To reduce dementia risk, eating well and exercising do more than puzzles and pills

If you want to save your brain from the ravages of dementia, keep the rest of your body well with exercise and healthy habits rather than relying on vitamins or other pills, according to new guidelines from the World Health Organization.

About 50 million people around the world have Alzheimer’s disease or another type of dementia, and nearly 10 million new cases arise each year, the WHO said in a report issued Tuesday. The cost of caring for people with dementia is expected to reach $2 trillion per year by 2030.

Although age is the top risk factor, “dementia is not a natural or inevitable consequence of aging,” the report says.

Many health conditions and behaviors affect the odds of developing it, and research suggests that one-third of dementia cases are preventable, said Maria Carrillo, chief science officer of the Alzheimer’s Assn., which has published similar advice.

Since dementia is currently incurable and so many experimental therapies have failed, focusing on prevention may “give us more benefit in the shorter term,” Carrillo said.

Much of the WHO’s advice is common sense, and echoes recommendations from the National Institute on Aging.

The new guidance includes getting enough exercise; treating health conditions such as diabetes, high blood pressure and high cholesterol; having an active social life; and avoiding or curbing harmful habits like smoking, overeating and drinking too much alcohol. Although there isn’t strong evidence that some of these actions will help preserve thinking skills, they’re known to aid general health, the WHO report says.

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Eating well — such as by following a Mediterranean-style diet — may help prevent dementia, the guidelines say. But don’t expect vitamin B or E pills, fish oil or multi-complex supplements that are promoted for brain health to help. The guidelines emphasize that there’s strong research showing that these shortcuts don’t work.

“There is currently no evidence to show that taking these supplements actually reduces the risk of cognitive decline and dementia, and in fact, we know that in high doses these can be harmful,” said the WHO’s Dr. Neerja Chowdhary.

“People should be looking for these nutrients through food ... not through supplements,” Carrillo agreed.

The WHO also declined to endorse puzzles, games and other activities aimed at boosting thinking skills. These can be considered for people with normal capacities or mild cognitive impairment, but there’s little evidence they provide any benefit.

Although antidepressants may be used to treat depression, there’s not enough evidence to recommend them for reducing dementia risk, the report says.

In addition, hearing aids may not reduce dementia risk, but older people should be screened for hearing loss and treated accordingly, the WHO says.