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Brain Health Services: organization, structure, and challenges for implementation. A user manual for Brain Health Services—part 1 of 6

2021; BioMed Central; Volume: 13; Issue: 1 Linguagem: Inglês

10.1186/s13195-021-00827-2

1758-9193

Daniele Altomare, José Luís Molinuevo, Craig Ritchie, Federica Ribaldi, Emmanuel Carrera, Bruno Dubois, Frank Jessen, Laura McWhirter, Philip Scheltens, Wiesje M. van der Flier, Bruno Vellas, Jean‐François Démonet, Giovanni B. Frisoni, Marc Abramowicz, Daniele Altomare, Frederik Barkhof, Marcelo L. Berthier, Mélanie Bieler-Aeschlimann, Kaj Blennow, Carol Brayne, Andrea Brioschi, Emmanuel Carrera, Gaël Chételat, Chantal Csajka, Jean‐François Démonet, Alessandra Dodich, Bruno Dubois, Giovanni B. Frisoni, Valentina Garibotto, Jean Georges, Samia Hurst, Frank Jessen, Miia Kivipelto, David J. Llewellyn, Laura McWhirter, Richard Milne, Carolina Minguillón, Carlo Miniussi, José Luís Molinuevo, Peter M. Nilsson, Janice M. Ranson, Federica Ribaldi, Craig Ritchie, Philip Scheltens, Alina Solomon, Wiesje M. van der Flier, Cornelia M. van Duijn, Bruno Vellas, Leonie N.C. Visser,

Aging, Elder Care, and Social Issues

Abstract Dementia has a devastating impact on the quality of life of patients and families and comes with a huge cost to society. Dementia prevention is considered a public health priority by the World Health Organization. Delaying the onset of dementia by treating associated risk factors will bring huge individual and societal benefit. Empirical evidence suggests that, in higher-income countries, dementia incidence is decreasing as a result of healthier lifestyles. This observation supports the notion that preventing dementia is possible and that a certain degree of prevention is already in action. Further reduction of dementia incidence through deliberate prevention plans is needed to counteract its growing prevalence due to increasing life expectancy. An increasing number of individuals with normal cognitive performance seek help in the current memory clinics asking an evaluation of their dementia risk, preventive interventions, or interventions to ameliorate their cognitive performance. Consistent evidence suggests that some of these individuals are indeed at increased risk of dementia. This new health demand asks for a shift of target population, from patients with cognitive impairment to worried but cognitively unimpaired individuals. However, current memory clinics do not have the programs and protocols in place to deal with this new population. We envision the development of new services, henceforth called Brain Health Services, devoted to respond to demands from cognitively unimpaired individuals concerned about their risk of dementia. The missions of Brain Health Services will be (i) dementia risk profiling, (ii) dementia risk communication, (iii) dementia risk reduction, and (iv) cognitive enhancement. In this paper, we present the organizational and structural challenges associated with the set-up of Brain Health Services.