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An Action Plan to Face the Challenge of Dementia: INTERNATIONAL STATEMENT ON DEMENTIA from IAP for Health

  • H. Chertkow
  • Research Executive Committee of the Canadian Consortium on Neurodegeneration in Aging
  • International IAP committee on Dementia
Open Access
Position Paper

Abstract

An international committee set up through the IAP for Health met to develop an action plan for dementia. Comprehensive international and national initiatives should move forward with calls for action that include increased public awareness regarding brain health and dementia, support for a broad range of dementia research objectives, and investment in national health care systems to ensure timely competent person-centred care for individuals with dementia. The elements of such action plans should include: 1) Development of national plans including assessment of relevant lifecourse risk and protective factors; 2) Increased investments in national research programs on dementia with approximately 1% of the national annual cost of the disease invested; 3) Allocating funds to support a broad range of biomedical, clinical, and health service and systems research; 4) Institution of risk reduction strategies; 5) Building the required trained workforce (health care workers, teachers, and others) to deal with the dementia crisis; 6) Ensuring that it is possible to live well with dementia; and 7) Ensuring that all have access to prevention programs, care, and supportive living environments.

Key words

Risk reduction strategies risk factors life course public awareness national plans 

References

  1. 1.
    Prince M, Bryce R, Albanese E, Wimo A, Ribeiro W, Ferri CP. The global prevalence of dementia: A systematic review and metaanalysis. Alzheimers Dement 2013;9:63–75.CrossRefPubMedGoogle Scholar
  2. 2.
    Prince MJ, Albanese E, Guerchet M, Prina M. World Alzheimer Report 2014 - Dementia and risk reduction: An analysis of protective and modifiable factors 2014.Google Scholar
  3. 3.
    CSHA. Canadian Study of Health and Aging: Risk factors for Alzheimer’s disease in Canada. Neurology 1994;44:2073–2080.CrossRefGoogle Scholar
  4. 4.
    Ferri CP, Prince M, Brayne C, et al. Global prevalence of dementia: a Delphi consensus study. Lancet 2005;366:2112–2117.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Winblad B, Amouyel P, Andrieu S, et al. Defeating Alzheimer’s disease and other dementias: a priority for European science and society. Lancet Neurol 2016;15:455–532.CrossRefPubMedGoogle Scholar
  6. 6.
    (WHO). Global action plan for the prevention and control of noncommunicable diseases 2013–2020. Geneva, Switzerland: World Health Organization, 2013.Google Scholar
  7. 7.
    WHO. WHO Global Network of Age-friendly CIties and Communities 2017.Google Scholar
  8. 8.
    OECD. Unleashing the Power of Big Data for Alzheimer’s Disease and Dementia Research: OECD Publishing.Google Scholar
  9. 9.
    Prince M. World Alzheimer Report 2016: Improving healthcare for people living with dementia. London, U.K.: Alzheimer’s Disease International, 2016.Google Scholar
  10. 10.
    Jeste DV, Meeks TW, Kim DS, Zubenko GS. Research agenda for DSM-V: diagnostic categories and criteria for neuropsychiatric syndromes in dementia. J Geriatr Psychiatry Neurol 2006;19:160–171.CrossRefPubMedGoogle Scholar
  11. 11.
    Schneider JA, Arvanitakis Z, Leurgans SE, Bennett DA. The neuropathology of probable Alzheimer disease and mild cognitive impairment. Ann Neurol 2009;66:200–208.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Schneider JA, Aggarwal NT, Barnes L, Boyle P, Bennett DA. The Neuropathology of Older Persons with and Without Dementia from Community versus Clinic Cohorts. J Alzheimers Dis 2009;18:691–701.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Hachinski V, Sposato LA. Dementia: from muddled diagnoses to treatable mechanisms Brain 2013;136:2652–2654.PubMedGoogle Scholar
