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The conference concluded with five examples of how preventive measures have been put into practice across different Nordic countries.

Elsa B. Frídfinnsdóttir, Senior Adviser, Ministry of Health, Iceland: Dementia prevention and Health-Promoting Communities in Iceland

In Iceland, considerable focus has been placed on promoting health at the community level, encouraging communities to create conditions that support both individuals and groups in maintaining their well-being.

The Health-Promoting Community is a comprehensive approach developed by the Directorate of Health in collaboration with municipalities, public institutions, and non-governmental organisations. It is based on the Ottawa Charter for Health Promotion, Health in All Policies, Healthy Cities, and Health-Promoting Schools, developed by the World Health Organization. The concept was established in 2013, with Reykjavík being one of the first to adopt it. Today, over 96% of Iceland’s population live in communities that follow this approach.

Elsa B. Frídfinnsdóttir, Senior Adviser at the Ministry of Health in Iceland, highlights successful Icelandic efforts in preventing cardiovascular disease, with a significant 80% reduction in coronary heart disease deaths among Icelanders aged 25 to 47 over the past 25 years. Notably, three-quarters of this decline is attributed to lifestyle changes.

– As we know, the same preventive measures for cardiovascular disease also apply to dementia: maintaining a healthy diet, staying active, and minimising smoking and alcohol consumption, among other factors.

Elsa B. Frídfinnsdóttir points out the importance of measurable goals, collected at the community level, as the foundation for new policies that are subsequently implemented and evaluated. Local communities need to allocate funding that prioritises health and well-being.

– This is an ongoing process. The main goal of healthy communities is to take a systematic, data-driven approach to creating environments that promote healthy behaviour, lifestyle, and well-being for all. This includes areas such as dementia prevention.

Kajsa Paniagua Iacobi, Public Health Planner, Angered Hospital, Sweden: The LeVa health promotion and lifestyle counselling model

The report Dementia prevention in the Nordics stresses that preventive measures and raising awareness are particularly important in vulnerable groups. Kajsa Paniagua Iacobi presented a model practice of how to reach groups with an immigrant background and low socioeconomic status.

Within the municipality of Gothenburg in Sweden, there are significant disparities in living standards, evident in both annual income and health outcomes. The LeVa ‘To live' clinic focuses on public health in the north-eastern part of Gothenburg, where many residents from lower socioeconomic backgrounds live.

– LeVa started as a pilot project in 2021 and is now fully operational. Our aim is to reduce health inequalities, support individuals in making healthy lifestyle choices, and promote health while preventing illnesses that would increase pressure on the health care system, society, and the individual, Kajsa Paniagua Iacobi states.

Although LeVa does not focus specifically on preventing or treating dementia, the healthy lifestyle promoted by the clinic, centred on everyday behavioural changes, could in many cases be beneficial for dementia prevention.

– Unfortunately some services such as monitoring blood cholesterol that were offered during the pilot project, have been dropped in the implemented model due to lack of resources.

Smoking, a sedentary lifestyle, unhealthy eating habits, and unemployment are some of the factors more prevalent among the LeVa clinic’s clientele compared to the general population. They also tend to seek health care less frequently.

To be more accessible, the clinic operates with two key focuses: clinical work and community collaboration. They offer drop-in hours to accommodate clients with limited digital skills. The clinic delivers its services free of charge, requires no referral, and provides translators for non-Swedish speakers. Additionally, they actively work to build trust within the community through outreach efforts and community co-creation. One example of co-creation with the residents in Angered is organising walking groups where people come together to walk in safe company and environments.

– Our challenges as health promoters are to build trust, reduce barriers, and encourage people to seek our services, as well as to engage with our clientele and ask what matters to them. It is crucial to involve the target group in the planning process of the clinic, says Kajsa Paniagua Iacobi.

