The “Technical Guidelines for Implementing a Healthcare Pathway for Integral Health for Older People” mentions about potentially modifiable risk factors such as physical inactivity, smoking, low cognitive activity etc. (Brazilian Ministry of Health, 2018e). In addition, primary healthcare policies, such as the Family Health Strategy, carry an important role in the reduction of risk factors for dementia, even though this policy has not been developed specifically for dementia, but for cardiovascular disease and diabetes mainly. The primary healthcare policies, among other things, promote preventive actions towards hypertension, diabetes, promotion of healthier lifestyles etc. which may contribute to the risk reduction of dementia.

References:

Brazilian Ministry of Health. (2018e). Orientações Técnicas para a Implementação de Linha de Cuidado para Atenção integral à Saúde da Pessoa Idosa no Sistema Único de Saúde—SUS. Ministério da Saúde do Brasil.

The Elderly Services Programme Plan (ESPP) proposes a recommendation on strengthening health maintenance, risk reduction, and illness prevention.

• Recommendation 4a – “For the prevention of health deterioration, the provision of suitable services to elderly persons with mild impairments should be strengthened, such as through enhancing Integrated Home Care Services (Ordinary Cases) in order to focus on these elderly persons” (Working Group on Elderly Services Programme Plan, 2017, p. 24).

References:

Working Group on Elderly Services Programme Plan, Elderly Commission of Government of Hong Kong SAR,. (2017). Elderly Services Programme Plan. Hong Kong: Elderly Commission of Government HKSAR Retrieved from https://www.elderlycommission.gov.hk/en/download/library/ESPP_Final_Report_Eng.pdf.

Risk reduction and prevention for dementia is addressed in part through the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS) (MoHFW, 2017b). While the NPCDCS does not specifically mention dementia, it addresses risk factors and co-morbid conditions in persons with dementia. This could involve screening for risk factors and promoting healthy behaviours to reduce risk of dementia.

References:

Ministry of Health and Family Welfare. (2017b). National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases and Stroke (NPCDCS).

The third action step focuses on dementia prevention and risk. It emphasises the accessibility of information on healthcare services which comply with the minimum standard for older people. This is consistent with the health promotion emphasised in the first action step, which focuses on the promotion of a healthy lifestyle (Ministry of Health Republic of Indonesia, 2015b).

References:

Ministry of Health Republic of Indonesia. (2015b). National Strategy: Management of Alzheimer and Other Dementia Diseases: Towards Healthy and Productive Older Persons. Ministry of Health Republic of Indonesia.

Not applicable.

It points to the need to strengthen prevention campaigns against diabetes, obesity, hypertension, and physical inactivity, in order to reduce risk factors associated with dementia.

NZ Dementia framework:

Dementia prevention and risk reduction are included in the same section as dementia awareness. Good practice points provided include encouraging people to live healthy and physically active lifestyles, provide education to primary health care services on the importance of risk reduction strategies, encourage cooperation between agencies to improve the health and wellbeing of the local population and engage with national public health campaigns to add the message ‘What is good for the heart is good for the brain’.

Dementia Action Plan:

The dementia plan includes the action point on Reducing the incidence of dementia. Action points recommend working with health promotion agencies to work with colleagues involved with other key non-communicable diseases and population health to design and implement a health promotion programme that includes dementia prevention/brain health protection.