Government policies targeting key risk factors for cognitive decline are potential levers for preventing or delaying dementia. Policy is therefore a central component of the exposome-the cumulative exposures shaping dementia risk across the life course. While extensive research links individual risk factors to dementia, less attention has been paid to how public policies structure these risks. We introduce the concept of the policy exposome and summarize findings from a structured expert consultation conducted by the Gateway Exposome Coordinating center (GECC) to identify priority policy research domains. We argue that systematic collection and harmonization of policy data across countries and sub-national regions can enable causal research on dementia. We propose a tiered research framework to guide policy data collection, prioritizing education, tobacco and alcohol control, air pollution, and old-age social assistance. Using tobacco control as a case study, we illustrate how policies can be operationalized as exposures linkable to dementia outcomes.

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. Translation of evidence about dementia risk into effective public health policy is a challenge. In this Consensus Statement, Demnitz-King and colleagues present 56 policy recommendations for dementia prevention, providing policymakers with a foundation for designing and implementing evidence-based dementia prevention strategies, prioritizing clear communication, targeted intervention and sustained research investment.

BACKGROUND:Evidence on whether modifiable behaviours, leisure engagement, and subjective well-being jointly shape longevity in the oldest-old (≥80 years) remains limited, especially in China. We aimed to examine the associations between modifiable factors and survival after age 80 in China. METHODS:This study comprised 30,398 participants aged 80 years and over, drawn from the Chinese Longitudinal Healthy Longevity Survey (CLHLS 1998-2018). Lifestyles (smoking status, drinking status, physical activity, and plant-based diet index), leisure activities (mental, physical, productive, and social activity), and subjective well-being were assessed using structured interviews. Median age at death after age 80 was estimated using Laplace regression. RESULTS:During follow-up, 21,648 (71.2%) participants died. Having healthy lifestyles (never smoking [4.2 months], never drinking [1.6 months], engaging in physical activity [3.4 months], eating healthful diet [2.2 months]), engaging in leisure activities (mental: 3.2 months; physical: 8.7 months; productive: 2.0 months; social: 2.8 months), and reporting high subjective well-being (5.4 months), were found to have significantly longer survival times. The median survival of people with a low-risk profile (maintained at least three healthy lifestyles, engaged in at least one leisure activity, and reported medium or high subjective well-being) was 18 months (95% CI 15.5 to 19.8) longer than that of those with a high-risk profile (unhealthy lifestyle, engaged in no leisure activities, and reported low subjective well-being). CONCLUSIONS:The study findings have demonstrated that adopting a healthy lifestyle, engaging in leisure activities, and fostering subjective well-being are associated with longer life expectancy among the oldest old in China.

Cellular senescence may affect the post-mitotic cells of the brain. We examined the expression of senescence markers, including p16, p21, γH2Ax and H3K9me3, in the frontal cortex of brain donations from the Cognitive Function and Ageing Study to assess their relationship to Alzheimer’s disease neuropathological change (ADNC) and dementia. p21, γH2Ax and H3K9me3 were expressed in pyramidal neurons and glia, whilst p16 was confined to glial cells. p21 and γH2Ax were correlated in neurons, and with p16 in glia. They did not increase with ADNC, tending to be higher at early Braak neurofibrillary tangle stages. Transcriptomic profiling of pyramidal neuron-enriched samples at low Braak stages showed that higher neuronal p21 expression was associated with altered pathways for neuronal function, neurodegeneration, protein homeostasis, mitochondrial dysfunction and synaptic signalling. In conclusion, the different expression profile of senescence markers in neurons and glia suggest possible differences in senescence-related mechanisms. Expression at lower ADNC stages suggests senescence may be important at earlier stages of Alzheimer’s pathogenesis, whilst transcriptomic changes suggest an impact on neuronal function. The lack of association of senescence markers with dementia status indicates that more work is needed to determine the value of senescence as a therapeutic target for dementia.

