Experts provide policy roadmap to reduce dementia risk, the leading cause of death in the UK

The Nottingham Consensus, published in Nature Reviews Neurology, was led by researchers at the NIHR Policy Research Unit in Dementia and Neurodegeneration at Queen Mary University of London (DeNPRU-QM). It sets out 56 recommendations aimed at turning decades of research into tangible policy.

The recommendations span four policy areas:

1. Reforming public messaging to improve awareness of brain health and dementia risk among the public.
2. Identifying and treating individual risk factors for dementia, such as hearing loss and high blood pressure.
3. Addressing the important structural factors influencing brain health that are outside an individual’s control (such as socioeconomic deprivation and air pollution).
4. Targeting research funding to address the gaps in our understanding of how best to reduce dementia risk.

Across all the recommendations, the panel emphasised the importance of addressing health inequalities to ensure that everyone in society has the same chance of living to an old age with a healthy brain. This means creating policies that account for how individual choices interact with social, economic and environmental conditions to influence brain health across a lifetime.

Lead author Dr Harriet Demnitz-King, Postdoc Research Fellow at Queen Mary University of London, said: “We know dementia risk can be reduced, but the evidence has not yet been transformed into a coherent governmental strategy. People need clear, evidence-based guidance on protecting their brain health, but the information they receive can be confusing or make them feel blamed. What we need now is coordinated, structural action to develop dementia prevention policies that are equitable, realistic and grounded in the lives people actually lead.”

Senior author Charles Marshall, Professor of Clinical Neurology at Queen Mary University of London, said: “Dementia is now the leading cause of death in the UK, so we desperately need a clear public health plan to improve this situation. We hope that this consensus will lead to better public messaging about dementia, improved recognition and management of other conditions that increase dementia risk, a strategy on structural approaches to improving brain health, and research that addresses gaps in our knowledge about how best to do all this. Implementing our recommendations will ensure that as many people as possible live to old age without dementia.”

Dementia cases are set to triple by 2050, yet public awareness that dementia risk can be reduced remains strikingly low.The panel, made up of a diverse group of 40 experts, identified three high-priority areas for individual action where evidence is particularly strong: hearing loss, social isolation and high blood pressure. But they also warned that without structural support – such as affordable hearing services, accessible social infrastructure and effective blood pressure management – these interventions will fail to reach the people who need them most.

The Nottingham Consensus provides clear, actionable recommendations to support a policy shift towards dementia prevention in line with the 10 Year Health Plan for England. It calls for a joined-up approach that builds dementia prevention into wider government action on issues such as smoking, alcohol, pollution and social inequality. Putting the recommendations into practice would send a clear signal that, with the right structural support, dementia risk can be reduced.