On behalf of the National Institute of Mental Health and in collaboration with the World Health Organization (WHO), our group has prepared an adaptation of the WHO guidelines on Risk Reduction of Cognitive Decline and Dementia.
Thanks to the improvement of health care, our society is ageing, which is associated with many health risks. These include the risk of declining mental functions such as memory or attention, and the risk of developing dementia. However, the WHO has no doubt that dementia is not a natural part of aging and can be prevented.
Over the last ten years, there has been some evidence that, although the total number of people with dementia is increasing due to increasing life expectancy, the rise in new cases of dementia is likely to slow down in high-income countries. It is not clear why this happens, but it seems to be mainly related to better care for heart disease and cardiovascular risk factors such as high blood pressure, high cholesterol or diabetes. The fact that society is now richer and better educated also probably plays a role. Our recent Czech study points out that similar positive changes are happening in our country.
What is the foundation of the recommendations? What is their essence? You too can reduce your chances of having dementia at an older age with your own lifestyle and health care. "The scientific evidence gathered for these best practices confirms what we have been expecting for some time. So what's good for our hearts is also good for our brains," said Tedros Adhanom Ghebreyesus, director of the WHO.
The guidelines are structured according to the strength of the evidence and the real possibility to implement preventive measures. A person who wants to follow the strongest recommendations should be physically active on a regular basis, for decades before memory problems even occur. They should also choose a diet that includes plenty of fruits and vegetables. They also certainly shouldn't spend money on various brain supplements that aren't effective, and they should take good care of their diabetes or high blood pressure and not drink alcohol.
These guidelines from WHO are therefore no surprise in for science, public health, and certainly not for you. There is no doubt that regular physical activity and a diet rich in fruits and vegetables are essential for human health. But a report from the WHO also brings to light various scientific ambiguities. For example, no convincing evidence has been found that treatment of depression or hearing impairment would help prevent dementia. And what about solving crossword puzzles? While this will certainly not harm your brain, there is also no strong evidence that these activities are effective.
There is no doubt that we in the Czechia have a lot of work to do in this field. Compared to other European Union countries, Czechs are significantly less healthy in certain respects, which may be reflected in their likelihood of dementia. More than 30% of Czech adults are obese, making us 6th in the European Union, and it is estimated that by 2030, up to 40% of the Czech population will be obese. Czechia also ranks 6th in European countries in the case of diabetes. By 2018, the total number of people with diabetes exceeded 1 million, and the number of new cases continues to increase by approximately 20,000 each year. Worth mentioning is the considerable physical inactivity of Czechs (found in 66% of adults), tobacco consumption (in a quarter of the population) and alcohol consumption, where we rank 3rd in pure alcohol consumption in Europe.
There is still much we do not know about the causes of dementia, and no miracle cure is coming, but we are still not powerless because, according to the current research, we have the most effective remedy in our own hands. By long-term management of the right lifestyle and care for our heart health, we can help our older self to stay mentally fit.
Link to the Czech adaptation of the WHO guidelines here.