INTRODUCTION:We aimed to explore the potential incremental cost-effectiveness of the PRODEMOS coach-supported mobile health intervention for primary prevention of dementia versus standard of care provided to people aged 55-75 years with low socio-economic status (SES) in the United Kingdom (UK), and any SES in China. METHODS:12-18-month PRODEMOS trial (ISRCTN15986016) efficacy outcomes on hypertension, obesity, hypercholesterolemia, physical inactivity and smoking were extrapolated to lifetime impact on dementia onset, myocardial infarction, stroke and death using a health-economic open-source simulation model. RESULTS:Simulated outcomes showed dementia cases were avoided (UK = -206 (-658 to 281), China = -140 (-456 to 205) per 100,000 persons) and disease-free time was gained for dementia, myocardial infarction and stroke (mean months per person UK = 0.4, 0.0 and 0.0; China = 0.2, 0.0 and 0.0 respectively). Assuming a maximum intervention duration of 10 years with a 10 % annual non-adherence rate, the incremental net health benefit in the UK (-0.190) and China (-0.009) indicated a potential lack cost-effectiveness. LIMITATIONS:Our method was limited by strong assumptions regarding causality and sustained effectiveness, lack of some country-specific input estimates, and the lack of probabilistic analysis. CONCLUSION:The PRODEMOS coach-supported mobile health intervention for the primary prevention of dementia, aimed at people aged 55 to 75 years with low SES in the UK and those of any SES in China, may potentially lack cost-effectiveness in both countries. However, lack of data required strong assumptions regarding causality and sustained effectiveness, which limited policy recommendations.

Importance:Reliable global estimates of the incidence and prevalence of dementia with Lewy bodies (DLB) are lacking, limiting understanding of its epidemiology and burden. Objective:To estimate pooled incidence and prevalence of DLB from population-based studies worldwide, overall and by age and sex. Data Sources and Study Selection:PubMed, Embase, and Scopus were systematically searched from inception to October 22, 2024, for population-based studies reporting DLB incidence and/or prevalence based on validated diagnostic criteria. Data Extraction and Synthesis:Three reviewers independently screened studies, extracted data, and assessed risk of bias according to PRISMA guidelines. Incidence and prevalence estimates were pooled using random-effects meta-analysis. Subgroup and sensitivity analyses explored variation by age, sex, and study design. Main Outcomes and Measures:Incident and prevalent DLB cases defined by consensus, Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases diagnostic criteria, with denominators based on census or author-defined population at risk. Results:From 2520 records screened, 16 population-based studies were included and 12 contributed to meta-analyses. In individuals 65 years or older, pooled incidence was 46.85 per 100 000 person-years (95% CI, 23.78-92.30) and pooled prevalence 352.26 per 100 000 population (95% CI, 112.25-1099.79). In individuals younger than 65 years, pooled incidence was 0.34 per 100 000 person-years (95% CI, 0.14-0.83) and prevalence 2.52 per 100 000 population (95% CI, 1.43-4.44). Incidence was higher in males (5.45; 95% CI, 4.13-7.19) than females (4.32; 95% CI, 2.48-7.52). Across all ages, pooled crude incidence was 4.79 (95% CI, 3.90-5.88). Only 1 study reported all-age prevalence (19.13; 95% CI, 15.38-23.51). Between-study heterogeneity was high (I2 ≥ 85%). Conclusions and Relevance:In this systematic review and meta-analysis of population-based studies, clinically diagnosed DLB was uncommon, likely reflecting underdiagnosis and diagnostic insensitivity. Reported incidence and prevalence rose steeply with age, were higher in men, and varied widely across settings. These findings provide a robust reference for future epidemiologic research and public health planning, underscoring the need for standardized diagnostic approaches and inclusion of underrepresented populations to refine global burden estimates.

