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\n \u2018We know more today than ever before about what drives dementia risk, and these guidelines translate that knowledge into action\u2019: World Health Organization
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\n News<\/p>\n
\n Practical interventions, cardiometabolic condition management, supplements, and menopause \u2013 the WHO has updated its prevention advice for GPs.
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\n \u2018We know more today than ever before about what drives dementia risk, and these guidelines translate that knowledge into action\u2019: World Health Organization
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Updated advice also includes interventions that reduce risk of noncommunicable diseases, including increasing physical activity, stopping smoking, reducing alcohol consumption, adopting a healthy diet, and a new recommendation to reduce exposure to air pollution.
newsGP weekly poll
\n GPs now have a new set of on-the-ground guidelines to help them prevent Australia\u2019s leading cause of death<\/a>: dementia.
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\nThe importance of lowering dementia risk across the life course has been highlighted by the World Health Organization (WHO) in its first guideline update in seven years.
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\nIts new prevention advice<\/a> focuses on proven actions that can effectively lower dementia risk \u2018through early awareness and timely action\u2019, pulling together evidence that can be actioned at a primary care level as well as broader health system initiatives.
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\nAmongst the recommendations are behaviour and lifestyle interventions to reduce the risk of dementia, including daily cognitive stimulation and training, and social activities for people who have normal cognition or are experiencing mild cognitive impairment.<\/p>\n
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\nManagement of cardiometabolic conditions, such as hypertension, diabetes, and high cholesterol can also help reduce dementia risk and there is emphasis on the benefits of tailored \u2018multidomain\u2019 interventions which target three or more risk factors.\u00a0
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\nThere is also updated advice on the use of supplements, with the guidelines stating that to reduce the risk of cognitive decline and\/or dementia specifically, \u2018supplementation of vitamins B and E, omega-3 polyunsaturated fatty acids (PUFA) and multivitamins\/minerals is not recommended.\u2019
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\n\u2018That\u2019s important for GPs to know because patients do come to see us asking about various supplements,\u2019 said Dr Stephanie Daly, Chair of RACGP Specific Interests Dementia.
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\n\u2018There\u2019s a lot of people in the private market wanting to influence people as to what they should be doing to look after their health.\u2019
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\nThere are also updated recommendations on the role of hormone replacement therapy in the context of dementia.
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\n\u2018Menopausal hormone therapy is not recommended for specifically reducing the risk of cognitive decline and\/or dementia in postmenopausal women aged 65 years and older,\u2019 the guidelines state.
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\n\u2018For women aged below 65 years \u2013 including those experiencing premature ovarian insufficiency, early menopause or perimenopause \u2013 and for the specific purpose of reducing the risk of cognitive decline and\/or dementia, there is currently insufficient evidence to advise for or against the use of menopausal hormone therapy.\u2019
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\nThe WHO says its new guidelines are designed to promote a \u2018life-course understanding of dementia risk\u2019, recognising that exposure to risk factors accumulates over time and that certain risk factors may have a greater impact at specific life stages.
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\nBut up to 45% of the dementia risk can be attributed to modifiable factors, such as smoking, social isolation, physical inactivity, air pollution and noncommunicable diseases, including high blood pressure and diabetes, the WHO explains.
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\nDr Daly says this helps to emphasise the message that brain health is something \u2018we should all be across and talking to our patients about\u2019.
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\n\u2018Although it\u2019s a disease that affects older people primarily, action that can be taken to reduce the risk is much earlier than we\u2019ve been talking to people about,\u2019 she told newsGP.
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\n\u2018As primary care practitioners, we need to think about brain health as really a life course intervention, and that there\u2019s a lot we can do from early life \u2013 maybe even before midlife.
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\n\u2018We need to really advocate for thinking about brain health as a critical conversation that every GP needs to understand, like we all know how to have cardiovascular health conversations.
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\n\u2018I\u2019m not sure that everybody is up to speed with the concept of brain health and how to have those conversations so I\u2019m hoping that these guidelines, together with the [upcoming Monash University] clinical guidelines, will help really emphasise that message that brain health is really something we should all be across and talking to our patients about.\u2019
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\nAs Australia\u2019s only researcher on the WHO\u2019s Guideline Development Group that produced the new advice, Professor Kaarin Anstey, Director of the UNSW Ageing Futures Institute, said these guidelines are a vital step forward.
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\nThe role of GPs in helping to action these updated guidelines is \u2018extremely important\u2019, she told newsGP.
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\n\u2018The guidelines are aimed at GPs who are most important for providing clinical advice and support with managing these risk factors at the individual level. They also are directed to other clinicians, as well as policy makers,\u2019 Professor Anstey said.
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\nOf interest are recommendations on diet, exercise and cognitive engagement.
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\n\u2018Evidence on health behaviours relating to exercise, healthy diet, cognitive activity is now strong enough to make recommendations about these to patients,\u2019 she said.
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\n\u2018There is now sufficient evidence to make recommendations to undertake cognitive activity and interventions to address hearing loss. Evidence to continue with management of hypertension, dyslipidaemia, and diabetes (this is not new).
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\n\u2018There is a new recommendation that dietary restriction may be offered to adults who are overweight and obese to reduce risk of cognitive decline, a new recommendation on multidomain interventions i.e. addressing risk factors holistically. These usually include physical activity, healthy dietary pattern and cognitive stimulation or training.
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\n\u2018And a new recommendation to reduce exposure to air pollution. It should be noted that the evidence base is still growing and several recommendations are of low certainty. This is especially where evidence was mostly drawn from observational studies.\u2019
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\nBut Dr Daly said governments must now support GPs to provide longer consultations to better action this advice.
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\n\u2018You can\u2019t do this work in a short consult, whether you\u2019re doing risk reduction or interventions to actually pick up cognitive decline,\u2019 she said.
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\n\u2018We need to have better funded, longer consults in order to do this because these are complex conversations that require a detailed conversation and it\u2019s not something that fits into short time framed medicine.\u2019
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\nProfessor Anstey added that societal factors also influence risk factors and access to healthcare.
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\n\u2018Dementia risk reduction is clearly complex and involves many aspects of health over the life course. This requires a whole of society approach,\u2019 she said.
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\n\u2018We need to ensure people can afford access to GPs to help manage risk factors, but also access to affordable healthy food, opportunities to exercise, and have clean air, hearing aids and social activities.\u2019
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\n dementia<\/a> dementia risk factors<\/a> preventive care<\/a>
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\n As a GP, would you work more hours in the after-hours period if there was more funding for this work, such as higher rebates or other incentives?<\/p>\n","protected":false},"excerpt":{"rendered":"
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