World Day

Alzheimer's, -40% cases with healthy living and rehabilitation becomes a right for patients and caregivers

Dementia in Italy affects up to 10% of the population among the more than 2 million people affected in various forms and the 4 million family members: recipes to act in advance with prevention on lifestyles and diseases and with 'maintenance' interventions in those already diagnosed

by Barbara Gobbi

19 September 2025

6' min read

6' min read

On the one hand, prevention as a 'powerful lever' that can avert up to 40% of dementia cases. On the other, rehabilitation capable of maintaining cognitive functions and autonomy for longer, when the disease is over, improving the life of both the patient and his or her caregiver. And, a factor of no small importance with the explosion of chronicity and the ageing of the population, to delay admission to facilities and hospital admissions so as to alleviate an expenditure estimated, for our country, at between 15 and 23 billion euros a year, 60-70% of which is borne by families.

The numbers

The world and Italy - where the Permanent Table on Dementia is working on updating the National Plan on these diseases - present themselves with these two weapons for the World Alzheimer's Day on 21 September. If the war against the disease is still far from being won, much can be done to corner it for as long as possible. Much can be done by governments, but so much can be done by each one of us, to counter staggering numbers in our country alone: an estimated 1.6 million people with dementia, 6-700 thousand of whom are diagnosed with Alzheimer's, plus 950 thousand individuals with mild cognitive impairment. While the Higher Institute of Health estimates that there are around 24 thousand cases of dementia in the 35-64 age group. The bill is a hefty one: if caregivers are also taken into account, amounting to around 4 million people affected, the estimate is that around 10 per cent of the Italian population is faced with this problem, as reported by the National Alzheimer's and Dementia Fund Report 2021-2023 of the Iss.

'The issue of rehabilitation will have to be included in the new Plan, ensuring that this type of intervention is an integral part of the care and assistance pathways,' says Mario Possenti, secretary general of the Federation. 'We need a real cultural change: we must stop thinking that life ends with the diagnosis of dementia. A person can still live a long life, fully and with dignity, if he or she has access to effective and personalised support, capable of enhancing residual abilities and accompanying the family. In a country where the overall costs of dementia exceed EUR 23 billion per year, more than 60 per cent of which is borne directly by families, investing in rehabilitation and support is not only an ethical duty, but also a strategic and sustainable choice for our future'.

The Prevention Decalogue

Like in a mirror, on one side are our 'good deeds' as individuals, and on the other those that governments are called upon to foster or put in place. Even if, as the World Health Organisation reminds us, there is even a risk of a retreat in general strategies against chronic diseases while 75% of states, the World Alzheimer Report 2025 certifies, still do not have a national plan for dementia.

In the prevention decalogue put together by the Alzheimer's Federation Italy by Simone Salemme, neurologist and consultant to the Istituto Superiore di Sanità (Iss) and Davide Mangani, immunology researcher at the Institute for Research in Biomedicine in Bellinzona, well-known 'defendants' appear: from hypertension to diabetes, from smoking to alcohol and poor diet. On the other hand, less immediately obvious as protective factors are attention to sight and hearing, active social relationships, exercise and the prevention of accidents and injuries. But here are the experts' tips for preventing dementia.

1. Blood pressure under control.

Hypertension is a 'silent killer': keeping it under control means protecting your heart and brain.

- What the individual can do: measure blood pressure regularly, follow prescribed medication, reduce salt use, maintain an active lifestyle, keep weight under control.

- What society can do: promote widespread screening, facilitate access to medicines, design cities that encourage movement, with parks and cycle paths.

2. Ldl cholesterol: knowing and treating it

High cholesterol in middle age increases the risk of dementia and stroke.

- What the individual can do: keep lipid levels under control, follow a Mediterranean diet, exercise, do not smoke and limit alcohol.

- What society can do: offer affordable cardiovascular check-ups, ensure access to drugs and therapies, promote policies for healthy eating and the use of clear nutrition labels.

3.Protect your hearing

Untreated hearing loss, often due to cost and stigma, promotes isolation and cognitive decline.

