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Review
. 2021 Oct 11;13(1):168.
doi: 10.1186/s13195-021-00827-2.

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

Daniele Altomare #  1   2 , José Luis Molinuevo #  3 , Craig Ritchie  4 , Federica Ribaldi  5   6   7   8 , Emmanuel Carrera  9 , Bruno Dubois  10 , Frank Jessen  11 , Laura McWhirter  4 , Philip Scheltens  12   13 , Wiesje M van der Flier  12   14 , Bruno Vellas  15 , Jean-François Démonet #  16 , Giovanni B Frisoni #  5   6 ; European Task Force for Brain Health Services
Collaborators, Affiliations
Review

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

Daniele Altomare et al. Alzheimers Res Ther. .

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.

Keywords: Aging; Alzheimer’s disease; Brain Health Services; Cognitive enhancement; Dementia; Dementia risk; Personalized medicine; Prevention; Risk communication; Risk reduction.

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Conflict of interest statement

JLM is currently a full-time employee of Lundbeck and has previously served as a consultant or at advisory boards for the following for-profit companies, or has given lectures in symposia sponsored by the following for-profit companies: Roche Diagnostics, Genentech, Novartis, Lundbeck, Oryzon, Biogen, Lilly, Janssen, Green Valley, MSD, Eisai, Alector, BioCross, GE Healthcare, ProMIS Neurosciences.

BD has received research funding (paid to the institution) from Merck-Avenir Foundation, Roche and consultancy fees from Biogen, Neurodiem, Green Valley, Cytox, Brainstorm. He is PI of clinical trials with EISAI, Genentech, Novartis, Biogen, Roche.

PS has received consultancy fees (paid to the institution) from AC Immune, Alkermes, Alnylam, Anavex, Biogen, Brainstorm Cell, Cortexyme, Denali, EIP, ImmunoBrain Checkpoint, GemVax, Genentech, Green Valley, Novartis, Novo Noridisk, PeopleBio, Renew LLC, Roche. He is PI of studies with AC Immune, CogRx, FUJI-film/Toyama, IONIS, UCB, Vivoryon. He serves on the board of the Brain Research Center.

WMvdF has received consultancy fees (paid to the institution) from Oxford Health Policy Forum CIC, Roche BV. She has been an invited speaker at Boehringer Ingelheim, Biogen MA Inc., and WebMD Neurology (Medscape). She has performed contract research for Biogen MA Inc. and Boehringer Ingelheim. All funding is paid to her institution. WF is associate editor at Alzheimer’s Research & Therapy.

JFD has received consultancy fees from Biogen and OM Pharma; unrestricted grants from OM Pharma; and has collaboration agreements with Siemens and MindMaze.

GBF reports grants from Alzheimer Forum Suisse, Académie Suisse des Sciences Médicales, Avid Radiopharmaceuticals, Biogen, GE International, Guerbert, Association Suisse pour la Recherche sur l’Alzheimer, IXICO, Merz Pharma, Nestlé, Novartis, Piramal, Roche, Siemens, Teva Pharmaceutical Industries, Vifor Pharma, and Alzheimer’s Association; he has received personal fees from AstraZeneca, Avid Radiopharmaceuticals, Elan Pharmaceuticals, GE International, Lundbeck, Pfizer, and TauRx Therapeutics.

The other coauthors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
BHS activities today and in the next few years, in comparison with memory clinics
See this image and copyright information in PMC

References

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