What is this guideline about?
This guideline makes recommendations on approaches in mid‑life to delay or prevent the onset of dementia, disability and frailty in later life. These terms describe sets of symptoms and outcomes that can be caused by a wide range of conditions.
The risk of dementia, disability and frailty will sometimes be determined by factors that can't be changed, such as inherited conditions or injury. But changing specific risk factors and behaviours can reduce the risk of dementia, disability and frailty for many people. These changeable factors – smoking, lack of physical activity, alcohol consumption, poor diet and being overweight – are the focus of this guideline.
While various local and national interventions, policies and programmes for non‑communicable chronic conditions are already in place that could reduce the risk of dementia, disability and frailty, they rarely include these conditions within their scope, nor include information on risk reduction. The aim is to delay the onset of dementia, disability and frailty, increasing the amount of time that people can be independent, healthy and active in later life (successful ageing) by:
helping people stop smoking, be more active, reduce alcohol consumption, improve their diet and, if necessary, lose weight and maintain a healthy weight
reducing the incidence of other non-communicable chronic conditions that can contribute to onset of dementia, disability and frailty
increasing people's resilience, for example by improving their social and emotional wellbeing.
The guideline is for commissioners, managers and practitioners with public health as part of their remit, working in the public, private and third sector. (For further details, see who should take action?) It may also be of interest to policy makers and members of the public.
This guideline focuses on interventions and actions delivered at national, regional and local level to reduce risk of dementia, disability and frailty in later life. It does not include recommendations about national policy or legislation, as this was specifically excluded in the remit given to NICE. There are, however, existing NICE guidelines that include recommendations on national policy to support behaviour change and assist local action, and these are cross‑referenced in this guideline where appropriate. Key related guidelines include prevention of cardiovascular disease and alcohol-use disorders: prevention.
See about this guideline for details of how the guideline was developed and its current status.
 Mid‑life is defined as adults aged 40–64 years, or those aged 39 years or under from disadvantaged populations (this group is at increased risk of ill health and more likely to develop multiple morbidities).