Ours is an aging population, more and more. But if on the one hand aging is a symptom of a society that enjoys relative well-being, on the other it also means increasing the risk of suffering from diseases related to advancing age, such as Alzheimer’s. For years, there have been appeals from various quarters inviting us to prepare for the explosion of dementia in the future. One way to do this is to analyze the present, understand what works and what doesn’t, to have a roadmap to work on. And this is what has been done by a team of experts from various disciplines who have questioned and discussed the issue of managing patients with Alzheimer’s, drawing up a series of points to work on so as not to be unprepared in the future. If today there are 600,000 people affected by the disease in Italy, within twenty years this number could grow to reach 2.5 million. And without a cure, with treatments that still struggle to come, managing the disease remains an ever-increasing challenge for clinicians, patients and caregivers.
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Financing and strengthening of territorial assistance
Some of the recommendations drawn up by the panel – a team of neurologists, pharmacologists, psychologists, general practitioners and health management experts, coordinated by Luca Pani, full professor of Pharmacology and Clinical Pharmacology of the University of Modena and Reggio Emilia and of Clinical Psychiatry of the University of Miami – concern critical issues common to other health care sectors. This is the case, for example, of the appeal for funding to ensure adequate diagnosis and care of patients, the homogeneity of care paths between the different centers at national level, the optimization of the continuity of care, which should be strengthened by strengthening the dialogue between centers of reference and the territory. Others, on the other hand, concern the particular aspects affected by Alzheimer’s disease, the experts recall, in the document created by Edra thanks to the support of Roche.
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Against stigma and for early diagnosis
So, they suggest, one of the key points to focus on is working to raise awareness of the disease and reduce the associated stigma – that of inevitably elderly, unpredictable and dangerous people. This is a problem that affects not only the population but also health professionals and which complicates people’s coexistence with their disease, underlines the panel of experts. Fighting stigma requires more actions, such as awareness campaigns, training courses and the involvement of various professional figures: from general practitioners, to specialists, to pharmacists.
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But it is also fundamental to work to enhance prevention and early diagnosis, one of the most important challenges in the fight against dementia, also for the development of effective treatments. In this field, the experts agree, the figure of the general practitioner is fundamental, who should be supported to identify patients at risk who need specialist assessments. But also the pharmacist, by referring the person to the family doctor, could play a sentinel role. In this area of help would then be the definition of biological markers which, together with assessments at a cognitive level, make it possible to identify the disease early, but still today mostly relegated to research rather than clinical practice. And, alongside this, the development of software for the analysis and identification of recurring patterns in neuroimaging data would also be desirable.
But even earlier, the ideal would be to intercept Alzheimer’s cases by conducting screening in populations at risk – for example thanks to databases created by putting together the data of the examinations associated with the renewal of licenses, the experts suggest – or random, on people afferent to multi-specialist centers. Finally, preparing to manage Alzheimer’s also means making sure that those who care for and live with a person with dementia have all the services that facilitate and help the management of the disease, such as day centers, at their disposal.