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World Alzheimer Report 2016 - Alzheimer Disease International

World Alzheimer Report 2016 Improving healthcare for people living with dementiacoverage, QualIty and costs now and In the future AuthorsProf Martin Prince The Global Observatory for Ageing and Dementia care ,King s College London, UKMs Adelina Comas-Herrera Personal Social Services Research Unit (PSSRU),London School of Economics and Political Science, UKProf Martin Knapp Personal Social Services Research Unit (PSSRU),London School of Economics and Political Science, UKDr Ma lenn Guerchet The Global Observatory for Ageing and Dementia care ,King s College London, UKMs Maria Karagiannidou The Global Observatory for Ageing and Dementia care , King s College London, UKPublished by Alzheimer s Disease International (ADI), Alzheimer s Disease InternationalAcknowledgementsFor chapter 6, the authors would like to acknowledge invaluable contributions from Emiliano Albanese, Sara Allin, Hoyoung An, Stefanie Becker, Cynthia Blick, Larry Chambers, Maneesha Chhikara, Eva Cyhlarova, Emily Freeman, Bo Hu.

chapter 5 Palliative care 70 Introduction 70 what is palliative care? 70 how, and when, is palliative care applicable to dementia care? 71

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Transcription of World Alzheimer Report 2016 - Alzheimer Disease International

1 World Alzheimer Report 2016 Improving healthcare for people living with dementiacoverage, QualIty and costs now and In the future AuthorsProf Martin Prince The Global Observatory for Ageing and Dementia care ,King s College London, UKMs Adelina Comas-Herrera Personal Social Services Research Unit (PSSRU),London School of Economics and Political Science, UKProf Martin Knapp Personal Social Services Research Unit (PSSRU),London School of Economics and Political Science, UKDr Ma lenn Guerchet The Global Observatory for Ageing and Dementia care ,King s College London, UKMs Maria Karagiannidou The Global Observatory for Ageing and Dementia care , King s College London, UKPublished by Alzheimer s Disease International (ADI)

2 , Alzheimer s Disease InternationalAcknowledgementsFor chapter 6, the authors would like to acknowledge invaluable contributions from Emiliano Albanese, Sara Allin, Hoyoung An, Stefanie Becker, Cynthia Blick, Larry Chambers, Maneesha Chhikara, Eva Cyhlarova, Emily Freeman, Bo Hu, Binna Kim, Hanna Kim, Ki Woong Kim, You Joung Kim, Andreas Kopp, Mariana Lopez-Ortega, Maria Lopez-Quiroga, Klara Lorenz, Kaeyun Park, Ruru Ping, Anna Rupert, Tara P. Sani, DY Suharya, Natalie Warrick, Marc Wortmann, Jie chapter 7, the authors would like to acknowledge Eva Cyhlarova, Daniel Chisholm and Amritpal Rehill, and the members of ADI s Medical and Scientific Advisory Panel (MSAP).

3 This Report was supported financially by GE Healthcare, Roche, Janssen, Lundbeck, Lilly and Biogen for which ADI is very grateful. ADI and the authors are fully responsible for the David O Connor photo ShutterstockChapter 1 Martin PrinceChapter 2 Martin Prince, Maria KaragiannidouChapter 3 Ma lenn Guerchet, Maria KaragiannidouChapter 4 Martin Prince, Maria KaragiannidouChapter 5 Martin Prince, Maria Karagiannidou Chapter 6 Adelina Comas-Herrera, Martin KnappChapter 7 Adelina Comas-Herrera, Martin Knapp, Martin PrinceChapter 8 Martin PrinceThe World Alzheimer Report 2016 was independently researched and authored by the Global Observatory for Ageing and Dementia care and the PSSRU at the London School of Economics and Political Sciences, with contributions listed above.

4 The evidence reported and the inferences drawn in Chapters 1-7 are the responsibility of the authors alone. Chapter 8 was developed by the authors with additional input from Alzheimer s Disease International . forewordToday, 47 million people live with dementia worldwide, more than the population of Spain. This number is projected to increase to more than 131 million by 2050, as populations age. Dementia also has a huge economic impact. The total estimated worldwide cost of dementia is US$818 billion, and it will become a trillion dollar Disease by huge majority of people with dementia have not received a diagnosis, and so are unable to access care and treatment. Even when dementia is diagnosed, the care provided is too often fragmented, uncoordinated, and unresponsive to the needs of people living with dementia, their carers and families.

