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Dementia and the population health approach: promise, pitfalls and progress. An Australian perspective

Published online by Cambridge University Press:  05 March 2015

Catherine Travers ,
David Lie  and
Melinda Martin-Khan
Catherine Travers
Affiliation:
School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia
David Lie
Affiliation:
Metro South Addiction & Mental Health Service, Queensland Health, Brisbane, Queensland, Australia
Melinda Martin-Khan*
Affiliation:
Centre for Online Health, The University of Queensland, Brisbane, Queensland, Australia Centre for Research in Geriatric Medicine, The University of Queensland, Woolloongabba, Queensland, Australia
*
Address for correspondence: Dr Melinda Martin-Khan, Research Fellow, Centre for Research in Geriatric Medicine, The University of Queensland, Level 2, Building 33, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Queensland 4102, Australia. Email: [email protected]
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Summary

The increasing prevalence of dementia in Australia (and worldwide) over the next few decades poses enormous social, health and economic challenges. In the absence of a cure, strategies to prevent, delay the onset of, or reduce the impact of dementia are required to contain a growing disease burden, and health and care costs. A population health approach has the potential to substantially reduce the impact of dementia. Internationally, many countries have started to adopt population health strategies that incorporate elements of dementia prevention. The authors examine some of the elements of such an approach and barriers to its implementation.

International dementia frameworks and strategies were reviewed to identify options utilized for a population health approach to dementia.

Internationally and nationally, dementia frameworks are being developed that include population health approaches. Most of the frameworks identified included early diagnosis and intervention, and increasing community awareness as key objectives, while several included promotion of the links between a healthy lifestyle and reduced risk for dementia.

A poor evidence base (especially for illness prevention), diagnostic and technical limitations, and policy and implementation issues are significant barriers in maximizing the promise of population health approaches in this area.

The review and analysis of the population health approach to dementia will inform national and jurisdictional policy development.

Keywords

Alzheimer’s diseasedementiahealth policyhealth promotionpublic healthprevention
Type
Review Article
Information
Reviews in Clinical Gerontology , Volume 25 , Issue 1 , February 2015 , pp. 60 - 71
Copyright
Copyright © Cambridge University Press 2015 