Background:Dementia is a leading cause of disability and mortality in Europe, yet no recent harmonised assessment has described its impact across the European Union (EU-27) and the WHO European Region. Methods:We used data from the Global Burden of Disease Study 2023 (GBD 2023) to estimate prevalence, mortality, and disability-adjusted life years (DALYs) for dementia from 1990 to 2023. Estimates were produced for the EU-27 and the WHO European Region, by age and sex. Non-fatal outcomes were modelled using DisMod-MR 2.1, and dementia-attributable mortality was estimated using an excess-mortality framework. We also quantified DALYs attributable to six modifiable risk factors. Findings:In 2023, 7.76 million people (95% UI 6.69-8.72) were living with dementia in the EU-27 and 12.28 million (10.44-13.90) in the WHO European Region, representing ∼90% increases since 1990 despite modest declines in age-standardised prevalence. Prevalence was nearly twice as high in women as in men. Dementia rose from the eighth to the third leading cause of death in the EU-27. Dementia accounted for 5.49 million DALYs (2.44-11.41) in the EU-27. An estimated 41% (24.4-57.4) of dementia DALYs in the EU-27 were attributable to modifiable risk factors, particularly ambient particulate matter pollution, high fasting plasma glucose, and high body-mass index, which are disproportionately concentrated in socioeconomically disadvantaged populations. Interpretation:Despite modest declines in age-standardised rates, the absolute burden of dementia in Europe continues to rise, driven by population ageing. The substantial contribution of modifiable risk factors highlights major opportunities for prevention. Robust, country-specific estimates are essential to guide integrated strategies combining prevention and care planning. Funding:Regione Puglia and CNR for Tecnopolo per la Medicina di Precisione; Regione Puglia for the national "Fund for Alzheimer's and Dementia 2021-2023" (Piano Regionale Demenze 2021/2023).

The Harmonized Cognitive Assessment Protocol (HCAP) is a detailed battery assessing cognition among older people used by studies across the world. Data harmonization is a key priority for HCAP studies. Errors or artefacts introduced during data collection become embedded in the dataset and cannot be fully resolved through post-hoc statistical adjustment alone. We used a mixed-methods approach using established theories from the existing literature on methodologies of longitudinal studies and the implementation of HCAP in four English-speaking studies adopting the same protocol. Through a detailed investigation involving the English Longitudinal Study of Ageing (ELSA), the Health and Retirement Study (HRS), The Irish Longitudinal Study on Ageing (TILDA), and the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA), we identified 60 factors contributing to the development of a conceptual framework for the evaluation and implementation of HCAP. We present this framework and a prototype checklist as a tool for providing a transparent and structured approach to improve data quality, cross-country comparability and for identifying, mitigating, and monitoring sources of bias. The framework consisting of four broad headings: (1) Organisation and design, (2) Competency of personnel and systems, (3) Implementation and outputs, and (4) Feedback and communication. This framework aims improves data quality at the point of collection, designed to complement and not replace, post-hoc statistical harmonization. By strengthening data at the outset enables subsequent harmonization to be more robust. We recommend studies seeking cross-national comparability to give careful consideration to operational aspects of fieldwork.

Dementia is a leading health policy challenge, with cases expected to triple by 2050, particularly in low- and middle-income countries. Epidemiological evidence demonstrates falling age-specific incidence rates in high-income countries, suggesting risk can be lowered at the population level.The Population-Level Approaches to Dementia Risk Reduction (PLADRR) Research Group is a diverse, international network of researchers committed to investigating how structural, social, and environmental conditions can promote life course brain health and reduce dementia risk across the population.This Policy Forum article sets out the guiding principles of our approach, the building blocks required, our research priorities, and how PLADRR research can inform and translate into policy changes.

Abstract Background Health insurance is key in pooling resources for increased access to health services. There is currently no national health insurance scheme (NHIS) in Uganda and determining the profile of individuals with alternative health insurance can support future planning. The aim of this analysis was to explore the association between health insurance coverage and sociodemographic factors, health service utilisation and healthcare seeking behaviour in the 2016 Uganda Demographic and Health Survey (2016 UDHS). Methods Descriptive statistics and bivariate Pearson’s chi-square tests of association were conducted for 18,506 women and 5,336 men sampled in the 2016 UDHS. Significant variables at p < 0.05 informed the multivariable mixed effects Poisson regression analysis; this examined associations between health insurance coverage, sociodemographic factors, health service utilisation, and knowledge of insurance. Analyses were carried out using R Programming. Results Among the low proportion (1.4%) of individuals with health insurance, coverage widened with increasing wealth and education levels. Results of the regression analysis suggested a positive association between health service utilisation and being married, and increasing age, wealth, and knowledge of health insurance. Conclusions Findings demonstrated a very low health insurance coverage among the 2016 UDHS. Adjusting for wealth and age, higher education levels were positively associated with coverage, indicating the importance of education in understanding health risk. Beyond an inclusive approach for vulnerable population groups, strategies for the NHIS need to incorporate sensitisation to stakeholders on the need for a personal health safety net. Further work on exploring how to ensure equity and financial risk protection in the NHIS implementation may be key to informal sector inclusion.

