Paola Barbarino, CEO

Alzheimer’s Disease International

Dementia: global

issues and local

impact -

The road to 2025

• Dementia is a trillion dollar disease in 2018 – rising to

US$2 trillion by 2030

• Making dementia a

global priority

• Reducing stigma

• Facilitating research

• Global voice

on dementia

since 1984

• Alzheimer associations in 94

Countries

• Official status with WHO

• World Alzheimer Reports on

latest care & research

Alzheimer’s Disease International Global voice on dementia in 94 countries

Focus on Low and Middle

Income Countries (LMICs)

• Only 4 national plans on dementia have been developed in LMICs (Cuba,

Mexico, Costa Rica, and Indonesia)

• The greatest number of plans in development are also in LMICs - 20

countries in 2018

The WHO Global Dementia

Action Plan

Source: World Health

Organization (WHO, 2017):

http://www.who.int/mental_health/

neurology/dementia

The plan has targets for each action area and will be monitored in 2020,

2023, and 2025

• Awareness and education

• Risk reduction

• Timely diagnosis and access to treatment

• Support at home, and for family caregivers

• Coordination of care, incl. community care

• Training for health professionals

• Dementia friendliness

• Commitment to research

• Data and technology

Dementia in Israel

• 150,000 people with dementia

• The number of elderly in Israel

is expected to reach 1.66 million

in 2035 - increasing 77%

between 2015 and 2035 at a

growth rate 2.2 times faster than

that of the general population*

• World Alzheimer Report 2015:

substantial outlier in Western

Europe - substantially and

significantly higher prevalence

Projections by Israel’s Central Bureau of

Statistics (CBS)*

Israel’s National Program

for Addressing Dementia

• 2013: a group of multi-

organizational and multi-ministerial

experts formulated

recommendations for a plan

• 2014: Director General of the

Ministry of Health used these as

the basis of the plan

• Holistic plan - covers all 7 action

areas of the WHO Plan

• Should be used as an example

Source:

https://www.health.gov.il/English/Topics/SeniorHeal

th/DEMENTIA/Pages/National_program.aspx

From plan to impact: Progress

towards the targets of the Global

action plan on dementia

• Progress to develop national responses to

dementia – Target 1 of the Global plan

• 32 Countries or territories have implemented

a dedicated response to dementia – 28 are in

development

• 27 WHO Member States have developed a

plan – 18% of Target 1 of the Global plan

• Progress is slow – more than 15 plans are

needed every year to achieve plans in 146

States by 2025

www.alz.co.uk/reports

Effectiveness of existing plans is

very uneven

Sample of 23 plans, November 2017

• Data on dementia is lacking

• Less than half of plans are

funded

National dementia policies

adopted since 2015

National dementia policies adopted since 2015

18 new plans needed every year from 2019 to cover 75% of countries by 2025

Dementia as public health priority:

The global challenge

• National plans are needed to address unique impact

of dementia in each country

• National plans need to be funded to be effective

• National plans and activities need to be monitored

• ADI, its members and people with dementia can help

to advocate, advise and monitor

• It will take time and effort translating global policy into

local action

See whether your country has developed a plan at:

www.alz.co.uk/dementia-plans

Positive signs of action in 2018

• Dementia included in the WHO draft programme of work

2019-2023

• Dementia included in the WHO commission on Non

Communicable Diseases Report to be discussed at UN

• GDO launched successfully to monitor national data and

responses

– But only 21 nations included - Israel is not one of them

Interesting publications in 2018

• Countries failing to diagnose dementia

- primary care doctors lack the necessary

skills and training

• Physicians average only 12 hours of

dementia training during medical school

• Primary care doctors correctly identify

only around 50-75% of dementia cases

• Only 2 OECD countries (UK and

Denmark) have set specific targets

to improve their diagnosis rates

Source:

http://www.oecd.org/

health/care-needed-

9789264085107-

en.htm

OECD: The Ten Key Objectives

for Dementia Policy

End of life (chapter 5) End of life care for people with dementia presents specific challenges

