Experts call for coordinated public education and research programmes to avert a brain disease crisis
Experts are calling for a public health campaign aimed at promoting a ‘brain-healthy lifestyle’ to reduce the risk of developing neurodegenerative brain diseases, such as Alzheimer’s disease and Parkinson’s disease.
The campaign should support existing health promotion work by emphasising that “what is good for the heart is generally good for the brain,” they urge.
In a report published by the Oxford Health Policy Forum today, they go on to talk about a ‘window of opportunity’ in midlife where individuals may be able to make the biggest difference to their risk of developing neurodegenerative disease or of delaying its progress.
The public education campaign should be underpinned by a coordinated research programme, which is aimed at developing clinical tests for identifying those at risk of developing neurodegenerative diseases ‒ before signs and symptoms appear. Research to develop new treatments and other tests to facilitate earlier diagnosis must also continue, and health systems must prepare now for the time when such tests are available.
“People need to understand the risk factors that can affect their brain health and what can be done to maintain it and to help prevent neurodegenerative diseases,” said neurologist Professor Gavin Giovannoni from Queen Mary University of London and Co-chair of the author group of a new evidence-based report, Time matters: a call to prioritize brain health.
The report summarises published evidence and the consensus findings of an international multidisciplinary expert group, including clinicians, researchers and representatives from patient advocacy and professional groups.
“Deterioration in the structure or function of nerve cells (neurodegeneration) begins many years before any symptoms become obvious. This means that diagnosis often occurs at a relatively late stage in the disease course, when substantial damage to nerve cells has already taken place,” explained Dr Alastair Noyce, from Queen Mary University of London and Co-chair of the author group.
“We conclude that there is a ‘10–20-year window of opportunity’ in midlife during which people can reduce the risk of developing a neurodegenerative disease or delay its progress. We cannot change our genetic make-up, but we can help reduce the risk of developing neurodegenerative diseases ourselves by taking exercise, keeping socially active, eating healthily, reducing alcohol intake, stopping smoking and keeping our brains active.”
Neurodegenerative diseases are becoming more common as people live longer, but they are not an inevitable consequence of normal ageing. Worldwide, Alzheimer’s disease affects about 50 million people and Parkinson’s disease affects more than 6.1 million people; these numbers are rising.
“Planning for the healthcare structures of the future has to start now if we’re to avert a crisis,” stressed Professor Giovannoni. “Neurodegenerative diseases pose an enormous socioeconomic and individual burden, and this will continue to grow as the population ages.”
The report sets out a series of consensus recommendations, including:
- improve public understanding of how to protect brain health through lifestyle measures – such as exercise and a healthy diet
- prepare for the likely increased demand for genetic testing by those wanting to understand their risk of a neurodegenerative disease
- provide access to available and effective treatments in a timely manner
- provide accessible holistic care, including prevention information, treatment options and support
- conduct research to identify accurate and cost-effective tests for disease detection and diagnosis
- develop, validate and approve tests, tools and apps for monitoring brain health.
Several professional associations and advocacy groups – including European Brain Council, Alzheimer’s Research UK, Parkinson’s UK and European Parkinson’s Disease Association – have endorsed the recommendations
Welcoming the report, Dr Hilary Evans, Chief Executive of Alzheimer’s Research UK, said: “Evidence shows that what’s good for the heart is good for the brain, but this message is yet to hit home with the public. Only a third of people think it’s possible to reduce their risk of dementia, and we must do more to empower people with knowledge about the actions they could take to protect their brain health. Alzheimer’s Research UK wholeheartedly supports the timely and important recommendations of this report.”
Representing the European Brain Council, Professor Monica Di Luca echoed the need for action and collaboration: “The European Brain Council has for years been highlighting the importance and cost of brain diseases. This report strengthens the case for governments to prioritise brain health and to prepare for the challenges that healthcare systems will face as the burden of brain disease continues to increase.”
Time matters: a call to prioritize brain health was launched at the European Health Forum Gastein conference (the ‘Davos’ for Public Health) on Thursday 3 October.
Read the full report HERE.
Notes to editor
Lead author and Chair, Professor Gavin Giovannoni, and other members of the author group are available for interview.
Professor Gavin Giovannoni is centre lead for neuroscience and trauma at the Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London.