Abstract Background Subjective cognitive decline (SCD) is considered an early preclinical marker for Alzheimer’s disease (AD). However, prevalence estimates vary widely due to inconsistent definitions. SCD Plus criteria were proposed by experts to improve specificity for preclinical AD. Population-based evidence on the prevalence and correlates of SCD Plus remains limited. Methods Data from three population-based European cohorts (LIFE-Adult-Study, English Longitudinal Study of Ageing, and Cognitive Function and Ageing Study) comprising adults aged ≥ 60 years without dementia or marked cognitive impairment were harmonized to derive a common definition of SCD Plus based on available core criteria. Generalized linear models examined correlates of SCD Plus in pooled and study-specific analyses. Results Among 18,795 participants (mean age (SD): 72.1 (6.8) years; 55.5% women), prevalence of SCD Plus, based on the harmonized operationalization, was 37.9% (33.3–53.7% across cohorts). In pooled analyses, SCD Plus was associated with higher education, depression, anxiety, hypertension, diabetes, heart disease, Parkinson’s disease, and history of stroke, and inversely associated with smoking and better cognitive performance. Study-specific analyses additionally indicated associations with sleep and hearing-related problems, lower physical activity, thyroid disease, and personality traits (higher neuroticism and lower openness, agreeableness, conscientiousness). Discussion SCD Plus was highly prevalent in three large European cohorts, assessed using a harmonized operationalization approach. Associations with several established, modifiable dementia risk factors underscore the relevance of SCD Plus for clinical risk assessment. Longitudinal studies are needed to determine whether the identified correlates influence subsequent cognitive decline in individuals with SCD Plus.

This study estimates pooled incidence and prevalence of dementia with Lewy bodies from population-based studies worldwide, overall and by age and sex. QuestionWhat are the incidence and prevalence of dementia with Lewy bodies (DLB) in population-based studies?FindingsIn this systematic review and meta-analysis, including 16 population-based studies from diverse world regions, the pooled incidence of DLB was 4.79 per 100 000 person-years. Incidence and prevalence rose sharply with age and were higher in males, and only 1 study reported all-age prevalence (19.13 per 100 000).MeaningDLB is a predominantly late-onset dementia with higher frequency than several other uncommon neurodegenerative disorders; standardized diagnostic practices and inclusion of underrepresented regions are essential to refine global estimates and guide policy and health care planning. ImportanceReliable global estimates of the incidence and prevalence of dementia with Lewy bodies (DLB) are lacking, limiting understanding of its epidemiology and burden.ObjectiveTo estimate pooled incidence and prevalence of DLB from population-based studies worldwide, overall and by age and sex.Data Sources and Study SelectionPubMed, Embase, and Scopus were systematically searched from inception to October 22, 2024, for population-based studies reporting DLB incidence and/or prevalence based on validated diagnostic criteria.Data Extraction and SynthesisThree reviewers independently screened studies, extracted data, and assessed risk of bias according to PRISMA guidelines. Incidence and prevalence estimates were pooled using random-effects meta-analysis. Subgroup and sensitivity analyses explored variation by age, sex, and study design.Main Outcomes and MeasuresIncident and prevalent DLB cases defined by consensus, Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases diagnostic criteria, with denominators based on census or author-defined population at risk.ResultsFrom 2520 records screened, 16 population-based studies were included and 12 contributed to meta-analyses. In individuals 65 years or older, pooled incidence was 46.85 per 100 000 person-years (95% CI, 23.78-92.30) and pooled prevalence 352.26 per 100 000 population (95% CI, 112.25-1099.79). In individuals younger than 65 years, pooled incidence was 0.34 per 100 000 person-years (95% CI, 0.14-0.83) and prevalence 2.52 per 100 000 population (95% CI, 1.43-4.44). Incidence was higher in males (5.45; 95% CI, 4.13-7.19) than females (4.32; 95% CI, 2.48-7.52). Across all ages, pooled crude incidence was 4.79 (95% CI, 3.90-5.88). Only 1 study reported all-age prevalence (19.13; 95% CI, 15.38-23.51). Between-study heterogeneity was high (I2 >= 85%).Conclusions and RelevanceIn this systematic review and meta-analysis of population-based studies, clinically diagnosed DLB was uncommon, likely reflecting underdiagnosis and diagnostic insensitivity. Reported incidence and prevalence rose steeply with age, were higher in men, and varied widely across settings. These findings provide a robust reference for future epidemiologic research and public health planning, underscoring the need for standardized diagnostic approaches and inclusion of underrepresented populations to refine global burden estimates.

