Cognitive stimulation refers to structured activities or programmes in a group or social setting, within a set amount of time, as well as everyday activities that enhance general cognitive function such as reading, storytelling and playing games that individuals can undertake themselves. Cognitive stimulating activities are everyday activities that enhance general cognitive function (e.g. reading and playing games), especially if the activities are new and challenging. Such activities also support other dimensions of healthy ageing, including improved mood, enhanced quality of life and increased engagement in other healthpromoting behaviours.

.Across different forms of cognitive activity – including cognitive training, cognitive stimulating interventions and cognitive stimulating activities – evidence generally shows improvements in domains such as memory, attention and executive function. Ensuring that cognitive gains translate into real-world functioning is essential for meaningful and sustained impact. . Lifelong cognitive activity – including early-life education, ongoing learning opportunities and participation in cognitively engaging pursuits

• is a foundational determinant of cognitive health across the life course, as highlighted in WHO’s position paper on brain health (23). . In line with existing WHO guidance, cognitive interventions should be offered to older adults living with cognitive decline or dementia (22,33,34).

. Cognitively stimulating activities should be encouraged through public health messaging that highlights the benefits of cognitive stimulation as part of a healthy ageing strategy. Messaging should provide simple, culturally relevant examples of cognitively stimulating activities that older adults can integrate into daily routines. . Collaboration with community organizations and existing social programmes can help to promote and normalize cognitively stimulating activities across diverse settings. . Barriers for participation in cognitively stimulating activities (e.g. limited mobility, transportation challenges and economic constraints) could be addressed through local programmes such as the use of libraries, community clubs and learning centres, and by integrating low-cost or no-cost activities into such programmes. . Special attention should be given to ensuring equity in access, especially among socioeconomically disadvantaged groups, rural populations and individuals with lower educational attainment. . More formalized cognitive stimulation interventions can be delivered through various modalities including group-based programmes, oneon-one training, community-based workshops and digital platforms, allowing flexibility in implementation. For example, digital tools, including mobile applications and online training platforms, offer scalable and cost-effective delivery options, particularly in remote or underserved regions. However, digital literacy and equitable access must be addressed. . Cognitive training is adaptable across settings and can be implemented at scale in diverse populations; however, ensuring its relevance and effectiveness requires tailoring both the training and cognitively stimulating activities to local cultural, linguistic and environmental contexts. . Offering cognitive training within existing health and social care systems (e.g. primary care, community settings or older-adult programmes) can facilitate broader access and uptake. To support programme delivery, particularly in settings with limited expertise in cognitive health promotion, workforce training may be required

Lifelong learning through early nurturing interactions, equitable access to quality education, and cognitively stimulating work and environments should be promoted for everyone, to optimize brain health (including cognitive health) across the life course, in line with WHO guidance. Clinical practice: y Integrated care for older people: guidelines on community-level interventions to manage declines in intrinsic capacity (1) Service delivery and care pathways: y Nurturing care for early childhood development: a framework for helping children survive and thrive to transform health and human potential (2) y Framework to implement a life course approach in practice (3) y Integrated care for older people (ICOPE): guidance for personcentred assessment and pathways in primary care, 2nd ed (4) Public health and policy: y Optimizing brain health across the life course: WHO position paper (5)