The Future Agenda

The problem of Alzheimer’s disease and other dementias is clear. What are the

solutions?

Dementia worldwide

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Numbers of people with dementia(millions)

Worldwide costs of dementia in 2010

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Possible solutions

• Cure• Prevention• Better care• Policy agenda• Research needs• Involve broader industries

Cure

• Large number of treatments in the pipeline• Better diagnostic tools to identify the

disease earlier• Recently several unsuccessful trials -need

to analyse, why?• Still little understanding of some basic

mechanisms in the brain and the role of genes

Prevention

• Recent article: overview of main risk factors and how they contribute (Barnes, Yaffe)

• All factors together explain half of the cases• Main risk factors are:

• Low education• Smoking• Physical inactivity• Depression• Midlife obesity and hypertension

• Clear link with other NCDs

Dementia care works

• Helping carers to care – the 10/66 dementia research group’s randomised control trial of a caregiver intervention in Russia, S. Gavrilova et al.

• New York Caregiver Intervention study, M. Mittelman• Effectiveness of educational interventions in improving

detection and management of dementia in primary care: cluster randomised controlled study, M. Downes et al.

• More comprehensive review in World Alzheimer Report 2011, to be launched 13 September

• It is a myth that nothing can be done!

Model for planning dementia services

Policy Agenda

• Every country should have a national Alzheimer’s/dementia plan

• Good examples from Australia, Korea, France, England, Norway etc

• Key issues: raising awareness, early diagnosis, better caregiver support, care services, workforce education, research agenda

Policy Pioneers

Our belief

• Seven priority areas – depression, psychosis, epilepsy, dementia, child and adolescent disorders, alcohol use, suicide

• Development of evidence-based practice guidelines for non-specialists in LAMIC

• Implementation• Evaluation

• Increasing the coverage of evidence-based community interventions in low and middle income countries

Dementia report 2012

• Collaboration WHO-ADI• Data from ADI reports 2009 and 2010• Good practices in awareness and

carer support• Recommendations• To be launched April 2012 (World

Health Day)

But there is more….

• NCD Summit: dementia part of the agenda?• Lack of public research funding• Need for better understanding of the working of the

brain and how it starts• More research on risk factors and efficacy of non

medical interventions• Could dementia be the area for innovative research

including genetics and personalised medication?• Need to consider changing the regulatory process

Role of Other Industries

• Only a few pioneers in other areas• Assisted technology could empower people with

dementia, increase their independence and keep them longer at home

• Nutrition• Innovative person-centred care provision• Financial and legal planning• Everyone involved in healthy lifestyle

www.adi2012.org