The world of Alzheimer's disease (AD) is moving to preclinical AD and to prevention.
1
,
2
This probably beneficial phenomenon will bring some new challenges. We will have
to identify the patients who are most at risk to develop dementia for future targeted
therapy and adapted intervention.
3
Older adults are presently more educated, with better control of vascular and metabolic
risk factors, and more elect to stay healthy. On the other hand, due to the augmentation
of life expectancy, more and more persons reach 85+ years, and so some general health
aspects, including comorbidities and frailty must be taken into consideration.
4
,
5
Primary care settings (PCSs) are in the best position to give the more adapted response
to this new challenge (Alzheimer prevention) because they know the patients, their
family, living conditions, other morbidities, and have a prospective view. Primary
care settings must be able to target 2 large categories of older adults at risk of
cognitive decline, and give the more appropriate response: Older adults with subjective
memory complaints
6
in generally good health condition and the oldest old with both physical and cognitive
frailty.
- Jessen F.
- Amariglio R.E.
- van Boxtel M.
- et al.
Subjective Cognitive Decline Initiative (SCD-I) Working Group. A conceptual framework
for research on subjective cognitive decline in preclinical Alzheimer's disease.
Alzheimers Dement. 2014 May 3; (pii: S1552-5260(14)00002-8. http://dx.doi.org/10.1016/j.jalz.2014.01.001. [Epub ahead
of print])
7
We review in this editorial these 2 potential targets and how cognitive decline monitoring
and prevention, including AD, could be integrated in the PCS.
8
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Footnotes
The authors declare no conflicts of interest.
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© 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