Introduction:Helicobacter pylori (H. pylori), herpes simplex-1 (HSV-1), and varicella-zoster virus (VZV) could increase dementia risk; however, evidence from large cohorts with long-term follow-up is scarce. Methods:Multivariable-adjusted Cox proportional-hazards models were used to investigate the association between H. pylori, HSV-1, and VZV seropositivity and dementia risk over 24 years in 8550 participants from the European Prospective Investigation into Cancer in Norfolk study in the United Kingdom. Results:H. pylori (hazard ratio [HR] = 1.24, 95% confidence interval [CI]: 1.09 to 1.41), but not HSV-1 (HR = 1.03, 95% CI: 0.91 to 1.18) or VZV (HR = 1.01, 95% CI: 0.86 to 1.19), was associated with dementia risk. The H. pylori-dementia association remained robust among incident cases >15 years after blood draw (HR = 1.26, 95% CI: 1.06 to 1.48). Seropositive tertiles of the H. pylori antibodies CagA (p = 0.007) and GroEL (p = 0.001) demonstrated significant trends with dementia risk. Discussion:H. pylori may represent a novel dementia prevention target, although early-life socioeconomic factors might confound the association.

BACKGROUND:Parkinson's disease (PD), multiple sclerosis (MS) and motor neurone disease (MND) are progressive and debilitating diseases that are increasing in prevalence globally. Some primary studies show an increased risk from long-term outdoor air pollution exposure, while others contradict this association. METHODS:A systematic review and meta-analysis were undertaken to assess the associations of long-term (≥1 year) outdoor air pollution exposure with PD, MS and MND incidence. We searched eight databases for publications up to July 2025. Primary case-control, cohort, cross-sectional or ecological studies investigating the association between long-term air pollution exposure and adult (>18 years old) PD, MS, or MND incidence were included. Meta-analyses were carried out using random-effects models with assessment of heterogeneity, meta-bias and shape of the exposure-response functions. PROSPERO (CRD42023417961). RESULTS:Of 42 papers included, 26, 3 and 3 were meta-analysed for PD, MS, and MND outcomes, respectively. 19 studies from North America, 12 from Europe and 10 from Asia were meta-analysed. For every 5 μg/m3 and 15 μg/m3 increase of Particulate Matter 2.5 (PM2.5) and PM10 concentration, estimated (95% Confidence Interval) PD risk was 10% (1.10; 1.03-1.19) and 18% (1.18; 1.01-1.38), respectively but effects varied across settings (Prediction Interval: 0.80-1.52 for PM2.5 and 0.41-3.36 for PM10), with the largest estimated risk for PM2.5 in Asia (1.19; 1.01-1.41). There was no clear evidence that PM2.5 (1.01; 0.77-1.32) or nitrogen dioxide (NO2, 0.98, 95% CI: 0.95-1.01) were associated with MS risk or PM2.5 with MND risk (1.07, 95% CI: 0.86-1.33). CONCLUSION:This systematic review reports increased PD risk from long-term PM2.5 and PM10 exposure. No association was observed for MS and MND from a very limited evidence base. The neurodegenerative diseases investigated here are rare and therefore alternatives to insufficiently powered cohort studies are needed to strengthen the evidence on risk.

