The article reviewed here is an editorial ‘Prevent Alzheimer’s Disease by 2020: A national strategic goal’ by Khachaturian and Khachaturian and freely available here.
Firstly this is an American article and so this is about a strategy to prevent dementia which factors in resources that are available in the USA (see review of the UK National Dementia Strategy here). The proposed strategy does however includes a proposal to set up a global network which would be indispensable to overcoming the significant challenges set out in the article.
The authors reference articles on the two Leon Thal Symposiums (see review of one here) as well as a webinar event on dementia prevention held in conjunction with the Alzforum. These conferences/events have facilitated the development of a strategy
It is Rocket Science!
The authors liken the prevention of Alzheimer’s Disease by 2020 to the Apollo space mission. Thus they write that
‘The national strategic goal to prevent AD within a decade is no more difficult, ambitious, or premature than the 1960s Apollo space program. The vision of preventing AD by 2020 is an attainable scientific objective‘
After the introduction, the authors focus on the governance of any necessary programs and the need to be able to rapidly respond to emerging scientific findings and opportunities. Later in the editorial they focus on the need for prevention trials and the establishment of a national registry of at-risk subjects who are willing to undergo clinical trials. They carry across the rationale from treatment to prevention trials showing that there are many similarities. They also give a broad costing for these trials. Towards the end of the article they write that
‘The goal of the proposed National Strategic Plan is to create a new paradigm for planning and supporting the organization of worldwide cooperative research networks to develop new technologies for the early detection and treatment of various forms of memory impairments‘
I thought this was an upbeat editorial with ambitious goals. But I think that is just what is needed. As they note earlier in the editorial there will be a very substantial increase in the number of cases of dementia in coming decades which as well as affecting the lives of the people with dementia and their families will have wider repurcussions on economies. This pattern is expected not just in countries such as the USA and the UK but in countries across the world. In the second quote above they use the term ‘memory impairment’ which is useful given the emerging disease entities such as mild cognitive impairment which are currently being further clarified and which are closely (although not invariably) related to dementia. This is also a tacit recognition that dementia strategies need to be sufficiently broad to capture the multiple pathways that lead to dementia.
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