Annika Tetrault, Coordinating Ward Nurse, The Wellbeing Services, County of Ostrobothnia, Finland: Seniors’Advisory Services, Ostrobothnia

The bilingual region of Ostrobothnia in western Finland has established a Seniors’ Advisory Services unit to target clients aged 65 and over who do not have regular health care services. Additionally, a FINGER network is being developed across the 14 municipalities in Ostrobothnia.

– The Ostrobothnian Seniors’ Advisory Services, in its current form, has been operational since the beginning of this year. It is still a work in progress, coordinating ward nurse Annika Tetrault says.

The objectives of the new Seniors’ Advisory Services are to shift the focus from ‘sick’ care to health care, support well-being and functional capacity, identify early risk factors for developing chronic illnesses, and prevent common age-related diseases, such as dementia.

–  We aim to provide low-threshold support with easy access to our telephone advisers. Our goal is to offer lifestyle advice based on the FINGER model for brain health, arrange group meetings, and provide individual health check-ups.

The conclusions drawn from the project so far indicate that while many services are available, the challenge lies in ensuring that both staff and clients can access them. Clients in need of lifestyle changes can be identified by the Seniors’ Advisory Services and can be referred to the appropriate programmes.

Additionally, a greater need for cooperation has been identified. Collaboration and communication between the Wellbeing County (a regional administrative body), municipalities, and other stakeholders must be improved, and the FINGER model needs to be actively integrated into daily work and activities.

– We are developing a shared digital service platform to make it easier to find activities and groups. We are also providing information internally to health care staff about the FINGER model, among other things, Annika Tetrault says.

Wilhelmina Hoffman, President, Swedish Dementia Centre, Sweden: FINGER-abc

Implementing new research-based models in the health care system is challenging and takes considerable time. The Swedish Dementia Centre, a government-funded national centre, serves as a bridge between authorities and academia on the one hand, and dementia patients and health care staff on the other.

– We aimed to make the national dementia guidelines more practical by launching a web-based learning portal in 2010. We now offer more than 15 web-based learning programmes and have successfully spread the dementia guidelines across Sweden, notes the president of the Swedish Dementia Centre Wilhelmina Hoffman.

Hoffman says the centre has recently developed a free web-based programme aimed at the public, in collaboration with Professor Miia Kivipelto, to promote the FINGER model in Sweden. The programme was launched in June 2024 to raise awareness of dementia prevention and promote brain health through the FINGER model. It was funded by Her Majesty Queen Silvia’s Foundation for Research and Education.

– The programme focuses on the core components of the FINGER model: healthy eating, physical activity, brain training, social engagement, and a health check-up. While we all know that each of these is beneficial on its own, the results are significantly better when all are done together.

The programme takes around 1.5 hours to complete and features animations, expert-led videos, and detailed texts.

– The programme will also be translated into Finnish and English. We need to spread these fantastic preventive methods as widely as possible throughout society.

Tina Normann Andersen, Manager, Municipality of Aarhus, Denmark: Demenshjørnet

The Danish city of Aarhus has branded itself as a dementia-friendly city with three key missions: to raise awareness and understanding of dementia, foster collaboration and partnerships with civil society, and offer dementia-friendly activities. The Dementia Corner, Demenshjørnet, which provides activities for people living with dementia, opened in 2014.

– The Dementia Corner is part of Aarhus municipality, where dementia prevention is a high political priority. It is aimed at people in the early stages of dementia, those with mild cognitive impairment, and their relatives.

Manager Tina Normann Andersen says that the Dementia Corner focuses on preventing the progression of the disease. It offers training courses, education, and counselling for relatives, promoting brain health and slowing the progression of the disease. 

– The training courses offer three weekly sessions of approximately three hours each over a period of 16 weeks. A course includes physical exercise, cognitive training, and cognitive stimulation therapy. The training is individually tailored and organised in groups to promote social connections and supportive relationships.

The municipality of Aarhus is dedicated to addressing the individual needs of residents living with dementia at different stages, which necessitates close cooperation between various departments within the city.