  14. 14.
    Hachinski V. Shifts in thinking about dementia. JAMA 2008;300:2172–2173.CrossRefPubMedGoogle Scholar
  15. 15.
    Larson EB, Yaffe K, Langa KM. New Insights into the Dementia Epidemic. N Engl J Med 2013;369:2275–2277.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Black S, Iadecola C. Vascular cognitive impairment: small vessels, big toll: introduction. Stroke 2009;40:S38–39.CrossRefPubMedGoogle Scholar
  17. 17.
    Smith E. Vascular Cognitive Impairment. Continuum (Minneap Minn) 2016;22:490–509.Google Scholar
  18. 18.
    Song X, Mitnitski A, Rockwood K. Age-related deficit accumulation and the risk of late-life dementia. Alzheimers Res Ther 2014;6:54.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Huber SJ, Shuttleworth EC, Freidenberg DL. Neuropsychological differences between the dementias of Alzheimer’s and Parkinson’s diseases. Archives of Neurology 1989;46:1287–1291.CrossRefPubMedGoogle Scholar
  20. 20.
    Brayne C, Richardson K, Matthews FE, et al. Neuropathological Correlates of Dementia in Over-80-Year-Old Brain Donors from the Population-Based Cambridge City over-75s Cohort (CC75C) Study. J Alzheimers Dis 2009;18:645–658.CrossRefPubMedGoogle Scholar
  21. 21.
    Richards M, Brayne C. What do we mean by Alzheimer’s disease? BMJ 2010;341:c4670.CrossRefPubMedGoogle Scholar
  22. 22.
    de-Graft Aikens A, Sanuade, O. Anie, K. Ageing and neurodegenerative diseases in low and middle income countries.. In: A. de-Graft Aikins and C. Agyemang (Eds), ed. Chronic non-communicable diseases in low and middle income countries: a synthesiis of research, interventions, and policies. Oxford: CABI Publishers, 2016: 50–68.CrossRefGoogle Scholar
  23. 23.
    Alzheimer’s-Association. 2015 Alzheimer’s disease facts and figures. Alzheimer’s & Dementia 2015;11:332–384.CrossRefGoogle Scholar
  24. 24.
    Richards M, Deary IJ. A life course approach to cognitive reserve: a model for cognitive aging and development? Ann Neurol 2005;58:617–622.CrossRefPubMedGoogle Scholar
  25. 25.
    Solomon A, Mangialasche F, Richard E, et al. Advances in the prevention of Alzheimer’s disease and dementia. J Intern Med 2014;275:229–250.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Norton S, Matthews FE, Barnes DE, Yaffe K, Brayne C. Potential for primary prevention of Alzheimer’s disease: an analysis of population-based data. Lancet Neurol 2014;13:788–794.CrossRefPubMedGoogle Scholar
  27. 27.
    Ngandu T, Lehtisalo J, Solomon A, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet 2015.Google Scholar
  28. 28.
    Kivipelto M, Mangialasche F. Alzheimer disease: To what extent can Alzheimer disease be prevented? Nat Rev Neurol 2014;10:552–553.CrossRefPubMedGoogle Scholar
  29. 29.
    Kivipelto M, Mangialasche F, Ngandu T. Can lifestyle changes prevent cognitive impairment? Lancet Neurol 2017;16:338–339.CrossRefPubMedGoogle Scholar
  30. 30.
    Mangialasche F, Solomon A, Winblad B, Mecocci P, Kivipelto M. Alzheimer’s disease: clinical trials and drug development. Lancet Neurol 2010;9:702–716.CrossRefPubMedGoogle Scholar
  31. 31.
    Doody RS, Thomas RG, Farlow M, et al. Phase 3 Trials of Solanezumab for Mildto-Moderate Alzheimer’s Disease. N Engl J Med 2014;370:311–321.CrossRefPubMedGoogle Scholar
  32. 32.