- What the individual can do: get screened after the age of 60, use hearing aids if necessary, protect hearing from noise (using earplugs if necessary and moderating the volume of TV, radio, etc.), lead an active social life.

- What society can do: make aids and rehabilitation accessible, create public environments with assistive listening (i.e. ensure that auditoriums, theatres and community spaces are equipped with sound systems that allow accessibility for people with hearing loss), promote campaigns to combat stigma.

4. Protect your sight

Seeing well maintains autonomy and cognitive stimulation.

- What the individual can do: have regular eye examinations, use appropriate glasses or lenses, do not postpone necessary operations such as cataracts, use adequate home lighting.

- What society can do: reduce waiting lists for surgery, promote vision screening, make eye care accessible, improve lighting and public signage.

5. Regular physical activity

Movement is one of the most effective weapons for brain health.

- What the individual can do: walking, swimming, dancing, alternating aerobic and strengthening exercises, to break the sedentary lifestyle.

- What society can do: develop 'active friendly' cities, support gyms and social programmes, encourage active mobility and public transport, promote physical activity with national awareness campaigns.

6. Mediterranean-type diet

The Mediterranean diet protects against inflammation and cognitive decline.

- What the individual can do: consume fruit, vegetables, whole grains, pulses, fish, olive oil; limit sugar and processed foods.

- What society can do: guarantee 'Mediterranean' public, school and work canteens, make fresh food more accessible, support local supply chains, discourage the spread of ultra-processed food with appropriate fiscal policies.

7. Stop smoking and alcohol excesses

Tobacco and alcohol damage the vessels, raise blood pressure and promote inflammation and brain atrophy.

- What the individual can do: stop smoking, avoid passive smoking, limit alcohol and avoid 'binge drinking'.

- What society can do: strengthen anti-smoking policies, offer addiction support services, regulate alcohol sales and advertising.

8. Diabetes, weight and metabolic health.

Type 2 diabetes and obesity increase the risk of dementia.

- What the individual can do: monitor blood sugar and weight, follow treatment, adopt a healthy lifestyle, get enough sleep and watch out for excessive stress.

- What society can do: activate prevention programmes, facilitate access to nutritionists, adopt policies limiting the consumption of sugary drinks, promote policies to ensure equity in access to healthy food.

9. Active mind and social relations

Relationships and mental stimuli strengthen the cognitive reserve.

- What the individual can do: learn new things, cultivate hobbies, participate in social activities, seek help in case of depression.

- What society can do: ensure quality education from childhood onwards, promote community centres and libraries, support third age universities, ensure accessible mental health services.

10. Beware of environmental hazards and trauma

Accidents and air pollution also affect brain health.

- What the individual can do: wear helmets when cycling and scootering; use appropriate protective equipment for sporting activities; prevent falls at home by using non-slip carpets, handrails and adequate lighting; reduce home combustion; prefer less polluted places.

- What society can do: implement 'clean air' plans to reduce traffic and combustion, increase urban greenery, strengthen road safety and prevention of falls in the home, make housing and neighbourhoods fit for the elderly.

Rehabilitation needed

Considering the rehabilitation of people with dementia as a right and therefore integrating it into national plans against the disease: this is the urge of the World Alzheimer Report 2025, which in this sense converges with the guidelines for the diagnosis and treatment of dementia drawn up by the Istituto Superiore di Sanità when they recall the importance of physical exercise - including walking, gentle gymnastics, exercise bikes and balance and muscle strengthening exercises - and approaches such as music therapy, reminiscence therapy and other creative and social activities.

In general, personalised rehabilitation in the World Report on Dementia is referred to as 'evidence' that can improve targeted daily functioning for people with dementia and can delay the loss of independence, but this clashes with the persistent global gap in access and the scarcity of resources and targeted interventions. In fact, the Report states, people with dementia rarely have access to rehabilitation, despite evidence that they may benefit from it. Yet smart (specific, measurable, achievable, relevant and time-limited) goals are part of an effective rehabilitation approach for people living with dementia. While studies have shown that people who engaged in individually tailored cognitive rehabilitation had lower levels of disability than people who received only standard care and remained in their homes for six months longer than average before moving to residential care.

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