/or dementia specifically, a healthy, balanced dietary pattern may be recommended to adults with normal cognition or mild cognitive impairment.”
The report also recommends against taking vitamin B, vitamin E, omega-3, or multivitamin and mineral supplements unless the individual has a deficiency. This is due to a lack of evidence and “unexpected harmful effects.”
A healthy diet, according to the report’s authors, needs to:
They explain that certain diets — such as the Mediterranean diet, the Dietary Approach to Stop Hypertension (DASH), and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) — are associated with positive cognitive outcomes.
They suggest that a well-rounded, healthy diet is better than supplementation, potentially due to its antioxidant and inflammatory properties.
It might also reduce the risk of high blood pressure and obesity, both of which are linked to poorer health outcomes.
The authors of the WHO report further outline the importance of managing existing disease states that are associated with dementia and cognitive decline. Additionally, certain biological states are also important.
The specific conditions and states are:
Reducing hearing loss to zero, the authors state, could reduce dementia cases worldwide by 7%. They write that “observational data suggest that hearing aid use may be associated with a reduced risk of dementia.”
The authors also investigated other factors, but concluded that, as it stands, the evidence of their role in dementia and cognitive decline is not yet strong enough. These are
MNT reached out to David Perlmutter, MD, a board-certified neurologist and Fellow of the American College of Nutrition, who was not involved in the report. Perlmutter was surprised that the evidence for sleep as a risk factor was not yet strong enough.
This is because “the report acknowledges that insomnia, sleep apnea, poor sleep quality, excessive daytime sleepiness, and both very short and very long sleep duration are all linked to increased dementia risk,” he noted.
MNT also contacted John La Puma, MD, a board-certified internal medicine physician, who was likewise not involved in the report and was also surprised by what he sees as an omission.
In La Puma’s opinion, “they found ‘insufficient evidence’ to recommend specific sleep interventions, and missed the most important controllable factor for brain health: Natural light at the right time and dose.”
“New data published in June show lower dementia risk with adequate daytime light exposure,” he told us.
However, Perlmutter believes that “this reflects the extraordinarily high evidentiary standard the WHO applies.”
New WHO recommendations: “Reducing exposure to ambient air pollution (especially PM2.5) may reduce the risk or incidence of cognitive decline and/or dementia,” and “Reducing exposure to household air pollution may reduce the risk or incidence of cognitive decline and/or dementia.”
PM2.5 refers to microscopic droplets or particles with a diameter of 2.5 micrometers or less, which is about 30 times smaller than the width of a human hair.
Some of the most important sources are:
These minuscule pollutants are associated with a wide range of health conditions, including cognitive decline and dementia.
The authors explain that these particles may cross the blood-brain barrier, causing inflammation, oxidative stress, and, consequently, neurodegeneration.
New WHO recommendation: “To reduce the risk of cognitive decline and/or dementia specifically, tailored, multidomain interventions may be offered.”
“Multidomain” means targeting multiple risk factors at once, and “tailored” in this context means customizing interventions to suit the specific needs of a population.
An example of how these approaches can be successful was recently published in The Lancet. The study recruited at-risk older adults in Latin America.
Their 2-year multidomain intervention involved supervised exercise classes 4 days each week based on local dances like the tango and salsa, and personalized dietary advice based on foods that were accessible and affordable in the local area.
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Individuals who took part in this scheme had significant cognitive benefits compared with the control group, who just attended four 1-hour meetings across the 2-year study.
Perlmutter outlined how the report differs from the 2019 version. He explained that:
“The addition of air pollution is probably the most notable new recommendation, reflecting a growing body of evidence that fine particulate matter, especially PM2.5, promotes neuroinflammation and may contribute directly to neurodegeneration.”
However, Perlmutter told us that “the overall message remains remarkably consistent: The greatest opportunity to reduce dementia risk comes from addressing modifiable lifestyle and vascular risk factors long before symptoms appear.”
The main difference, he told MNT, is that the evidence base is now much stronger. He is also pleased to see the endorsement of multidomain interventions, which he believes can be very effective.
“The real message of these updated WHO guidelines is actually quite reassuring,” said Perlmutter.
Reflecting on where individuals can start when it comes to lowering their dementia risk, he advised: “Start with the fundamentals. Build a lifestyle that keeps metabolism healthy, prioritize regular physical activity, eat in a way that controls blood sugar and reduces inflammation, make restorative sleep a priority, remain socially connected and mentally engaged, and minimize avoidable exposures such as smoking and air pollution.”
Kawashima further advised: “Start by doing something cognitively demanding for a few minutes every day. Read aloud. Do simple arithmetic quickly. Learn something new, like a language or a musical instrument.”
Finally, La Puma puts it simply: “Modern life has stolen our cognitive resilience. We need to be purposeful to prevent dementia, and we can be.”