Professor Philip Scheltens, a leading expert in Alzheimer’s disease and Co-chair of the report, is based at the Alzheimer Center Amsterdam, Amsterdam University Medical Centers, Netherlands.
Author and Co-chair of the report, Dr Alastair Noyce, is a Clinical Senior Lecturer, at Queen Mary University of London and a Neurology Registrar at Barts. His main research interests are in the area of Parkinson’s disease.
Time matters: a call to prioritize brain is published by Oxford Health Policy Forum CIC, a not-for-profit community interest company registered in England and Wales (Registration number: 10475240).
A full copy of the report is available at www.oxfordhealthpolicyforum.org
Preparation of the report was funded by educational grants from Biogen and F. Hoffmann-La Roche, who had no influence on the content.
About neurodegenerative diseases
Neurodegeneration is a consequence of disease-related processes in the brain that result in a loss of function of the nervous system.1 Neurodegenerative diseases are long-term progressive conditions that cause a decline in brain health and result in premature age. Age is the strongest risk factor for neurodegenerative diseases,2 and these diseases are becoming more common as people are living longer.
The two most common neurodegenerative diseases are Alzheimer’s disease and Parkinson’s disease. Some, but not all, neurodegenerative diseases are causes of dementia. Dementia is the fifth highest cause of death and the number of global deaths is predicted to double over the next 20 years.3
The financial cost of neurodegenerative disease to society is considerable, both in terms of direct (e.g. medical) and indirect (e.g. sick leave) healthcare costs and in the significant loss of workforce hours. The global costs of dementia have increased from US$604 billion in 2010 to US$818 billion in 2015.3,4 The World Health Organization (WHO) has estimated that, by 2030, Alzheimer’s disease and other dementias will be responsible for 1.2% of the total deterioration in health-related quality of life.5
Alzheimer’s disease (AD) is the most common neurodegenerative disease and the most common cause of dementia.6 It involves the progressive loss of specialised cells in the brain (neurons) that affect behaviour, memory and cognition, which significantly and progressively impacts a person’s ability to maintain the activities of daily living.7,8 More than 520,000 people in the UK have dementia caused by AD; worldwide, AD affects about 50 million people.7,8
Parkinson’s disease (PD) is caused when brain cells stop producing ‘dopamine’, a chemical that controls movement.9 Symptoms can include an altered way of walking, a stooped posture, tremors and small handwriting.9 In the later stages it is characterised by balance problems which often result in falls. The number of people diagnosed with PD in the UK is around 145,000; worldwide, PD affects more than 6 million people.10
- Mattson MP, Magnus T. Ageing and neuronal vulnerability. Nat Rev Neurosci 2006;7:278–94.
- Livingston G, Sommerlad A, Orgeta V et al. Dementia prevention, intervention, and care. Lancet 2017;390:2673–734.
- Prince M, Wimo A, Guerchet M et al. World Alzheimer report 2015: the global impact of dementia, 2015. Available from: https://www.alz.co.uk/research/world-report-2015 (Accessed 15 January 2019).
- Wimo A, Guerchet M, Ali GC et al. The worldwide costs of dementia 2015 and comparisons with 2010. Alzheimers Dement 2017;13:1–7.
- World Health Organization. Neurological Disorders. Public health challenges Switzerland: WHO, 2006. Available from: https://www.who.int/mental_health/neurology/neurological_disorders_report_web.pdf (Accessed 15 January 2019).
- Cummings JL, Cole G. Alzheimer disease. JAMA 2002;287:2335–8.
- World Health Organization. Dementia fact sheet, 2017. Available from: http://www.who.int/en/news-room/fact-sheets/detail/dementia (Accessed 6 February 2019).
- Alzheimer’s Research UK. Dementia Attitudes Monitor – Wave 1 Report 2018, 2019. Available from: https://www.dementiastatistics.org/wp-content/uploads/2019/02/Dementia-Attitudes-Monitor-Wave-1-Report.pdf (Accessed 6 February 2019).
- Sveinbjornsdottir S. The clinical symptoms of Parkinson’s disease. J Neurochem 2016;139:318–24.
- Dorsey ER, Elbaz A, Nichols E et al. Global, regional, and national burden of Parkinson’s disease, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet Neurol 2018;17:939–53.
Chris Mahony, Interim Faculty Communications Executive (Medicine and Dentistry)
Marketing and Communications Department, Queen Mary University of London
T: 0207 8825315