The Nottingham consensus on dementia risk reduction policy: recommendations from a modified Delphi process

Harriet Demnitz-King¹, Sube Banerjee², Claudia Cooper³, Charlotte Kenten³, Rosemary Phillips⁴, Sedigheh Zabihi³, Yvonne Birks⁵, Carol Brayne⁶, Sallyann Browning⁴, Camille Carroll⁷, Georgina Charlesworth⁸, Carol Ac Coupland^{9

10}, Tom Dening¹¹, Ruth Dobson¹², Isabelle F Foote^{12

13}, Sarah Foster¹⁴, Chris Fox^{15

16

17}, Robert Howard¹⁸, Jeremy D Isaacs^{19

20

21}, Uzma Jaffry¹⁴, Ivan Koychev^{22

23}, Gill Livingston¹⁸, David J Llewellyn^{9

15}, Richard Oakley²⁴, Magdalena Opazo Bretón²⁵, Martin Orrell¹¹, Alastair J Noyce^{12

26}, Tommy Pouncey⁴, Greta Rait²⁷, Janice Ranson¹⁵, Mohammed Rauf⁴, Vanessa Raymont²³, Elizabeth L Sampson^{3

28}, Jonathan M Schott^{29

30}, Debs Smith⁴, Xin You Tai³¹, Alison Thomson¹², Sebastian Walsh⁶, Dylan M Williams^{18

32}, Naaheed Mukadam^{18

33}, Charles R Marshall^{34

35}; National Institute of Health and Care Research Policy Research Unit in Dementia and Neurodegeneration at Queen Mary University of London (DeNPRU-QM)

Collaborators, Affiliations

Collaborators

National Institute of Health and Care Research Policy Research Unit in Dementia and Neurodegeneration at Queen Mary University of London (DeNPRU-QM):
Georgina Carr, Clarissa Giebel, Karen Harrison-Dening, Rachael M Hunter, Iain Lang

Affiliations

¹ Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University, London, UK. h.demnitz-king@qmul.ac.uk.
² Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.
³ Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University, London, UK.
⁴ DeNPRU-QM Patient and Public Engagement Group, London, UK.
⁵ Older Adults' Social Care (OSCaR) Group, School for Business and Society, University of York, York, UK.
⁶ Department of Psychiatry, Cambridge Public Health, University of Cambridge, Cambridge, UK.
⁷ Translational and Clinical Research Institute, Newcastle University, Newcastle, UK.
⁸ UCL Unit for Stigma Research (UCLUS), Clinical, Educational and Heath Psychology, Psychology and Language Sciences, University College London, London, UK.
⁹ Centre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UK.
¹⁰ Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University, London, UK.
¹¹ Institute of Mental Health, University of Nottingham, Nottingham, UK.
¹² Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University, London, UK.
¹³ Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA.
¹⁴ Alzheimer's Research UK, Cambridge, UK.
¹⁵ University of Exeter Medical School, Exeter, UK.
¹⁶ NIHR Health Technology Research Coordinating Centre, Sheffield, UK.
¹⁷ HRC in Sustainable Innovation, Exeter, UK.
¹⁸ Division of Psychiatry, University College London, London, UK.
¹⁹ Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK.
²⁰ Neuroscience & Cell Biology Research Institute, School of Health & Medical Sciences, City St George's, University of London, London, UK.
²¹ NHS England, London, UK.
²² Department of Brain Sciences, Imperial College London, London, UK.
²³ Department of Psychiatry, University of Oxford, Oxford, UK.
²⁴ Alzheimer's Society, London, UK.
²⁵ Unit of Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.
²⁶ Department of Neurology, Barts Health NHS Trust, London, UK.
²⁷ Research Department of Primary Care and Population Health, University College London, London, UK.
²⁸ Academic Centre for Healthy Ageing, Whipps Cross Hospital, Barts Health NHS Trust, London, UK.
²⁹ Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK.
³⁰ UK Dementia Research Institute, London, UK.
³¹ Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
³² Unit for Lifelong Health and Ageing, University College London, London, UK.
³³ North London NHS Foundation Trust, London, UK.
³⁴ Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University, London, UK. charles.marshall@qmul.ac.uk.
³⁵ Department of Neurology, Barts Health NHS Trust, London, UK. charles.marshall@qmul.ac.uk.

PMID: 41545741
DOI: 10.1038/s41582-025-01173-9

Review

The Nottingham consensus on dementia risk reduction policy: recommendations from a modified Delphi process

Harriet Demnitz-King et al. Nat Rev Neurol. 2026 Feb.

. 2026 Feb;22(2):123-135.

doi: 10.1038/s41582-025-01173-9. Epub 2026 Jan 16.

Authors

Collaborators

National Institute of Health and Care Research Policy Research Unit in Dementia and Neurodegeneration at Queen Mary University of London (DeNPRU-QM):
Georgina Carr, Clarissa Giebel, Karen Harrison-Dening, Rachael M Hunter, Iain Lang