Advanced dementia (chapter 5) Greater need for formal care services and specialised accommodation

Early dementia (chapter 4) Living in the community and relying on informal care

Those who wish to care for friends and relatives are supported

People with dementia live in safe and appropriate environments

Communities are safer for and more accepting of people with dementia

Dementia is diagnosed quickly once someone becomes concerned about symptoms

The risk of people developing dementia is minimised

Prevention (out of scope)

First symptoms appear

Diagnosis (chapter 3)

Care is coordinated, proactive and delivered closer to home

Health facilities recognise and effectively manage dementia patients

Progression of dementia

Care coordination and the role of technology (chapter 6) 1

2

3

4

5

Formal care services are safe and of a high quality

6

10 9

7

People with dementia die with dignity in the place of their choosing

8

The potential of technology to transform dementia care is realised

Store

• In 2015 informal carers provided 82

billion hours of care for people

living with dementia

• This is the equivalent of more than

40 million full time workers – and

will increase to 65 million full time

workers by 2030 Source:

https://www.alz.co.uk

/adi/pdf/global-

estimates-of-

informal-care.pdf

Some other interesting work in

2018

• 2016: Dementia Friends initiative started

by Israel’s Ministry of Health, JDCESHEL

(The Association for the Planning and

Development of Services for the Aged in

Israel) and EMDA

• Several local authorities have taken up

the programme – supervised by EMDA,

who provides tools and support

• June 2017: information sessions and

training nation-wide

• 2018: 6,000 dementia friends

WHO Global Action Plan - Action area 2:

Dementia awareness and friendliness

https://www.youtube.com/watch?feature=pl

ayer_embedded&v=TsrkKE_rba8

Dementia Awareness Campaign

2014: Call for proposals from

Sick Funds to propose

projects for the development

of the services in primary

medical care, in the area of

prevention, early diagnosis

and treatment of patients

suffering from Alzheimer and

other types of dementia

Source:

https://www.health.gov.il/Subjects/Geriatric

s/Dementia/Documents/Dementia_announ

cement.pdf (in Hebrew)

WHO Global Action Plan - Action area 3 and 4:

risk reduction; diagnosis, treatment and care

• Request for proposal to issue health

funds to address continuum of care

from community hospital-community

with emphasis on primary caregiver

• Caregiver support and in-service

training of professionals

• Dementia Care Pathways program to

improve/streamline hospital discharge

process

WHO Global Action Plan - Action area 5:

Support for dementia carers

• March 2018: UK-Israel Synergy

Symposium – Protein misfolding in

ageing and neurodegeneration: from

basic biology to drug development

• Sponsored by the British Council,

Frontiers and UK Science and

Innovation Network

• Covered topics from mechanisms of

neurodegeneration in aging, to drug

design and therapeutics perspectives

WHO Global Action Plan - Action area 7:

Dementia research and innovation

A call to action: Israel can really help

the global effort

• Israel is an important country

when it comes to global dementia

advocacy – holistic national plan,

research, awareness campaigns

• Need more coordinated global

advocacy to reach the plan’s

targets

• Israel can provide an example of

inspiration to others

Looking forward to 2019

at ADI • Global Dementia Observatory

(GDO)

• Focus on entrepreneurship

and innovation

• More work on consumer

empowerment

• Research participation global

webinars (CT)

• STRiDE project

• World Alzheimer Report 2019

- stigma and raising

awareness

Sign up on the ADI website: www.alz.co.uk/webinars-research-participation

Let’s Talk Dementia

Research webinar series

Global partnerships

Follow ADI on Twitter @AlzDisInt

Like us on Facebook /alzheimersdiseaseinternational

Visit our website www.alz.co.uk

Upcoming meetings

International Conference of Alzheimer's Disease

International, Singapore – 18-20 March 2020