    Salloway S, Sperling R, Fox NC, et al. Two Phase 3 Trials of Bapineuzumab in Mild-to-Moderate Alzheimer’s Disease. N Engl J Med 2014;370:322–333.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Baumgart M, Snyder HM, Carrillo MC, Fazio S, Kim H, Johns H. Summary of the evidence on modifiable risk factors for cognitive decline and dementia: A populationbased perspective. Alzheimers Dement 2015;11:718–726.CrossRefPubMedGoogle Scholar
  34. 34.
    Welsh MD. Measurement of quality of life in neurodegenerative disorders. Curr Neurol Neurosci Rep 2001;1:346–349.CrossRefPubMedGoogle Scholar
  35. 35.
    Hughes JC. Conceptual issues in ‘cognitive impairment’. Curr Opin Psychiatry 2015;28:188–193.PubMedGoogle Scholar
  36. 36.
    Hogan DB, Bailey P, Carswell A, et al. Management of mild to moderate Alzheimer’s disease and dementia. Alzheimer’s & Dementia 2007;3:355–384.CrossRefGoogle Scholar
  37. 37.
    Ebly EM, Hogan DB, Rockwood K. Living alone with dementia. Dementia & Geriatric Cognitive Disorders 1999;10:541–548.CrossRefGoogle Scholar
  38. 38.
    Chalmers J. Dementia Friendly City Initiative Halifax 2014. Halifax NS: https://www.halifax.ca/boardscom/access/documents/DementiaFriendlyCityAAC140317.pdf.Google Scholar
  39. 39.
    Feldman, H. and Estabrooks C. The Canadian dementia challenge: Ensuring optimal care and services for those at risk or with dementia throughout the country. Canadian Journal of Public Health 2017; 108,e95–e97. doi:10.17269/ cjph.108.5852.CrossRefPubMedGoogle Scholar
  40. 40.
    Fargo KN, Aisen P, Albert M, et al. 2014 Report on the Milestones for the US National Plan to Address Alzheimer’s Disease. Alzheimers Dement 2014;10:S430–S452.CrossRefPubMedGoogle Scholar
  41. 41.
    Maloney B, Lahiri DK. Epigenetics of dementia: understanding the disease as a transformation rather than a state. Lancet Neurol 2016;15:760–774.CrossRefPubMedGoogle Scholar
  42. 42.
    Brayne C. A population perspective on the IWG-2 research diagnostic criteria for Alzheimer’s disease. Lancet Neurol 2014;13:532–534.CrossRefPubMedGoogle Scholar
  43. 43.
    Clare L, Wu YT, Teale JC, et al. Potentially modifiable lifestyle factors, cognitive reserve, and cognitive function in later life: A cross-sectional study. PLoS Med 2017;14:e1002259.CrossRefGoogle Scholar
  44. 44.
    Alzheimer Society of Canada. Rising Tide: The Impact of Dementia on Canadian Society2010 http://www.alzheimer.ca/docs/RisingTide/Rising Tide_FullReport_Eng_FINAL_Securedversion.pdf.
  45. 45.
    Wimo A, Jonsson L, Bond J, Prince M, Winblad B. The worldwide economic impact of dementia 2010. Alzheimers Dement 2013;9:1–11.CrossRefPubMedGoogle Scholar
  46. 46.
    Wimo A, Guerchet M, Ali GC, et al. The worldwide costs of dementia 2015 and comparisons with 2010. Alzheimers Dement 2017;13:1–7.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Jacklin KM, Walker JD, Shawande M. The emergence of dementia as a health concern among First Nations populations in Alberta, Canada. Canadian Journal of Public Health 2013;104:e39–e44.CrossRefGoogle Scholar
  48. 48.
    Innes A, Morgan D, Kosteniuk J. Dementia care in rural and remote settings: a systematic review of informal/family caregiving. Maturitas 2011;68:34–46.CrossRefPubMedGoogle Scholar
  49. 49.
    Morgan D, Innes A, Kosteniuk J. Dementia care in rural and remote settings: a systematic review of formal or paid care. Maturitas 2011;68:17–33.CrossRefPubMedGoogle Scholar
  50. 50.
    Gauthier S, Rosa-Neto P, Kass JS. Ethical Considerations for the Use of Next-Generation Alzheimer Drugs in Symptomatic and At-Risk Patients. Continuum (Minneap Minn) 2016;22:615–618.Google Scholar
  51. 51.
    Gauthier S, Leuzy A, Racine E, Rosa-Neto P. Diagnosis and management of Alzheimer’s disease: Past, present and future ethical issues. Prog Neurobiol 2013.Google Scholar
  52. 52.