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References

1Australian Institute of Health and Welfare (AIHW). Dementia in Australia: national data analysis and development. AIHW cat. no. AGE 53. Canberra: AIHW; 2006.Google Scholar
2Access Economics. Keeping dementia front of mind: incidence and prevalence 2009–2050. Canberra: Alzheimer's Australia; 2009.Google Scholar
3Goss, J.Projection of Australian health care expenditure by disease, 2003 to 2033. Cat. no. HWE 43. Canberra: AIHW; 2008.Google Scholar
4Alzheimer's Disease International (ADI). World Alzheimer Report 2009. London: ADI; 2009. Available at: http://www.alz.co.uk/research/worldreport/.Google Scholar
5Access Economics. Delaying the onset of Alzheimer's disease: projections and issues. ACT: Alzheimer's Australia; 2004.Google Scholar
6World Health Organisation (WHO). The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Geneva: WHO; 1993. Available at: http://www.who.int/substance_abuse/terminology/ICD10ResearchDiagnosis.pdf.Google Scholar
7Ballard, C, Gauthier, S, Corbett, A, Brayne, C, Aarsland, D, Jones, E. Alzheimer's disease. Lancet 2011; 377: 1019–31.CrossRefGoogle ScholarPubMed
8Kurrle, S, Hogarth, R, Hill, J.Physical Comorbidities of dementia. Sydney: Dementia Collaborative Research Centre; 2010.Google Scholar
9WHO. Health Promotion Glossary. Geneva: WHO; 1986. Available at: http://www.who.int/hpr/NPH/docs/hp_glossary_en.pdf.Google Scholar
10Commission on Chronic Illness. Chronic illness in the United States. Vol. 1. Published for the Commonwealth Fund. Cambridge, MA: Harvard University Press; 1957.Google Scholar
11Brodaty, H. Realistic expectations for the management of Alzheimer's disease. European Neuropsyhopharmacology 1999; 9: 43–52.Google Scholar
12Mrazek, PJ, Haggerty, RJ (eds). Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research. Washington, DC: National Academy Press; 1994.Google Scholar
13Gordon, R. An operational classification of disease prevention. Public Health Rep 1983; 98: 107–109.Google Scholar
14Commonwealth Department of Health and Aged Care. National Action Plan for Promotion, Prevention and Early Intervention for Mental Health 2000. Canberra, ACT: Mental Health and Special Programs Branch, Commonwealth Department of Health and Aged Care; 2000.Google Scholar
15National Public Health Partnership (NPHP). A planning framework for public health practice. Melbourne: NPHP; 2000.Google Scholar
16WHO. The Ottawa Charter for Health Promotion. Geneva: WHO; 1986.Google Scholar
17Australian Institute of Health and Welfare (AIHW). Chronic disease and associated risk factors in Australia, AIHW cat. no. PHE 81. Canberra: AIHW; 2006.Google Scholar
18Alzheimer Europe: Policy in Practice: National Dementia Plans. Available at: http://www.alzheimer-europe.org/EN/Policy-in-Practice2/National-Dementia-Plans.Google Scholar
19Congress of the USA. (2010). An act to establish the National Alzheimer's Project. Available at: http://www.gpo.gov/fdsys/pkg/BILLS-111s3036enr/pdf/BILLS-111s3036enr.pdf.Google Scholar
20Daviglus, ML, Bell, CC, Berrettini, W, Bowen, PE, Connolly, ES Jr, Cox, NJet al.National Institutes of Health State-of-the-Science Conference Statement: preventing Alzheimer disease and cognitive decline. Ann Intern Med 2010; 153: 176–81.Google Scholar
21Eyre, H, Kahn, R, Robertson, RM, ACS/ADA/AHA Collaborative Writing Committee. Preventing cancer, cardiovascular disease, and diabetes: a common agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association. CA Cancer J Clin 2004; 54: 190–207.Google Scholar
22Department of Human Services. Pathways to the Future, 2006 and Beyond – Dementia Framework for Victoria 2006–2008. Melbourne: Victorian Government; 2006. Available at: http://www.health.vic.gov.au/agedcare/downloads/dementia_policyframework.pdf.Google Scholar
23Department of Health. Living well with dementia: a National Dementia Strategy. London: UK Department of Health; 2009. Available at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_094058.Google Scholar
24Olazarán, J, Reisberg, B, Clare, L, Cruz, I, Peña-Casanova, J, Del Ser, Tet al.Nonpharmacological therapies in Alzheimer's disease: a systematic review of efficacy. Dementia Geriatr Cogn Disord 2010; 30: 161–78.Google Scholar
25Banerjee, S, Wittenberg, R. Clinical and cost effectiveness of services for early diagnosis and intervention in dementia. Int J of Geriatric Psychiatry 2009; 24: 748–54.Google Scholar
