World Alzheimer’s Report

Effective interventions

Effective interventions The World Alzheimer Report 2011, released 13 September 2011 by Alzheimer’s Disease International (ADI) to mark September as the first-ever World Alzheimer’s Month, shows that there are interventions that are effective in the early stages of Alzheimer’s disease, some of which may be more effective when started earlier, and that there is a strong economic argument in favour of earlier diagnosis and timely intervention.

Currently, the great majority of people with dementia receive a diagnosis late in the course of the disease, if at all, resulting in a substantial “treatment gap”. This greatly limits their access to valuable information, treatment, care, and support and compounds problems for all involvedpatients, families, carers, communities and health systems.

“There is no single way to close the treatment gap worldwide,” said Professor Martin Prince at the Institute of Psychiatry, King’s College London, the main author of the report – titled The Benefits of Early Diagnosis and Intervention.

“What is clear is that every country needs a national dementia strategy that promotes early diagnosis and a continuum of care thereafter. Primary care services, specialist diagnostic and treatment centres and community-based services all have a part to play, but to differing degrees depending upon resources."

Middle East warning

Speaking in Dubai, Dr Stefan Diez, Consultant Neurologist at the Neuroscience Center of Excellence at the American Hospital Dubai, said: “As a relatively young population, there is low awareness of Alzheimer’s disease in the Middle East and so helping families understand the disease in a family member is the priority when dealing with patients.

“It is a devastating disease and the region will eventually have to face the increasing burden of Alzheimer’s as the population naturally ages. There are few statistics about the disease in the Middle East but we do see early incidence (up to 10 years earlier than in the West) of other age related diseases such as stroke and heart disease in Egypt, where stats are available. Unfortunately, this suggests that the Middle East may face the burden of Alzheimer’s disease and related dementias much earlier than in the West. The good news is that our ability to predict the disease in patients – and ultimately the potential to treat the disease – is improving rapidly.”

Marc Wortmann, Executive Director of ADI, commented: “Earlier diagnosis can also transform the design and execution of clinical trials to test new treatments. But first we need to ensure that people have access to the effective interventions that are already proven and available, which means that health systems need to be prepared, trained and skilled to provide timely and accurate diagnoses, communicated sensitively, with appropriate support.”
The new ADI report reveals the following:
- As many as three-quarters of the estimated 36 million people worldwide living with dementia have not been diagnosed and hence cannot benefit from treatment, information and care. In high-income countries, only 20-50% of dementia cases are recognised and documented in primary care. In low- and middleincome countries, this proportion could be as low as 10%.

- Failure to diagnose often results from the false belief that dementia is a normal part of aging, and that nothing can be done to help. On the contrary, the new report finds that interventions can make a difference, even in the early stages of the illness.

- Drugs and psychological interventions for people with earlystage dementia can improve cognition, independence, and quality of life. Support and counselling for caregivers can improve mood, reduce strain and delay institutionalisation of people with dementia.

- Governments, concerned about the rising costs of long-term care linked to dementia, should “spend now to save later”. Based on a review of economic analyses, the report estimates that earlier diagnosis could yield net savings of up to US$10,000 per patient in high-income countries.

Recommendations for government
- Promote basic competency among physicians and other healthcare professionals in early detection of dementia in primary care services.

- Where feasible, create networks of specialist diagnostic entres to confirm early-stage dementia diagnosis and formulate care management plans.

- In resource-poor settings, apply the World Health Organisation’s recently developed guidelines for diagnosis and initial management by non-specialist health workers.

- Publicise the availability of evidence-based interventions that are effective in improving cognitive function, treating depression, improving caregiver mood and delaying institutionalisation.

- Increase investment in research-especially randomised control trials to test drugs earlier and over longer periods of time, and to test the efficacy of interventions with particular relevance to earlystage dementia.

 Date of upload: 15th Nov 2011


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