Dr. Omar El-Agnaf, Executive Director, Qatar Biomedical Research Institute, explains why we should follow the recommendations of the World Health Organization’s first report on reducing the risk of dementia

I greatly welcome the World Health Organization (WHO)’s first guidelines on reducing the risk of dementia.

WHO brings together the world’s top health experts to produce international reference materials, and I place great faith in the opinions and advice of its health experts.

Their recommendations were published in a report titled Risk Reduction of Cognitive Decline and Dementia: WHO Guidelines. World Health Organization; 2019. (Licence: CC BY-NC-SA 3.0 IGO). It provides extremely useful recommendations to reduce our risk of developing dementia, which is the fifth leading cause of death worldwide.

Almost 10 million new cases of dementia are diagnosed every year and WHO has warned that the number of people with the disorder is expected to triple in the next 30 years.

Dementia causes a deterioration in memory, thinking, behavior, and the ability to perform everyday activities, and there are more than 50 types, of which Alzheimer’s is by far the most common.

Age is the biggest risk factor for cognitive decline, although dementia is not a natural or inevitable consequence of ageing, while genetics can play a role in a small percentage of dementia’s cases.

Although there is no effective treatment for dementia, which affects 5% of the worldwide population over the age of 65, and up to 25% over the age of 85, there are several things we can do to delay or slow the onset and progression of the disease.

WHO’s 12-Step Guide to Reducing the Risk of Developing Dementia

• Exercise – at least 150 minutes of moderate-intensity aerobic physical activity or at least 75 minutes of vigorous-intensity aerobic physical activity per week (or a combination of the two).
• Stop smoking – smoking increases the risk of cognitive decline and dementia in addition to other health issues.
• Eat well – a Mediterranean diet consisting of a high intake of cereals, fruits, fish, legumes, and vegetables, but little meat or dairy products is advised. There is no proven benefit in relation to reducing the risk of dementia in taking dietary supplements such as vitamins B and E.
• Avoid heavy alcohol intake – heavy drinking increases the risk of cognitive decline and/or dementia.
• Brain training – board games and crosswords can reduce the risk of cognitive decline and/or dementia.
• Be social – social participation and social support are strongly connected to good health and well-being.
• Manage your weight – studies show that obesity in mid-life increases the risk of dementia.
• Check your blood pressure – a pattern of increased blood pressure during mid-life followed by a rapid decrease in blood pressure later in life has been found in individuals who go on to develop dementia.
• Get checked for diabetes – the presence of late life diabetes has been linked to an increased risk of dementia so get yourself checked at least once a year.
• Check your cholesterol – a number of epidemiological studies have demonstrated a close relationship between high cholesterol levels and the onset of dementia.
• Seek treatment if you are depressed – there is substantial evidence linking depression to cognitive decline and dementia.
• Get your hearing checked – hearing loss has been associated with an increased risk of cognitive decline or dementia.

Dietary Supplements Divide Opinion

The WHO report provides extremely valuable information although I do not share their views on dietary supplements. WHO believes that vitamins B and E have no proven benefit with respect to dementia.

However, well-documented studies have shown that vitamin E is a very powerful antioxidant molecule that can protect cells and tissue from free radical damage. Therefore, in general, antioxidants offer protection from chronic diseases including neurodegenerative diseases. As long as we take a natural product, I believe taking antioxidants is beneficial for our health.

The Environment has a Devastating Impact on our Health

Although it wasn’t included in the WHO report, it is also important to take into account the devastating effect that the environment can play in relation to health and diseases. Another WHO report, Health and Environment Tools for Effective Decision-Making, explained that environmental some factors are a root cause of a significant burden of death, disease, and disability – globally and particularly in developing countries. They range from poor water quality and access, vector-borne disease and air pollution to toxic chemical exposures, climate change, and degraded urban environments.

The report states that many of these deaths are avoidable and much of this disease is preventable. It is well documented by epidemiological studies that exposure to toxic environmental agents can potentially lead to neurological disorders. Reducing exposure to toxic environmental agents is a critical area of prevention from neurological disorders. Therefore, I fully endorse the report’s recommendation that we must translate our global knowledge base on environment and health linkages into practical policy tools and action at the national, regional, and global level, incorporating health and environmental considerations into social, economic, and political decisions.

