ABSTRACT
The care of a patient with Alzheimer's disease (AD) is considered from the perspective of an ecosystem, that is, a systemic approach describing effective partnership, collaboration and research aimed at creating value, involving all participants in the AD patient journey. The effectiveness of this ecosystem is only possible with the involvement of all stakeholders in its development, including patients, healthcare professionals at all levels, government agencies, private companies, and patient organizations. The unmet health care and information needs of patients with AD are a consequence of barriers in the AD ecosystem. Key barriers for the patient include low awareness and stigmatization of the disease in society, lack of quality epidemiological data, difficulties in timely diagnosis, lack of prevention programs, unpreparedness of most physicians to conduct AD patient rehabilitation, and other factors. Based on the analysis of the ecosystem of AD and the patient pathway, 10 main directions (strategies) necessary for the formation of the ecosystem were identified: conducting research in the diagnosis and epidemiology of AD, creating and implementing a cognitive health program, forming a legal framework, raising public awareness, optimizing patient routing for timely diagnosis, organizing a network of memory clinics/laboratories, creating a register of patients with dementia, developing digital solutions and supporting social projects.
Subject(s)
Alzheimer Disease , Alzheimer Disease/diagnosis , Alzheimer Disease/epidemiology , Alzheimer Disease/therapy , Delivery of Health Care , Ecosystem , Humans , Russia/epidemiologyABSTRACT
OBJECTIVE: To study the structure and prevalence of cognitive and non-cognitive mental disorders in the elderly caregivers of the patients with Alzheimer's disease (AD). MATERIAL AND METHODS: We compared two groups of people: 59 caregivers living with AD patients who were not their blood relatives (group 1) and 20 first-degree relatives of AD patients who lived separately and were not caregivers (group 2). RESULTS: In group 1, the frequency of depression was 35,2% and in group 20,0% (p<0,05). Behavioral and psychotic disorders in the patient, in particular, excitement, anxiety, sleep disorders, irritability and apathy, were risk factors of depression in caregivers. Mild cognitive impairment was identified in 16% in group 1 and in 10% in group 2 (p<0,05). CONCLUSION: Caregiving to the patient with AD is a risk factor for depression disorders in the old age. People who are at risk need special medical, social and psychological care.
ABSTRACT
Mental disorders of cognitive and non-cognitive spectrum in the first-degree relatives of patients with Alzheimer's disease (AD) were studied in 134 relatives, mean age 47.6 years, including 110 children and 24 siblings of probands. Compared to the age-matched controls (22 normals without relatives with AD), the higher frequency of the following mental disorders was found in the relatives: Alzheimer's phobia, irritable weakness, mild cognitive impairment, including difficulties in learning new information and reduced sustained attention due to tiredness (2 times more frequent), difficulties in recollection of remote events (1.4 times more frequent), signs of constitutional cognitive deficit in the anamnesis (2-4 times more frequent), the combinations of two or three types of cognitive deficits (3-4 times more frequent), the combination of communicating hydrocephalus with MRI signs of cerebrovascular pathology (3,4 times more frequent). The data obtained in the study can help develop treatment/ rehabilitation measures to prevent the progression of cognitive deficit.
