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European initiative on Alzheimer’s disease and other dementias

2010/2084(INI)

PURPOSE: to propose a European initiative on Alzheimer’s disease and other dementias

BACKGROUND: dementia is a decline in mental ability that usually develops slowly, causing impaired memory, thinking and judgement, and personality may deteriorate. It predominantly affects those aged over 60. The best available estimates indicate that, in 2006, 7.3 million Europeans between 30 and 99 years of age were suffering from different types of dementia (12.5 per 1 000 inhabitants). Within this group, more women (4.9 million) than men (2.4 million) are affected. With the increase in life expectancy, dementia's incidence has increased dramatically and some current forecasts project a doubling of the number of persons affected every 20 years. The total direct and informal care costs of Alzheimer's disease and other dementias in 2005 amounted to EUR 130 billion for the EU 27 region (EUR 21 000 per patient/year); 56% of costs were generated by informal care. However, Alzheimer's disease remains under-diagnosed in the EU. According to the available epidemiological data, only half of those suffering from the disease are currently identified.

The objective of this Communication is to set out actions providing support to Member States in ensuring effective and efficient recognition, prevention, diagnosis, treatment, care, and research for Alzheimer's disease and other dementias in Europe. For this a Joint Action between the European Commission and the Member States as defined in the Work Plan for the implementation of the Second Health Programme (2008-2013) will be launched in 2010. This will in turn contribute to the overarching goal - an improvement in health outcomes, and therefore a growth in Healthy Life Years, a key Lisbon Strategy indicator.

CONTENT: there are four key issues that Community action could help to address:

  • people can act to help prevent dementia, especially vascular dementia and in some extent also Alzheimer's disease. Early diagnosis can ensure that interventions take place while they are most effective. However, there is a lack of awareness of the importance of prevention and early intervention;
  • there is a clear need for improved understanding of dementias, in particular of Alzheimer's disease and other neurodegenerative types. Yet there is very limited coordination of research, an issue with particular potential for European added value, and a lack of sufficient epidemiological data to help direct research and action in the future;
  • there are good practices emerging in different places across the EU with regard to diagnosis, treatment and financing of therapies for these conditions, but they are not being shared throughout the Union. This is all the more important given that the EU is confronted with staff shortages of formal carers, and problems stemming from a lack of support for informal carers;
  • insufficient attention is being paid to rights of people suffering from a cognitive deficit. There is also a lack of recognition of the mental capital of older people, lack of understanding by the general public of what Alzheimer's disease is, and a stigma associated with dementias that can influence the health of these patients.

Community action

Acting early to diagnose dementia and to promote well-being with age: promoting good physical and mental health (e.g. developing a healthy cardiovascular system, encouraging education and learning throughout life) can help to avoid cognitive decline leading to dementia. Furthermore, there is growing evidence that mental activity and stimulation (through lifelong learning as well as through social interactions) reduces the risk of developing dementia. The Commission proposes the following actions:

  • to incorporate the 'dementia dimension' into the EU's ongoing and future actions on health prevention, especially those related to cardiovascular health and physical activity;
  • to produce a set of recommendations, which would help citizens to prevent dementia diseases;
  • to include the 'dementia dimension' in flexible European policies on retirement and in the framework for action on older people in the European Pact for Mental Health and Wellbeing. of 13 June 2008.

A shared European effort to better understand dementia conditions: improving epidemiological knowledge and coordination of research. Reliable prevalence and incidence data on dementias are essential if Member States are to be able to make appropriate provision. The Commission proposes:

  • to improve epidemiological data on Alzheimer's disease and other dementias, implementing the conclusions of the European Collaboration on Dementia (EuroCoDe)” Project;
  • to use the planned European Health Examination Survey to provide new Europe-wide data on the prevalence of people with early cognitive deficiencies;
  • to adopt a proposal for a Council Recommendation on a pilot Joint Programming initiative on combating neurodegenerative diseases as a pilot, in particular Alzheimer's disease. The purpose of this Recommendation is to develop a new approach, through cooperation and collaboration between national research programmes, for more effectively tackling common European challenges in the area of neurodegenerative diseases, hence making better use of Europe's limited public R&D funds.

Supporting national solidarity with regard to dementias: sharing best practices for care of people suffering dementia: the Commission proposes:

  • -to map good practices related to treatment and care for persons suffering from Alzheimer's disease and other forms of dementia and to improve the dissemination and application of such practices (using, when possible, the Structural Funds);
  • to develop, by means of the Open Method of Coordination, quality frameworks for medical and care services for people with dementias;
  • to use facilities provided for in the EU Disability Action Plan (DAP) 2003-2010 to support patients' organisations.

Respecting the rights of people with dementias: the image of Alzheimer’s disease and other dementias in European society is a negative one, often associated with fear and helplessness that can influence the health of these patients. The Commission proposes to:

  • establish, using the facilities provided by the Health Programme, a European Network for rights and dignity of people with dementia, which should formulate recommendations on dignity, autonomy and social inclusion, and to share best practices on respecting the rights of vulnerable adults and tackling patient abuse.

The Commission will use the different legal instruments at its disposal (Health Programme, FP7, EU Disability Action, Open Method of Coordination and Statistical Programme) in an integrated way that permits a high level of efficiency and coordination, and optimum use of resources. Community action can help to support the Member States in addressing the issue of dementias as European society ages, but success in meeting this challenge will mostly depend on the primary role of Member States and civil society.

The Commission will also support World Alzheimer's Day (21 September) through European and national initiatives, and will also foster cooperation at an international level with all interested countries and in close collaboration with the World Health Organisation. International cooperation is already an integral part of the Framework Programmes for Research.

Next steps: the Commission will produce by 2013 an implementation report on this Communication at the end of the Joint Action between the European Commission and the Member States implementing the actions of this Communication.