Affiliations

¹ Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University, London, UK. h.demnitz-king@qmul.ac.uk.
² Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.
³ Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University, London, UK.
⁴ DeNPRU-QM Patient and Public Engagement Group, London, UK.
⁵ Older Adults' Social Care (OSCaR) Group, School for Business and Society, University of York, York, UK.
⁶ Department of Psychiatry, Cambridge Public Health, University of Cambridge, Cambridge, UK.
⁷ Translational and Clinical Research Institute, Newcastle University, Newcastle, UK.
⁸ UCL Unit for Stigma Research (UCLUS), Clinical, Educational and Heath Psychology, Psychology and Language Sciences, University College London, London, UK.
⁹ Centre for Academic Primary Care, School of Medicine, University of Nottingham, Nottingham, UK.
¹⁰ Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University, London, UK.
¹¹ Institute of Mental Health, University of Nottingham, Nottingham, UK.
¹² Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University, London, UK.
¹³ Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA.
¹⁴ Alzheimer's Research UK, Cambridge, UK.
¹⁵ University of Exeter Medical School, Exeter, UK.
¹⁶ NIHR Health Technology Research Coordinating Centre, Sheffield, UK.
¹⁷ HRC in Sustainable Innovation, Exeter, UK.
¹⁸ Division of Psychiatry, University College London, London, UK.
¹⁹ Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK.
²⁰ Neuroscience & Cell Biology Research Institute, School of Health & Medical Sciences, City St George's, University of London, London, UK.
²¹ NHS England, London, UK.
²² Department of Brain Sciences, Imperial College London, London, UK.
²³ Department of Psychiatry, University of Oxford, Oxford, UK.
²⁴ Alzheimer's Society, London, UK.
²⁵ Unit of Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.
²⁶ Department of Neurology, Barts Health NHS Trust, London, UK.
²⁷ Research Department of Primary Care and Population Health, University College London, London, UK.
²⁸ Academic Centre for Healthy Ageing, Whipps Cross Hospital, Barts Health NHS Trust, London, UK.
²⁹ Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK.
³⁰ UK Dementia Research Institute, London, UK.
³¹ Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
³² Unit for Lifelong Health and Ageing, University College London, London, UK.
³³ North London NHS Foundation Trust, London, UK.
³⁴ Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University, London, UK. charles.marshall@qmul.ac.uk.
³⁵ Department of Neurology, Barts Health NHS Trust, London, UK. charles.marshall@qmul.ac.uk.

PMID: 41545741
DOI: 10.1038/s41582-025-01173-9

Abstract

Translation of evidence about dementia risk and its reduction into effective, equitable public health policy is a major challenge. To address this challenge, the National Institute for Health and Care Research Policy Research Unit in Dementia and Neurodegeneration at Queen Mary University of London (DeNPRU-QM) convened a multidisciplinary panel of 40 experts from across England, with diverse lived, academic, clinical, policy and advocacy experience, at various career stages, and of diverse gender and ethnicity, to develop actionable policy recommendations for dementia risk reduction. Through a 2-day in-person workshop and a subsequent three-round modified Delphi survey, the panel evaluated and refined statements on dementia prevention. The panel achieved consensus on 56 recommendations in four domains: public health messaging, individual-level interventions, population-level interventions and research commissioning. A key priority across all domains was the need to consider and address health inequalities so that prevention efforts do not exacerbate existing disparities. Our recommendations provide policymakers with a robust foundation for designing and implementing an evidence-based dementia prevention strategy in England and provide guidance that can inform approaches in other countries and contexts. By prioritizing clear communication, targeted intervention and sustained research investment, the recommendations can help to address structural inequities and advance dementia risk reduction. Ongoing cross-sector advocacy will be crucial in driving policy adoption and implementation.

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Conflict of interest statement

Competing interests: H.D.-K. declares funding from ESRC Post Doctoral Fellowship ES/Z50404X/1. S.B. declares grants from the Alzheimer’s Association, the Alzheimer’s Society, Canadian Institute for Health Research, Economic and Social Research Council, Engineering and Physical Sciences Research Council, Health Education England, and National Institute for Health and Care Research (NIHR), and he has held the following positions: Executive Dean at the University of Plymouth, Non-Executive Director Somerset NHS Foundation Trust, Pro-Vice Chancellor at the University of Nottingham, Trustee of the Alzheimer’s Society, and Trustee of Morden College. C.Carroll receives a salary from Newcastle University and Parkinson’s UK. She has received advisory, consulting or lecture fees from AbbVie, Bial, Britannia, inMuneBio, Mission Therapeutics, Merz, and Roche and research funding from Cure Parkinson’s, Edmond J Safra Foundation, Gatsby Charitable Foundation, John Black Charitable Foundation, Michael J Fox Foundation, NIHR, Parkinson’s UK and van Andel Institute. I.F.F. is funded by a grant from the National Institute on Aging (NIA; R01AG073593). J.D.I. is a member of the academic steering committee for the COGNIKET-MCI Trial, a study of the effects of a nutritional intervention of ketogenic medium-chain triglycerides and B vitamins on cognitive functioning in older adults with mild cognitive impairment (Nestle Health Science), and is National Clinical Director for Dementia and Older People’s Mental Health, NHS England. G.L. declares grants from the Alzheimer’s Association, Brain Canada (ARCOM-22–875327), NIHR PGfAR (NIHR202345 and NIHR203670), the Norwegian Research Council (ES637280), Medical Research Council (MRC 7512758), Wellcome (UNS114095) and Wellcome Trust UK (221854/Z/20/Z); declares support as an NIHR Senior Investigator (NIHR201321), from North Thames NIHR Applied Research Collaboration (ID1861414), and from the University College London Hospitals NIHR Biomedical Research Centre; declares an honorarium from Prada Foundation; is a trustee of Nightingale Hammerson care homes; and is an unpaid Member of Governance Committee Global Council on Brain Health. J.M.S. is Chief Medical Officer for Alzheimer’s Research UK. S.W. declares funding from Alzheimer’s Research UK East and NIHR Doctoral Fellowship (NIHR 302276) Pump Priming Grant. All other authors declare no competing interests.

References

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The Nottingham consensus on dementia risk reduction policy: recommendations from a modified Delphi process

Collaborators

Affiliations

The Nottingham consensus on dementia risk reduction policy: recommendations from a modified Delphi process

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical