People in mid-life are advised that the risk of developing dementia can be reduced by making lifestyle changes

• Brain health is a new approach to ensure the potential gains from reducing the risk of developing dementia are maximised. This reframing is vital to translate the growing evidence base into policy change, public awareness and public health interventions, that enable the realisation of these gains.
• A life-course perspective, starting in early life through to older age, is needed to integrate advice on the prevention of ill health and encourage, facilitate and maintain healthier living.
• Good brain health must be promoted throughout life for people of all ages. It is a more holistic and engaging prevention strategy to reduce the decline and disability associated with the onset of long-term conditions like dementia.
• Brain health is about more than just dementia, with modifiable risk factors shared with other non-communicable diseases and determinants of healthy ageing. Acknowledgement of this should drive joint efforts across public health initiatives and strengthen support for related policies indirectly benefiting the population’s brain health.
• Government and the NHS should ensure brain health is prioritised in the new dementia and health promotion strategies and is central to wider ambitions for prevention. These policies should consider the breadth of risk factors and wider determinants of health that influence health outcomes and inequalities.
• The pursuit of better brain health should be an integral component of COVID-19 person-centred recovery plans to enable people to live longer, more independent and resilient lives.

Best practice recommendations include:

• To Scrutinise the risks for hearing loss throughout the life course, to reduce the risk of exposure to this risk factor
• Make it clear that some common unhealthy behaviours can increase the risk of dementia and that addressing those behaviours will reduce the likelihood of developing dementia and other non-communicable chronic conditions.
• Encourage smokers to quit or use harm reduction measures by highlighting the immediate and long-term benefits. In particular, make it clear that there is a link between smoking and dementia, disability and frailty.
• Show how a wide range of domestic, leisure and work activities can help people to be physically active and explain how even modest increases in physical activity, at any age, can be beneficial. Include information on how physical activity:
• reduces the risk of illness in both the short and long term
• preserves memory and cognitive ability
• reduces risk of falls and leads to a healthier old age
• improves wellbeing and quality of life
• should be a part of everyday life for a person's whole life course.
• Explain that alcohol consumption can increase the risk of dementia, disability and frailty and encourage people to reduce the amount they drink as much as possible.
• Explain that regularly consuming meals, snacks and beverages high in salt, fats and sugars is bad for health.
• Explain that a diet mainly based on vegetables, fruits, beans and pulses, wholegrains and fish, is likely to improve their health.
• Advise people to aim to maintain a healthy body weight.

National Institute of health and Care Excellence guidelines:

• NICE NG16 2015 Dementia, disability and frailty in later life – mid-life approaches to delay or prevent onset: "changing specific risk factors and behaviours can reduce the risk of dementia. These changeable factors – smoking, lack of physical activity, alcohol consumption, poor diet and being overweight." Providing advice on reducing the risks of dementia, disability and frailty at every appropriate opportunity. Public and third sector providers (such as local authorities, leisure services, emergency services and health and social care providers) should:
• Use routine appointments and contacts to identify people at risk of dementia, disability and frailty (for example, appointments with a GP or practice nurse, when attending leisure centre classes, or visiting a community pharmacy).
• Take advantage of times in people's lives when substantial change occurs. (Examples include: retirement, when children leave home, when starting to care for older relatives or grandchildren, or during the menopause.) These are times when people may consider adopting new healthy behaviours, or may be at risk of adopting unhealthy ones.
• Whenever the opportunity arises give people advice on how to reduce the risk factors for dementia, disability and frailty or refer them to specialist services when necessary (see recommendation 9 in NICE's guideline on behaviour change: individual approaches).