Forecasting the global burden of Alzheimer's disease

Brookmeyer, Ron; Johnson, Elizabeth; Ziegler-Graham, Kathryn; Arrighi, H. Michael

doi:10.1016/j.jalz.2007.04.381

Cited by 2,916 publications

(1,996 citation statements)

References 16 publications

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“…Over the coming decades, Alzheimer’s disease and other dementias will become the primary public-health concern, with the forecast that globally there will be 100 million people with dementia by 2050 [2] and 14 million of these will be in Europe [3]. Dementia has been a long-standing concern in Europe, where major research efforts have focused on understanding the pathogenesis and epidemiology of dementia, and comparing this data outcomes from the USA.…”

Section: Introductionmentioning

confidence: 99%

Experiences of advanced dementia care in seven European countries: implications for educating the workforce

Crespo

Riquelme

MacRae

et al. 2018

Global Health Action

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Background: There is a paucity of robust research concerning the care experiences of peoplewith advanced dementia within Europe. It is essential to understand these experiences if weare to address care inequalities and create impactful dementia policies to improve servicesthat support individuals and enable family caring. Objectives: To identify the strengths and weaknesses in daily life perceived by people with dementia and family caring across Europe by exemplifying experiences and the range of typical care settings for advanced dementia care in seven partner countries. Methods: Twenty two in-depth qualitative case studies were completed in seven European countries across a range of care settings considered typical within that country. Narrative accounts of care illuminated a unique set of experiences and highlighted what was working well (strengths or positive aspects) and not so well (weaknesses or negative aspects) for people with advanced dementia and family caring. A constant comparative method of analysis through thematic synthesis was used to identify the common themes. Results: Eight key themes were identified; Early diagnosis, good coordination between service providers, future planning, support and education for carers, enabling the person with dementia to live thebest life possible and education on advanced dementia for professional and family caregiverswere all significant and recurring issues considered important for care experiences to bepositive. Conclusion: People with advanced dementia may have limited opportunities for self-realization and become increasingly reliant on the support of others to maximize their health and well-being. Careful attention must be given to their psychosocial well-being, living environment and family caring to enable them to live the best life possible. Building on what the case studies tell us about what works well, we discuss the potential for integrating the findings into interprofesional learning solutions for the professional workforce across Europe to champion practice-based change.

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Section: Introductionmentioning

confidence: 99%

Experiences of advanced dementia care in seven European countries: implications for educating the workforce

Crespo

Riquelme

MacRae

et al. 2018

Global Health Action

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“…It is the third leading cause of death and the leading cause of disability burden in adults aged 65 years and over in Australia 3, 4. Co‐morbidities and polypharmacy are common in people with dementia, though evidence is scarce for medication safety, tolerability and efficacy in this population 5, 6, 7…”

Section: Introductionmentioning

confidence: 99%

Medication appropriateness tool for co‐morbid health conditions in dementia: consensus recommendations from a multidisciplinary expert panel

Page

Potter

Clifford

et al. 2016

Internal Medicine Journal

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BackgroundMedication management for people living with dementia is a complex task as it is unclear what constitutes optimal medication management in this population due to the shifting focus of health priorities and the balance between the benefits and harms of medications.AimThis study sought expert opinion to create a consensus list to define appropriate medication management of co‐morbidities for people with dementia.MethodsThis study used the Delphi technique. We invited multidisciplinary experts in geriatric therapeutics including pharmacists, doctors, nurse practitioners, a patient advocate and a psychologist to participate. Participants were asked to engage into three or more rounds of questioning. Round 1 was a questionnaire comprised of one question defining dementia and seven open‐ended questions about appropriate management of co‐morbidities in people with dementia. Two investigators qualitatively analysed the responses to questions from Round 1 using thematic analysis. The results of this analysis were provided to participants as statements in the Round 2 survey. The participants were asked to rate their agreement with each statement on a 5‐point Likert scale. The median and interquartile range (IQR) were calculated for the responses to each statement. Consensus was pre‐specified as an IQR less than or equal to 1. Statements where consensus was not achieved were presented to participants in Round 3. The Round 2 median and IQR values were provided and participants were again asked to rate their agreement with each statement on a 5‐point Likert scale. The statements where participants agreed or strongly agreed were included in the Medication Appropriateness Tool for Co‐morbid Health conditions in Dementia criteria.ResultsFifty‐seven experts agreed to participate in the study, of whom 58% were pharmacists and 36% were medical practitioners. Fifty‐five participants completed the Round 1 (95% response rate). A total of 128 statements was included in the Round 2 survey. Consensus was reached on 93 statements in Round 2 (n = 48 responders, 84% response rate) and on 18 statements in Round 3 (n = 43 responders, 75% response rate). The participants reached consensus on 111 of 128 statements. Of these statements, 67 statements were included in the Medication Appropriateness Tool for Co‐morbid Health conditions in Dementia criteria. The statements were in the broad themes of preventative medication, symptom management, disease progression, psychoactive medication, treatment goals, principles of medication use, side‐effects and medication reviews.DiscussionThis research provides consensus‐based guidance for clinicians who manage co‐morbid health conditions in people with dementia.

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“…In 2010, the World Health Organization estimated the number of persons with AD-related dementia at 35.6 million, which is expected to triple by 2050 to over 115 million [1]. The projected number of persons with AD in the USA by 2050 is 13.5 million, and the medical costs will exceed $20 trillion over the next 40 years [2,3]. The measurable socioeconomic annual costs of the disease on a global scale were estimated to exceed $600 billion in 2010 [1,4].…”

Section: Introductionmentioning

confidence: 99%

Targeting the Prodromal Stage of Alzheimer's Disease: Bioenergetic and Mitochondrial Opportunities

2015

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Alzheimer's disease (AD) has a complex and progressive neurodegenerative phenotype, with hypometabolism and impaired mitochondrial bioenergetics among the earliest pathogenic events. Bioenergetic deficits are well documented in preclinical models of mammalian aging and AD, emerge early in the prodromal phase of AD, and in those at risk for AD. This review discusses the importance of early therapeutic intervention during the prodromal stage that precedes irreversible degeneration in AD. Mechanisms of action for current mitochondrial and bioenergetic therapeutics for AD broadly fall into the following categories: 1) glucose metabolism and substrate supply; 2) mitochondrial enhancers to potentiate energy production; 3) antioxidants to scavenge reactive oxygen species and reduce oxidative damage; 4) candidates that target apoptotic and mitophagy pathways to either remove damaged mitochondria or prevent neuronal death. Thus far, mitochondrial therapeutic strategies have shown promise at the preclinical stage but have had little-to-no success in clinical trials. Lessons learned from preclinical and clinical therapeutic studies are discussed. Understanding the bioenergetic adaptations that occur during aging and AD led us to focus on a systems biology approach that targets the bioenergetic system rather than a single component of this system. Bioenergetic system-level therapeutics personalized to bioenergetic phenotype would target bioenergetic deficits across the prodromal and clinical stages to prevent and delay progression of AD.

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Forecasting the global burden of Alzheimer's disease

Abstract: Background:The goal was to forecast the global burden of Alzheimer's disease and evaluate the

Cited by 2,916 publications

References 16 publications

Experiences of advanced dementia care in seven European countries: implications for educating the workforce

Experiences of advanced dementia care in seven European countries: implications for educating the workforce

Medication appropriateness tool for co‐morbid health conditions in dementia: consensus recommendations from a multidisciplinary expert panel

Targeting the Prodromal Stage of Alzheimer's Disease: Bioenergetic and Mitochondrial Opportunities

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