Recommendations for Alzheimer's Diagnosis, Treatment, and Care
Background
Age is just a number, some people profoundly proclaim. Yet, is it so? It is a number that many people often misread. Not only the blue planet, but even the world population is aging. Over 10% of the world population is aged more than 65 years. Global aging is a double-edged sword, where one end flaunts the success chronicles of medical and economic achievements, and the other end exhibits a growing burden of tackling age-related diseases. The challenges may be unnerving, but they provide opportunities for cross-department collaborations between scientists, health care providers, clinicians, policymakers, the business community, advocacy groups, society, and governments worldwide. One such study is the Ware Invitational Summit whose agenda was to develop both cross-cutting and domain-specific recommendations for a range of stakeholders involved in the public health crisis because of Alzheimer's disease.
Objective
The objective of this article is to understand and comprehend the underlying principles and priorities that must be addressed both short term and long term, to intercept the ongoing public health challenges related to Alzheimer's disease (AD). History tends to repeat itself. AD is a major hurdle we are trying to cross. Not long ago, we faced a similar hurdle regarding cardiovascular diseases. Scientific collaboration with social, medical, scientific, government and business communities acted as a major catalyst in controlling cardiovascular diseases. Now, there is a similar situation that needs similar but more advanced collaborations. Embracing the right principles and priorities would guide us to plan and provide quality care, help us in developing effective treatment, lead us in scientific advancements, steer us in policy decisions, and maneuver us in studying the history of Alzheimer's and other dementias.
Studies
Four different workgroups took part in the summit to identify recommendations for the following four goals:
Research and develop quality pharmacologic and alternate treatments, while striving to prevent the disease at its core.
Improve the efficiency of clinical trials and use the knowledge gained productively.
Provide valuable options for the people who are diagnosed with early identification of the disease or who have the neurodegenerative process already in-flight.
Efficient, economical, and ethical care to patients and their caregivers including family members, irrespective of the stage of the disease.
Results
The recommendations from the summit include multi-faceted solutions covering both the short and long-term. For better treatment including non-pharmacologic treatments, additional Government funds are needed, along with amended regulations to develop Alzheimer's drugs including alternative care delivery models. To improve the efficiency of clinical trials, it is imperative to not only standardize the existing biomarkers but also incorporate biomarker assessments into all clinical trials including the ones for early presymptomatic stages. To enable better care, develop a risk stratification model with a national population registry for the elderly including ones without dementia. To provide cost-effective care, amend existing laws to protect the people's rights, do more research on diverse delivery models, and increase support for both patients and caregivers.
Conclusion
With the representation of a multidisciplinary group of stakeholders, the recommendations targeted integrated services, public awareness, cost-effective diagnosis and treatments, public engagements in the decision-making process, historical study of the disease, advanced research including biomarker assessment, and but not the least, ensuring dementia as a priority across all stakeholders including the public, and governments. The suggested recommendations took into consideration both the urgency of the public health challenges and the reality of shrinking budgets. Despite the daunting challenges due to lack of funds, lack of awareness, and lack of legislation, there is a growing demand for more funding, more laws, more attention, and more research on Alzheimer's disease.
Sources:
Naylor, Mary D, et al. “Advancing Alzheimer's Disease Diagnosis, Treatment, and Care: Recommendations from the Ware Invitational Summit.” Alzheimer's & Dementia : the Journal of the Alzheimer's Association, U.S. National Library of Medicine, Sept. 2012, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3552530/.
“World Population Ageing 2019: Highlights.” United Nations - Department of Economic and Social Affairs Population Division, 2019, www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeing2019-Highlights.pdf.