Brain health strategies in middle-aged individuals with mild neurocognitive disorder: a scoping review

Brain health refers to optimal brain functioning and integrity, shaped by complex cognitive, psychological, and social determinants. Individuals with mild neurocognitive disorder (mNCD) are at higher risk of developing dementia. Prioritising brain health is essential throughout the lifespan, particularly at midlife when health risks often emerge alongside heavy life responsibilities. International frameworks emphasise addressing modifiable risk factors across the lifespan to reduce dementia risk, yet little is known about the strategies middle-aged individuals with mNCD use to maintain brain health in everyday life. Understanding how people in midlife interpret and act on information about brain health is essential to align clinical care and prevention policies with lived experience. This scoping review followed the Joanna Briggs Institute methodology and mapped data published from August 2015 to 2025 using the 2024 Lancet Commission on dementia and the Cochrane PROGRESS-Plus equity framework. The primary aim of this review was to map the range and characteristics of non-pharmacological brain health strategies used by middle-aged individuals with mNCD to reduce the risks of developing dementia. After screening 6349 records, 17 articles were included. The results are presented in three groups: brain health strategies, facilitators and barriers across strategies, and the equity analysis. Strategies were classified as formalised interventions and self-directed practices. Facilitators and barriers varied according to population characteristics and the strategies used. Equity gaps included limited representation of study participants from rural and low-socioeconomic settings, reduced generalisability to male populations, and underrepresentation of minoritised ethnic groups. Clinicians, service planners, and policymakers should prioritise equity-oriented brain health strategies co-designed with middle-aged individuals. Equity and co-design should be explicitly integrated within global brain health policies and agendas.