26Takeda, A, Tanaka, N, Chiba, T. Prospects of future measures for persons with dementia in Japan. Psychogeriatrics 2010; 10: 95–101.CrossRefGoogle ScholarPubMed
27California's Alzheimer's Disease State Plan Task Force (CADSPTF). California's State plan for Alzheimer's disease: An action plan for 2011–2021. California: CADSPTF; 2009. Available at: www.chhs.ca.gov/Documents/State%20Plan%20-%20FINAL.pdf.Google Scholar
28Quantum Consulting Australia. (2011). Review of the National Framework for Action on Dementia 2006–2010. Canberra: Commonwealth Department of Health and Ageing; 2011. Available at: http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-dementia-nfad.htm.Google Scholar
29Williams, JW, Plassman, BL, Burke, J, Holsinger, T, Benjamin, S.Preventing Alzheimer's Disease and Cognitive Decline. Evidence Report/Technology Assessment No. 193. AHRQ Publication No. 10-E005. Rockville, MD: Agency for Healthcare Research and Quality; 2010.Google ScholarPubMed
30Qiu, C, Xu, W, Fratiglioni, L. Vascular and psychosocial factors in Alzheimer's disease: epidemiological evidence towards intervention. J Alzheimer's Dis 2010; 20: 689–97.CrossRefGoogle Scholar
31Woodward, M, Brodaty, H, Budge, M, Byrne, G, Farrow, M, Flicker, Let al.Dementia Risk Reduction: The Evidence. Canberra: Alzheimer's Australia; 2007. Available at: http://www.alzheimers.org.au/upload/RiskReductionSept07.pdf.Google Scholar
32O’Brien, JT, Erkinjuntti, T, Reisberg, B, Roman, G, Sawada, T, Pantoni, Let al.Vascular cognitive impairment. Lancet Neurology 2003; 2: 89–98.Google Scholar
33Australian Bureau of Statistics (ABS). National Health Survey 2004–05: Summary of Results. ABS cat no. 4364.0. Canberra, ACT: ABS; 2006.Google Scholar
34Gatz, M, Reynolds, CA, Fratiglioni, L, Johansson, B, Mortimer, JA, Berg, Set al.Role of genes and environments for explaining Alzheimer's disease. Arch Gen Psychiatry 2006; 63: 168–74.CrossRefGoogle Scholar
35Iliffe, S, Drennen, V.Primary Care and Dementia. London: Jessica Kingsley; 2001.Google Scholar
36American Psychiatric Association (APA). Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Washington, DC: APA; 1994.Google Scholar
37McKhann, G, Drachman, D, Folstein, M, Katzman, R, Price, D, Stadlan, EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's disease. Neurology 1984; 34: 939–44.Google Scholar
38National Screening Committee. Appraisal for screening for Alzheimer's disease. London: UK NSC; 2009.Google Scholar
39Phillips, J, Pond, D, Goode, SM.Timely diagnosis of dementia: can we do better? Canberra: Alzheimer's Australia; 2011. Available at: http://www.fightdementia.org.au/research-publications/alzheimers-australia-numbered-publications.aspx.Google Scholar
40Milne, A. Dementia screening and early diagnosis: the case for and against. Health, Risk Soc 2010; 12: 65–76.CrossRefGoogle Scholar
41Moodie, R, Harper, T, Oldenburg, B.A national agency for promoting health and preventing illness. National Health and Hospitals Reform Commission (NHHRC). Canberra: NHHRC; 2008. Available at: http://www.health.gov.au/internet/nhhrc/publishing.nsf/Content/16F7A93D8F578DB4CA2574D7001830E9/$File/national-agency-promoting-health-illness.pdf.Google Scholar
42Scottish Government. Scotland's National Dementia Strategy; 2010. Available at: http://www.scotland.gov.uk/Publications/2010/09/10151751/17.Google Scholar
43.Welsh Assembly Government National Dementia Action Plan for Wales (Draft); 2009. Available at: http://wales.gov.uk/consultations/olderpeople/nationaldementiaactionplan/?lang=en&status=closed.Google Scholar
44French Government. National plan for ‘Alzheimer and related diseases’ 2008–2012; 2008. Available at: http://www.alzheimer-europe.org/Policy-in-Practice2/National-Dementia-Plans/France.Google Scholar
45Ministry of Health, Welfare and Sports. The Dementia Care Plan; 2008. Available at: http://www.alzheimer-europe.org/Policy-in-Practice2/National-Dementia-Plans/Netherlands.Google Scholar
46Norwegian Ministry of Health and Care Services (MHCS). Dementia Plan 2015. Norwegian MHCS: Oslo; 2007. Available at: http://www.regjeringen.no/upload/HOD/Dokumenter%20KTA/DementiaPlan2015.pdf.Google Scholar
47Republic of Korea Government. Korea's War on Dementia; 2008. Available at: http://www.alz.co.uk/plans/republic-of-korea.Google Scholar
48Lee, S. Dementia strategy Korea. Int J Geriatr Psychiatry 2010; 25: 931–32.Google Scholar