5 This is World Alzheimer Report 2016 reviews the state of healthcare for dementia around the World , and recommends ways that it can be improved. There is a clear and urgent need to improve the coverage of healthcare around the World , for people living with dementia now and those who will be in the future. Through cost modelling, the Report shows that these improvements are affordable and achievable, but governments and societies need to effect transformative change to deliver them. It is essential that this are grateful to the authors from The Global Observatory for Ageing and Dementia care at King s College London and the Personal Social Services Research Unit at the London School of Economics and Political Science for producing this Report .

6 We appreciate the support of our sponsors GE Healthcare, Roche, Janssen, Lundbeck, Lilly and Biogen which made the Report , the global federation of 85 Alzheimer associations, is committed to ensuring that dementia becomes an International health priority. We believe national dementia plans are the first step towards ensuring all countries are equipped to enable people to live well with dementia, and help to reduce the risk of dementia for future generations. There is now a growing list of countries which have such provision in place or are developing national dementia plans, but it is not enough. We hope that the adoption of a Global Plan on Dementia by the World Health Organization in 2017 will commit member states to act on many of the recommendations contained in this the World , we need to drive forward improvements in healthcare and social care , as well as eliminating the stigma around dementia and ensuring that people living with dementia are included in society and that their human rights are recognised are committed to ensuring prevention, care and inclusion happen today, and a cure ReesChair Alzheimer s Disease InternationalImprovIng healthcare for people lIvI ng wIth dementIaalzheImer s Disease International .

7 World Alzheimer Report 2016 ContentsExecutive summary 1chapter 1 Introduction 6healthcare in context 6structural barriers to the delivery of effective healthcare for older people 7purposes of healthcare for dementia 8healthcare resources 8functions and processes of healthcare for dementia 9principles of healthcare for dementia 9health system level interventions to improve the quality of dementia care 11conclusion 17chapter 2 The role of primary care in the dementia healthcare system 21objectives and search strategy 21search results, and characteristics of the eligible studies 21framework for presentation of research findings on the role of primary care in dementia healthcare 27detection and diagnosis 27post-diagnostic care and support 34continuing care 36summary and discussion 39chapter 3 care coordination and case management for people with dementia 46objectives and search strategy 46search results, and characteristics of the eligible studies 47what is the evidence to support case management (cost-) effectiveness?

8 47 Implementation of case management 54summary and discussion 55chapter 4 Acute general hospital care for people with dementia 58 Background 58how often are people with dementia admitted to hospital? 58are older people with dementia at increased risk of harm during a hospital admission, and what are the likely mechanisms? 60what are the excess healthcare costs associated with acute hospital care for people with dementia, and what are the principal drivers? 61how might admissions to hospital be avoided? 62for those people with dementia who are admitted to hospital, what might reduce harm, and improve outcomes? 64chapter 5 palliative care 70 Introduction 70what is palliative care ?

9 70how, and when, is palliative care applicable to dementia care ? 71advanced care planning 72end-of-life care 76summary and conclusion 80chapter 6 Dementia care in Canada, China, Indonesia, Mexico, South Africa, South Korea and Switzerland 84 Introduction 84dementia care in canada 84dementia care in china 87dementia care in Indonesia 91dementia care in mexico 94dementia care in south africa 96dementia care in south Korea 100dementia care in switzerland 104chapter 7 Cost implications of the dementia healthcare pathways 110care pathways modelling 110costing methods 113results 115chapter 8 Summary and conclusion 122 Introduction the scope of this Report 122summary of review findings 123discussion and conclusion 127 ImprovIng healthcare for people lIvI ng wIth dementIaalzheImer s Disease International .

10 World Alzheimer Report 2016 Alzheimer s Disease International World Alzheimer Report 2016 Improving healthcare for people living with dementia coverage, QualIty and costs now and In the futurethe global observatory for ageing and dementia careThe Global Observatory for Ageing and Dementia care , hosted at the Health Service and Population Research Department, King s College London, was founded in 2013. Supported by Alzheimer s Disease International , and King s College London, the Observatory has a tripartite mission:1. To build upon ADI s 10/66 Dementia Research Group program of population-based and intervention research in low and middle income countries, maximising the impact that research findings from our data can have upon policy and To develop, evaluate, and promote primary care and community interventions for people with To synthesise global evidence for policymakers and public, in particular, continuing and developing our role in the preparation of high impact evidence-based reports for Alzheimer s Disease International ( World Alzheimer Reports 2009, 2010, 2011, 2013, 2014 and 2015, and Nutrition and dementia), the World Health Organization (Dementia.)


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