QBRI’s Role in Tackling Dementia

At Qatar Biomedical Research Institute (QBRI), part of Hamad Bin Khalifa University – which is a member of Qatar Foundation – we place great importance on researching dementia, among other diseases.

QBRI is collaborating with Weill Cornell Medicine-Qatar and Hamad Medical Corporation in a study to identify dementia among Qatar’s population. Moreover, an important aspect of our collaboration is identifying novel biomarkers to assist with early diagnosis and prognosis of Alzheimer’s disease. According to United Nations’ estimates, more than 4,400 people over the age of 60 in Qatar have dementia.

I am extremely proud of our Neurological Disorders Research Center, which has played a major role in establishing QBRI as the regional leader for research on dementia.

An important aspect of our work relates to identifying novel biomarkers to assist with the diagnosis and prognosis of neurodevelopmental disorders e.g. autism and neurodegenerative diseases e.g. Parkinson

Qatar National Dementia Plan

The Qatar National Dementia Plan was launched by the Ministry of Public Health last year and sets out seven action areas that address those areas of dementia care which will have the most impact on improving quality of care and the patient experience.

The plan marked the first step in achieving the 2022 national target of a ‘one-year increase in Healthy Life Years for the over 65-year-old population’. It also outlines Qatar’s vision for the development and expansion of future services for people living with dementia.

Preventive Medicine

I believe the best treatment for any disease is prevention, and at QBRI, we recommend that the nation and the region should introduce a new strategy for preventive medicine.

We need to raise more public awareness and engage with schools and families. The starting point to having a healthy lifestyle is what you eat, so we need to encourage everyone to adopt a healthy lifestyle.

A healthy diet doesn’t mean simply reducing the amount of fatty foods and carbohydrates we eat; we also need to get enough nutrients.

We should avoid alcohol and any type of smoking. We need to do everything we can to lead a healthy lifestyle, and that means eating well, exercising, avoiding harmful foods and substances, getting enough sleep, and avoiding stress.

I urge everyone to follow the guidelines in the WHO report, which can be found at https://apps.who.int/iris/bitstream/handle/10665/312180/9789241550543-eng.pdf?ua=1

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ABOUT DR. OMAR EL-AGNAF

Dr. Omar El-Agnaf, the Executive Director of the Qatar Biomedical Research Institute (QBRI), is considered a pioneer in the field of neurodegenerative diseases. He is the recipient of eight regional and international awards recognizing his scientific and leadership contributions, holds 12 patents, and possesses notable experience in licensing products stemming from his novel research.

Dr. El-Agnaf was awarded a PhD in Biochemistry in 1997 from the Queen’s University Belfast, UK. His early post-doctoral work included stints at the School of Biology and Biochemistry at Queen’s University Belfast, and St. George’s Medical School in London. He was awarded a research fellowship in 2001 from the Parkinson’s Disease Society-UK to establish his research group at Lancaster University. In 2004, he was appointed to the Biochemistry Department at the College of Medicine at United Arab Emirates University. He joined the College of Science and Engineering at Hamad Bin Khalifa University in 2014, and was appointed as QBRI Executive Director in December 2018.

ABOUT QATAR BIOMEDICAL RESEARCH INSTITUTE

Founded in 2012, Qatar Biomedical Research Institute (QBRI) is a pioneering national research institute under Hamad Bin Khalifa University (HBKU), which aims to improve and transform healthcare through innovation in prevention, diagnosis, and treatment of diseases affecting the Qatari population and the region.

ABOUT HAMAD BIN KHALIFA UNIVERSITY

Innovating Today, Shaping Tomorrow

Hamad Bin Khalifa University (HBKU), a member of Qatar Foundation for Education, Science, and Community Development (QF), was founded in 2010 as a research-intensive university that acts as a catalyst for transformative change in Qatar and the region while having global impact. Located in Education City, HBKU is committed to building and cultivating human capacity through an enriching academic experience, innovative ecosystem, and unique partnerships. HBKU delivers multidisciplinary undergraduate and graduate programs through its colleges, and provides opportunities for research and scholarship through its institutes and centers. For more information about HBKU, visit www.hbku.edu.qa.