Dataset Information

Dementia prevention in memory clinics: recommendations from the European task force for brain health services.

ABSTRACT: Observational population studies indicate that prevention of dementia and cognitive decline is being accomplished, possibly as an unintended result of better vascular prevention and healthier lifestyles. Population aging in the coming decades requires deliberate efforts to further decrease its prevalence and societal burden. Increasing evidence supports the efficacy of preventive interventions on persons with intact cognition and high dementia risk. We report recommendations for the deployment of second-generation memory clinics (Brain Health Services) whose mission is evidence-based and ethical dementia prevention in at-risk individuals. The cornerstone interventions consist of (i) assessment of genetic and potentially modifiable risk factors including brain pathology, and risk stratification, (ii) risk communication with ad-hoc protocols, (iii) risk reduction with multi-domain interventions, and (iv) cognitive enhancement with cognitive and physical training. A roadmap is proposed for concept validation and ensuing clinical deployment.

SUBMITTER: Frisoni GB

PROVIDER: S-EPMC9989648 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Dementia prevention in memory clinics: recommendations from the European task force for brain health services.

Frisoni Giovanni B GB Altomare Daniele D Ribaldi Federica F Villain Nicolas N Brayne Carol C Mukadam Naaheed N Abramowicz Marc M Barkhof Frederik F Berthier Marcelo M Bieler-Aeschlimann Melanie M Blennow Kaj K Brioschi Guevara Andrea A Carrera Emmanuel E Chételat Gaël G Csajka Chantal C Demonet Jean-François JF Dodich Alessandra A Garibotto Valentina V Georges Jean J Hurst Samia S Jessen Frank F Kivipelto Miia M Llewellyn David J DJ McWhirter Laura L Milne Richard R Minguillón Carolina C Miniussi Carlo C Molinuevo José Luis JL Nilsson Peter M PM Noyce Alastair A Ranson Janice M JM Grau-Rivera Oriol O Schott Jonathan M JM Solomon Alina A Stephen Ruth R van der Flier Wiesje W van Duijn Cornelia C Vellas Bruno B Visser Leonie N C LNC Cummings Jeffrey L JL Scheltens Philip P Ritchie Craig C Dubois Bruno B

The Lancet regional health. Europe 20230131

Observational population studies indicate that prevention of dementia and cognitive decline is being accomplished, possibly as an unintended result of better vascular prevention and healthier lifestyles. Population aging in the coming decades requires deliberate efforts to further decrease its prevalence and societal burden. Increasing evidence supports the efficacy of preventive interventions on persons with intact cognition and high dementia risk. We report recommendations for the deployment o ...[more]

PMID: 36895446

Similar Datasets

Project description:BACKGROUND:US Preventive Services Task Force (USPSTF) released new recommendations on statin use for atherosclerotic cardiovascular disease (ASCVD) prevention. The Affordable Care Act (ACA) mandates USPSTF recommendations with an "A" or "B" grade receive insurance coverage without copayment. We assessed the potential impact of these recommendations. OBJECTIVE:To assess the US population meeting criteria for statin use and factors associated with use, and calculate associated costs. DESIGN AND MEASURES:We estimated 10-year ASCVD event risk scores from National Health and Nutrition Examination Survey data using Pooled Cohort Equations from the American College of Cardiology/American Heart Association and applied them to Medical Expenditure Panel Survey data. We estimated the population meeting USPSTF criteria and calculated the number of statin prescription fills and out-of-pocket and total costs. We assessed associations between statin use and sociodemographic and health characteristics and national trends in use from 1996 to 2014. PARTICIPANTS:A nationally representative sample of people aged ≥ 40 years, representing 150 million people living in the USA. KEY RESULTS:Of 26.8 million adults recommended for statins, only 41.8% were taking them. Female sex, Hispanic ethnicity, uninsured status, or living in the South was associated with lower odds of using statins. Under ACA, people with private insurance would avoid out-of-pocket cost of $9 for each generic prescription, resulting in savings of approximately $44 in annual costs. ACA's mandate for insurance coverage would result in a $193 million shift in out-of-pocket cost for statins from patients to private insurers. CONCLUSIONS:New USPSTF recommendations may result in decreased out-of-pocket costs and expanded access to statins. Previous research has shown that eliminating copayments increased adherence and decreased rates of ASCVD events without increasing overall healthcare costs. Future research will determine whether the USPSTF's recommendations will result in similar findings.

Project description:ImportanceThere are important differences among guideline recommendations for using statin therapy in primary prevention. New recommendations from the US Preventive Services Task Force (USPSTF) emphasize therapy based on the presence of 1 or more cardiovascular disease (CVD) risk factors and a 10-year global CVD risk of 10% or greater.ObjectiveTo determine the difference in eligibility for primary prevention statin treatment among US adults, assuming full application of USPSTF recommendations compared with the American College of Cardiology/American Heart Association (ACC/AHA) guidelines.Design, setting, and participantsNational Health and Nutrition Examination Survey (NHANES) data (2009-2014) were used to assess statin eligibility under the 2016 USPSTF recommendations vs the 2013 ACC/AHA cholesterol guidelines among a nationally representative sample of 3416 US adults aged 40 to 75 years with fasting lipid data and triglyceride levels of 400 mg/dL or less, without prior CVD.ExposuresThe 2016 USPSTF recommendations vs 2013 ACC/AHA guidelines.Main outcomes and measuresEligibility for primary prevention statin therapy.ResultsAmong the US primary prevention population represented by 3416 individuals in NHANES, the median weighted age was 53 years (interquartile range, 46-61), and 53% (95% CI, 52%-55%) were women. Along with the 21.5% (95% CI, 19.3%-23.7%) of patients who reported currently taking lipid-lowering medication, full implementation of the USPSTF recommendations would be associated with initiation of statin therapy in an additional 15.8% (95% CI, 14.0%-17.5%) of patients, compared with an additional 24.3% (95% CI, 22.3%-26.3%) of patients who would be recommended for statin initiation under full implementation of the 2013 ACC/AHA guidelines. Among the 8.9% of individuals in the primary prevention population who would be recommended for statins by ACC/AHA guidelines but not by USPSTF recommendations, 55% would be adults aged 40 to 59 years with a mean 30-year cardiovascular risk greater than 30%, and 28% would have diabetes.Conclusions and relevanceIn this sample of US adults from 2009-2014, adherence to the 2016 USPSTF recommendations for statin therapy, compared with the 2013 ACC/AHA guidelines, could lead to a lower number of individuals recommended for primary prevention statin therapy, including many younger adults with high mean long-term CVD risk.

Dataset Information

Dementia prevention in memory clinics: recommendations from the European task force for brain health services.

Publications

Dementia prevention in memory clinics: recommendations from the European task force for brain health services.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets