ADI commissioned a team of researchers led by Professor Martin Prince from King's College London Institute of Psychiatry, to undertake the first-ever, comprehensive, systematic review of all evidence on early diagnosis and early intervention for dementia.
Currently, the 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 involved - patients, families, carers, communities and health professionals.
Lead author Prof Prince said: 'There is no single way to close the treatment gap worldwide. 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.'
'Failure to diagnose Alzheimer's in a timely manner represents a tragic missed opportunity to improve the quality of life for millions of people,' said Dr. Daisy Acosta, Chairman of ADI. 'It only adds to an already massive global health, social, and fiscal challenge - one we hope to see in the spotlight at next week's United Nations Summit on Non-Communicable Diseases.'
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 recognized and documented in primary care. In low- and middle-income 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 early-stage dementia can improve cognition, independence, and quality of life. Support and counselling for caregivers can improve mood, reduce strain and delay institutionalization 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 over US$10,000 per patient in high-income countries.
'Over the past year, the research team has reviewed thousands of scientific studies detailing the impact of early diagnosis and treatment, and we have found evidence to suggest real benefits for patients and caregivers,' said Marc Wortmann, Executive Director of ADI.
'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.'
To that end, ADI recommends that every country have a national Alzheimer's/dementia strategy that promotes early diagnosis and intervention. More specifically, governments must:
Promote basic competency among physicians and other health care professionals in early detection of dementia in primary care services.
Where feasible, create networks of specialist diagnostic centres to confirm early-stage dementia diagnosis and formulate care management plans.
In resource-poor settings, apply the World Health Organization's recently developed guidelines for diagnosis and initial management by non-specialist health workers.
Publicize the availability of evidence-based interventions that are effective in improving cognitive function, treating depression, improving caregiver mood and delaying institutionalization.
Increase investment in research—especially randomized control trials to test drugs earlier and over longer periods of time, and to test the efficacy of interventions with particular relevance to early-stage dementia.
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For further information, please contact:
Louise Pratt, Institute of Psychiatry, King's College London, +44 20 7848 5378, louise.a.pratt@kcl.ac.uk
Sarah Smith, Alzheimer's Disease International (London), +44 7930 917647, s.smith@alz.co.uk
Niles Frantz, Alzheimer's Association (Chicago), +1 312 335 5777, niles.frantz@alz.org
UK case studies available from Alzheimer's Society contact Emma Field 020 7423 3595
Notes to editors:
About dementia and Alzheimer's disease
Dementia is a syndrome that can be caused by a number of progressive disorders that affect memory, thinking, behavior and the ability to perform everyday activities. Alzheimer's disease is the most common cause of dementia. www.alz.co.uk/about-dementia According to the World Alzheimer Report 2009, the number of people with dementia is forecast to nearly double every 20 years—from 36 million in 2010 to 115 million in 2050. According to the World Alzheimer Report 2010, the costs associated with dementia totaled US$604 billion, about 1% of global GDP.
September 2011 is the first-ever World Alzheimer's Month. www.alz.org/wam/wam.asp
About the World Alzheimer Report 2011
From Tuesday 13 September the 2011 World Alzheimer Report is available at www.alz.co.uk/worldreport2011 along with reports published in previous years.
Alzheimer's Disease International (ADI) is the international federation of 76 Alzheimer associations that support people with dementia and their families in their respective countries. Founded in 1984, ADI serves as a network for Alzheimer associations around the world to share and exchange information, resources and skills. Its vision is "a better quality of life for people with dementia and their families." ADI is based in London and is registered as a non-profit organization in the state of Illinois. For more information, visit www.alz.co.uk
King's College London is one of the top 30 universities in the world (2011/2012 QS international world rankings), the Sunday Times 'University of the Year 2010/11' and the fourth oldest in England. A research-led university based in the heart of London, it has nearly 23,500 students (of whom nearly 9,000 are graduate students) from 150 countries and approximately 6,000 employees.
King's has an outstanding reputation for providing world-class teaching and cutting-edge research. In the 2008 Research Assessment Exercise for British universities, 23 departments were ranked in the top quartile of British universities; over half of our academic staff work in departments that are in the top 10 per cent in the UK in their field and can thus be classed as world leading. The College is in the top seven UK universities for research earnings and has an overall annual income of nearly £450 million.
King's has a particularly distinguished reputation in the humanities, law, the sciences (including a wide range of health areas such as psychiatry, medicine, nursing and dentistry) and social sciences including international affairs. It has played a major role in many of the advances that have shaped modern life, such as the discovery of the structure of DNA and research that led to the development of radio, television, mobile phones and radar. It is the largest centre for the education of healthcare professionals in Europe; no university has more Medical Research Council Centres.
King's College London and Guy's and St Thomas', King's College Hospital and South London and Maudsley NHS Foundation Trusts are part of King's Health Partners. King's Health Partners Academic Health Sciences Centre (AHSC) is a pioneering global collaboration between one of the world's leading research-led universities and three of London's most successful NHS Foundation Trusts, including leading teaching hospitals and comprehensive mental health services. For more information, visit www.kingshealthpartners.org.
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