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Prevention of dementia

Prevention, DFCs, Awareness

The prevention aspects contained within the strategies were primarily, though not exclusively, focused on primary prevention 1, with secondary and tertiary prevention mentioned to a lesser degree. It is the case that many of the services and supports contained in other areas of the strategies constitute preventative measures to some degree, however, very few of the strategies identified those measures as such.

Primary prevention

The English and Welsh strategies both commit to a number of actions to ensure that the public people understand the steps they can take to reduce their risk, or delay the onset, of dementia, including ensuring risk reduction messages are included in relevant public health policies and programmes, as well as ensuring people with dementia receive advice about changes they could make to improve their general health and well-being.

The Irish strategy follows a similar approach addressing both population and individual level prevention. The national focus includes targeting high risk populations, including people with intellectual disabilities, with the strategy proposing to manage individual tobacco and alcohol use, as well as the physical activity of the person with dementia, within their care plans.

The Flanders strategy focuses on existing prevention organisations incorporating dementia into their campaigns and messaging, linking this to legislation on health prevention. This was organised in collaboration with a number of other countries (Germany, Luxembourg, Netherlands and Norway) to develop the “SaniMemorix” resources.

The Israeli strategy committed to implementing a programme and disseminating findings in relation to prevention following a clinical consensus conference.

The Greek strategy focuses on work required across health, social care, local authorities and non-profit organisations to raise awareness of prevention and risk factors. The Greek strategy is unique in its commitment to the introduction of annual screening programmes around risk factors.

The Northern Ireland strategy provides detailed information on the area of prevention, addressing a number of areas including the promotion of healthy lifestyles and avoidance of risk factors. The strategy is unique insofar as it is the only one which references and gives consideration to initiatives that may reduce serious head injuries.

The Luxembourg strategy committed to carrying out a primary prevention campaign focused on active ageing and good health by maintaining social contacts. There was a specific focus on the role of carers and their health, raising awareness of respite, as well as means of primary and secondary prevention.

The Spanish neurodegenerative strategy focuses on primary prevention and the elimination of the factors associated with the appearance of neurodegenerative diseases. Specifically, it proposes the promotion of healthy lifestyles as a means of preventing or delaying the development of some neurodegenerative diseases, through community and inter-sectoral programmes (e.g. in schools, health education etc.) as well as through the promotion of occupational health programmes.

Prevention of associated risk

The Norwegian strategy provides a greater focus on the prevention of risks associated with dementia, such as an increase in falls, with a target of a 10 % reduction in the number of hip fractures by 2018 through training and development of quality indicators, home visits and the patient safety programme. As part of this, the strategy commits to developing new guidelines to assist municipalities in developing preventive and health-promoting measures for older people, including recommendations on models for preventive home visits and health-promoting services.

The Northern Irish strategy indicates consideration will be given to further development of secondary prevention targets to its dementia indicator. Additionally, it proposes developing referral pathways for genetic testing services for people likely to have genetic risk factors for developing dementia. Finally, national services commit to ensuring that a range of provision is developed to help people preserve function.

The French neurodegenerative strategy focuses on tertiary preventative measures, and as part of this, underlining the role of individuals and the carer or family member closest to them in managing the illness, primarily through therapeutic education.

Links to existing prevention strategies

The Norwegian strategy distinguishes between primary and secondary prevention, looking at both risk factors for developing dementia but also minimising the effects of the condition once it has developed. As part of this, the strategy focuses on the overlap in preventing dementia and other non-communicable diseases (NCDs), which is reflected in Norway’s NCD strategy (which is linked to the World Health Organization’s target of reducing premature mortality by 25%).

The Finnish strategy commits, by 2020, to ensuring that brain health promotion has been factored into all sectors of society. This includes dedicated funding supporting activities promoting brain health, including all public bodies having responsibility for providing support and information about brain health, as well as NGOs publishing information. Additionally, joint municipal authorities will have responsibility for updating their health care provision plans to incorporate brain health.

The Italian strategy also notes the need to promote both primary and secondary prevention of dementia. It noted that dementia had been included within the country’s first national prevention plan and was under consideration as part of the ongoing development of the revised plan. In a similar approach, the Irish strategy notes that, at a national level, there is overlap in reducing dementia through addressing risk factors and the strategy on physical activity.

The Norwegian strategy commits to the creation of a separate strategy for older people with a view to promoting activity through employment, voluntary work, participation in the local community, social life and physical activity, with more emphasis given to health promotion and the ways communities can strengthen individual’s functional capacity. Separately, there is reference within the strategy to a white paper which is being drawn up in relation to substance misuse.

The English strategy proposes its measures within the context of a healthy ageing campaign and access to tools such as a personalised risk assessment calculator.

Focus on the role of practitioners

The Northern Irish strategy incorporates elements of prevention whilst specifically outlining the role of certain practitioners. Primary care professionals have a prominent role in this regard, targeting different population groups, including middle aged and older people, people with existing conditions which put them at risk and people with an existing diagnosis. Primary care professionals are expected to offer lifestyle advice, monitor, review and treat modifiable factors, and play a central role in the ongoing care of people who have been diagnosed with the condition. As part of this, the strategy notes that consideration will be given to the addition of primary prevention targets for dementia.

Similarly, the Czech strategy placed the focus of prevention onto healthcare professionals, noting the need for changes to the training of GPs and the professional development of pharmacists.

Footnote

1     For the purposes of this document, primary prevention is considered as interventions aimed at those targeted before health effects occur, secondary prevention as interventions which aim to identify diseases in the earliest stages and tertiary prevention as interventions which manage the disease after diagnosis to slow or stop disease progression.

 

 
 

Last Updated: Monday 29 April 2019

 

 
  • Acknowledgements

    This report received funding under an operating grant from the European Union’s Health Programme (2014-2020). The content of the Yearbook represents the views of the author only and is his/her sole responsibility; it cannot be considered to reflect the views of the European Commission and/or the Consumers, Health, Agriculture and Food Executive Agency or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for use that may be made of the information it contains
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