    Leibing A. The earlier the better: Alzheimer’s prevention, early detection, and the quest for pharmacological interventions. Cult Med Psychiatry 2014;38:217–236.CrossRefPubMedGoogle Scholar
  53. 53.
    Chertkow H, Nasreddine Z, Joanette Y, et al. Mild cognitive impairment and cognitive impairment, no dementia: Part A, concept and diagnosis. Alzheimer’s & Dementia 2007;3:266–282.CrossRefGoogle Scholar
  54. 54.
    Feldman HH, Jacova C. Mild Cognitive Impairment. Am J Geriatr Psychiatry 2005;13:645–655.CrossRefPubMedGoogle Scholar
  55. 55.
    Feldman HH, Jacova C, Robillard A, et al. Diagnosis and treatment of dementia: 2. Diagnosis. Cmaj 2008;178:825–836.CrossRefPubMedGoogle Scholar
  56. 56.
    Scheltens P, Blennow K, Breteler MM, et al. Alzheimer’s disease. Lancet 2016;388:505–517.CrossRefPubMedGoogle Scholar
  57. 57.
    Rossini PM, Di Iorio R, Granata G, Miraglia F, Vecchio F. From Mild Cognitive Impairment to Alzheimer’s Disease: A New Perspective in the ≪Land≫ of Human Brain Reactivity and Connectivity. J Alzheimers Dis 2016;53:1389–1393.CrossRefPubMedGoogle Scholar
  58. 58.
    Herrmann N, Lanctot KL. From transmitters to treatment: the pharmacotherapy of behavioural disturbances in dementia. Canadian Journal of Psychiatry - Revue Canadienne de Psychiatrie 1997;42:51S–64S.Google Scholar
  59. 59.
    Herrmann N, Gauthier S, Lysy PG. Clinical practice guidelines for severe Alzheimer’s disease. Alzheimer’s & Dementia 2007;3:385–397.CrossRefGoogle Scholar
  60. 60.
    Peters ME, Rosenberg PB, Steinberg M, et al. Neuropsychiatric symptoms as risk factors for progression from CIND to dementia: the Cache County Study. Am J Geriatr Psychiatry 2013;21:1116–1124.CrossRefPubMedGoogle Scholar
  61. 61.
    Norton MC, Dew J, Smith H, et al. Lifestyle Behavior Pattern Is Associated with Different levels of Risk for Incident Dementia and Alzheimer’s Disease: The Cache County Study. J Am Geriatr Soc 2012;60:405–412.CrossRefPubMedPubMedCentralGoogle Scholar
  62. 62.
    Brodaty H, Donkin M. Family caregivers of people with dementia. Dialogues Clin Neurosci 2009;11:217–228.PubMedPubMedCentralGoogle Scholar
  63. 63.
    Ory MG, Hoffman RR, 3rd, Yee JL, Tennstedt S, Schulz R. Prevalence and impact of caregiving: a detailed comparison between dementia and nondementia caregivers. The Gerontologist 1999;39:177–185.CrossRefPubMedGoogle Scholar
  64. 64.
    Karlawish JH, Klocinski JL, Merz J, Clark CM, Asch DA. Caregivers’ preferences for the treatment of patients with Alzheimer’s disease. Neurology 2000;55:1008–1014.CrossRefPubMedGoogle Scholar
  65. 65.
    Dorsey ER, George BP, Leff B, Willis AW. The coming crisis: Obtaining care for the growing burden of neurodegenerative conditions. Neurology 2013;80:1989–1996.CrossRefPubMedPubMedCentralGoogle Scholar
  66. 66.
    Evans DA, Grodstein F, Loewenstein D, Kaye J, Weintraub S. Reducing case ascertainment costs in U.S. population studies of Alzheimer’s disease, dementia, and cognitive impairment-Part 2. Alzheimers Dement 2011;7:110–123.CrossRefPubMedPubMedCentralGoogle Scholar
  67. 67.
    Leuzy A, Gauthier S. Ethical issues in Alzheimer’s disease: an overview. Expert Rev Neurother 2012;12:557–567.CrossRefPubMedGoogle Scholar

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© The Author(s) 2018

Open Access: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, duplication, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

Authors and Affiliations

  • H. Chertkow
    • 1
  • Research Executive Committee of the Canadian Consortium on Neurodegeneration in Aging
  • International IAP committee on Dementia
  1. 1.3755 chemin de la Côte-Ste-CatherineMontréalCanada

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