BACKGROUND:Although global estimates for dementia risk reduction are available, risk profiles might differ in a high-income, welfare-state setting. Few studies have been conducted that simultaneously estimate the prevalence of dementia risk factors and their associated risk of dementia within the same nationwide population. We aimed to estimate the relative risk of dementia and the population attributable fractions (PAFs) for 16 potentially modifiable risk factors, their combinations, and their interactions based on routinely collected health registry and survey data. METHODS:We conducted a nationwide cohort study based on data from Danish registries and the Danish National Health Survey (DNHS). The whole population, which included individuals born in or before 1957 who were alive, living in Denmark, and dementia-free at the start of follow-up, was followed up from age 65 years, or Jan 1, 2010 (whichever came last); individuals with additional data from the DNHS formed a subpopulation. Follow-up ended at death, emigration, dementia diagnosis, or on Dec 31, 2022 (whichever came first). The primary outcome was incident all-cause late-onset dementia diagnosis (age ≥65 years). We calculated dementia hazard ratios and PAFs for 16 risk factors (depression, traumatic brain injury, hospital-diagnosed infections, vision impairment, cardiovascular disease, sleep disorders, diabetes, hearing loss, hypercholesterolaemia, low education, hypertension, physical inactivity, social isolation, smoking, alcohol consumption, and obesity), as well as their combinations, and interactions between risk factors. Analyses were stratified by sex, birth cohorts, and educational level. Sensitivity analysis included accounting for reverse causation by splitting the risk time into less than 5 years and more than 5 years since exposure. FINDINGS:The whole population comprised 1 753 515 individuals, of whom 194 368 had additional DNHS data. The overall PAF for dementia in Denmark was 37·8% (95% CI 35·6-40·0) for the assessed risk factors. PAF for individual risk factors was highest for hospital-diagnosed infections (9·4% [9·3-9·4]), depression (8·7% [8·6-8·8]), and cardiovascular disease (CVD; 7·6% [7·6-7·7]). After accounting for reverse causation, the PAF for hospital-diagnosed infections was 7·0% (95% CI 6·9-7·0), and 5·7% (5·7-5·8) for depression. The apparently protective effect of obesity on dementia was also shown to be driven by reverse causation. The overall PAF was higher in males, 1948-57 birth cohorts, and individuals with low education. Risk factor profiles varied by sex and birth cohorts. Risk factor combinations involving depression, hospital-diagnosed infections, or CVD showed the strongest superadditive effects. Interactions between some risk factors were seen in only some of the studied subgroups (eg, in the 1948-57 birth cohorts and individuals with low education). INTERPRETATION:These findings reinforce the need for tailored dementia interventions building on country-specific evidence. Our findings on interactions between different risk factors are important for generating novel hypotheses on the mechanisms underlying dementia disorders and highlighting at-risk population groups for whom targeting of one risk factor could reduce the risk associated with the co-occurring factor. FUNDING:The Alzheimer-forskningsfonden, the KID foundation, and the Danish Ministry of Health.

INTRODUCTION:Evidence suggests that up to 40% of dementia risk is modifiable (Livingston et al., 2020, Lancet). However, the majority of interventional evidence for dementia risk reduction relies on individual behaviour change, which does not account for social context and is unlikely to produce benefit at scale (Walsh et al., 2022, Lancet Healthy Longevity). Canada has been a leader in dementia research globally but has lagged in policy supporting dementia prevention and risk reduction. Our objective was to review existing dementia strategies and policies to assess their focus on population-level prevention and risk reduction in the Canadian context. METHODS:Primary research databases and grey literature (PubMed, healthevidence.org, customized google search databases) were searched using terms related to "dementia", "policy", and "province/territory". Results were independently double-screened, and included if they were active, finalised policy documents, written in French or English, explicitly focused on dementia from a Canadian provincial or federal authority. Data were extracted based on directed content analysis into pre-determined categories that were iteratively updated: 1) priorities/actions/interventions addressing prevention or risk reduction; 2) Equity and inclusion; 3) Implementation and evaluation. RESULTS:Seven of thirteen provinces/territories had published dementia strategies, in addition to a national strategy. Only half included any risk reduction/prevention in their priorities, all of which were public awareness raising activities. People living with dementia and their caregivers were included in 5/8 strategies and few provinces had an implementation plan or dedicated funding. CONCLUSION:Canadian dementia policy does not prioritize prevention, particularly risk reduction strategies that are population-based and stand to create the most impact. Future dementia strategies should focus on population-level prevention and risk reduction as a key priority in order to produce large, equitable reductions in dementia prevalence. Further, input from people with lived experience should be integral to the development of new policies, as well as built-in organizational accountability and funding to ensure timely uptake and success of policy objectives.