Dementia Prevention, Intervention, and Care

Acting now on dementia prevention, intervention, and care will vastly improve living and dying for individuals with dementia and their families, and in doing so, will transform the future for society. Prevention and management of dementia: a priority for public healthToday, nearly 50 million people worldwide have dementia, with this figure projected to increase to 75 million by 2030 and to 132 million by 2050,1 largely driven by population ageing. Dementia causes not only disability and dependency for individuals affected by the disorder, but can also have a profoundly detrimental effect on family and other carers, who are at high risk of developing depression and anxiety disorders.2 The cost of caring for people with dementia is more than US$800 billion per year globally, rising to $2 trillion by 2030. Full-Text PDF Progress on dementia—leaving no one behindThe Lancet Commission Dementia Prevention, Intervention, and Care1 makes a timely evidence-driven contribution to global efforts to improve the lives of people with dementia and their carers, and limit the future impact on societies. The Commission proposes ambitious prevention targets, treatment of cognitive symptoms in people with Alzheimer's disease or dementia with Lewy bodies, individualised dementia care, provision of care for carers, planning for the future for patients and families, risk protection balanced with respect for autonomy, management of neuropsychiatric symptoms, consideration of dementia in end of life care, and use of technological innovations to improve care but not replace social contact. Full-Text PDF Gill Livingston: transforming dementia prevention and careIt was during a placement as a junior doctor in the 1980s at Friern Barnet, one of the largest psychiatric hospitals in Europe, that Gill Livingston first witnessed the real human impact of dementia. “People were living in old Victorian wards of 24 people with little privacy. It seemed a terrible way to live”, she recalls. The experience sparked a lifelong interest and a passion to improve the lives of people with dementia and their carers. But for Livingston it also became a personal concern when dementia affected her own family. Full-Text PDF Prevention of dementia by targeting risk factorsThe report by Gill Livingston and colleagues (Dec 16, 2017 p 2673)1 is a valuable collation of a large body of medical research evidence that aims to combat the dementia epidemic, the greatest global challenge for health and social care in the 21st century. One of the key messages of the Commission is the need to be ambitious in terms of prevention. Using population attributable fractions (PAF), the authors estimate that as much as 35% of dementia cases could be prevented by targeting nine modifiable risk factors. Full-Text PDF Prevention of dementia by targeting risk factorsThe Lancet Commission (Dec 16, 2017, p 2673)1 on prevention and management of dementia reviews the mounting evidence that hearing loss is a major risk factor for cognitive decline. Crucial information is still absent about the nature of this linkage and what factors might modify the cognitive effect of peripheral hearing loss. Particularly, the potential relevance of central hearing impairment should not be underestimated. As Gill Livingston and colleagues1 acknowledge, on pathophysiological and neuroanatomical grounds, central auditory processing is likely to be susceptible early in the course of Alzheimer's disease and other dementias. Full-Text PDF Prevention of dementia by targeting risk factors – Authors' replyWe welcome the opportunity to respond to the letters about The Lancet Commission1 on dementia prevention, intervention, and care. Full-Text PDF Living and dying with dementiaGiven that an effective new medication to halt, improve or cure dementia seems as remote as ever, Care needed: Improving the lives of people with dementia (June 12) from the OECD instead prioritises living with dementia. Most patients, provided the proper support, prefer and are able to live at home long after a diagnosis. But only eight of 21 OECD countries can estimate the proportion of people with dementia living in the community and only Australia and Canada consistently measure their quality of life. Full-Text PDF Dementia in the UK: preparing the NHS for new treatmentsDementia is a devastating disease that brings fear, confusion, and loneliness to the lives of patients and their families. Today, around 850 000 people in the UK are living with dementia, costing the National Health Service (NHS) and UK society more than £26 billion annually. By 2025, it is estimated that over 1 million people in the UK will be affected, with the prevalence and costs of care for these patients expected to double by 2050. These are worrisome figures given the absence of any safe, clinically effective, disease-modifying therapy for Alzheimer's disease or other forms of dementia. Full-Text PDF Let's talk about dementiaOn Sept 1, kicking off World Alzheimer's Month, Alzheimer's Disease International joined forces with the Pan American Health Organization, launching Let's Talk About Dementia, a campaign aiming “to demystify dementia and to get people talking”. The ambition is to encourage discussion in families and with health providers to reduce the stigma associated with Alzheimer's disease and all forms of dementia. Events elsewhere include the Age Against the Machine festival in the UK, which offers a practical workshop on making homes, workplaces, or projects dementia-friendly and a performance of How to Keep Time, which looks at the effects of dementia on speech, memory, and family life. Full-Text PDF Dementia burden coming into focusWHO announced the launch of the Global Dementia Observatory (GDO) on Dec 7. This new internet-focused platform aims to provide a constant monitoring service for data relating to dementia planning around the world. The GDO currently features data from 21 countries, with the aim to expand monitoring to 50 countries by the end of 2018. Important data, such as government policy, treatment and care infrastructure, and disease burden, will be accessible online and kept constantly updated. The first sets of data are positive : 81% of the participating countries have a dementia awareness campaign, and 71% provide support and training for carers. Full-Text PDF Response to the growing dementia burden must be fasterAccording to 2017 estimates from WHO, nearly 50 million people are living with dementia, and by 2030 the number is expected to reach 82 million. As this figure grows, so too will the need for support and care for people with dementia, which is projected to cost US$ 2 trillion globally by 2030. The need to prepare for and try to prevent some of this personal and financial burden has received increasing attention, most notably with adoption by the World Health Assembly last year of the WHO global action plan on dementia . Full-Text PDF