This document provides information about dementia, its history, prevalence, causes, and socioeconomic impact. Some key points: - Dementia was first described in 1907, with Alzheimer's disease identified in 1906. Pathology research was conducted in Prague in the early 20th century. - Dementia prevalence is increasing with population aging. It is projected to become one of the leading causes of disease burden globally in the 21st century. - Alzheimer's disease is the most common cause of dementia, but vascular factors and other neurodegenerative diseases can also cause dementia. - The total annual costs of dementia in the EU were estimated at €130 billion in 2007. Most costs are from informal unpaid care.

1. Dementia and its impact
Iva Holmerová

2. Dementia history
1907 – 1 case of dementia
Über eine eigenartige Erkrankung der
Hirnrinde. Allgemeine Zeitschrift für
Psychiatrie 64:146-148
ALOIS ALZHEIMER
Amyloid. plaky Neurofib. klubka

4. •OSKAR FISCHER
1876- 1942
(Slaný - KZ Teresienstadt)
Worked in the Department
of Pathology, Psychiatric
Department, Charles
University in Prague
Oskar Fischer, 1876 - 1942

5. Oskar Fischer. Die presbyophrene Demenz. 1910. 275 cases, plaques in 56 cases older 50 let.
Plaque stages I – VIII. Club – shaped neurites.Michel Goedert. Oskar Fischer and the study of
dementia. Brain 2008.

6. Arnold Pick (1851-1925)
• Director of Mental Hospital
Dobřany(1880-1886)
• Chief of Psychiatric
Department, Charles
University in Prague (1886-
1921)
• „Relation of senile
brain atrophy and
aphasia“ 1892 – first
description of „Pick´s
disease)

7. Prevalence of serious diseases and age
(FR PRES 2008, P.Amouyel)
40
30 Dementia
Cases / 100
20
Stroke
10
Parkinson
0
60 70 80 90 100
Age (years)

8. Disease burden
H.Brodaty (Paris Alzheimer, 2008):
- 19th century – infections
- 20th century – cardiovascular and
oncological diseases
- 21st century – neurodegeneration

9. World report on Alzheimer´s 2010
• 2010 – world´s costs of dementia – 1% GDP
• The care for persons dementia being a state –
then 18th largest enomomy
• Being a company then bigger than Wal-Mart or
Exxon Mobil…
• One of the most important group of diseases
BUT: investment in research, prevention and
therapy uncomparably lower than in other
diseases…

10. Socioeconomic burden of AD in Europe
(2007, Eurocode)
• Average costs of care of an „average“
dementia patient in EU 22- 30 thousand
euro per year
• Total costs in EU-27 130 billions euros
• 56% informal care
• 44% health, social and long-term care
(professional)

11. Persons with dementia - numbers
(dle ADI 2008, EuroCoDe)
EU 2011 Czech Republic:
2000 – 88 000
8 100 000 2005 – 95 000
2010 – 111 000
CZ 2011 2015 – 124 000
110 000 - 140 000 2020 – 138 000
2025 – 157 000
Globally 2030 – 180 000
2035 – 202 000
39 000 000 2040 – 213 000
2045 – 218 000
2050 – 227 000

12. Causes of dementia
• Alzheimer´s disease – the most frequent cause
• Vascular factors – the next most frequent cause
of demetia (vascular), important co-factor of
dementia manifestation (also in
neurodegeneration)
• Other neurodegenerative diseases (FTLD,
LBD…)
• curable causes of dementia and pseudodementia
cca 1% (hypothyroidism, NPH, depression…)

13. Syndrom of dementia (ABC)
• ADLs – impaired self-sufficiency
• Behavioral and psychological
symptoms
• Cognitive impairment

14. Making dementia a European priority
• Adoption of European Parliament Written Declaration by 59.24%
of MEPs – call for European Action Plan 80/2008
• European Commission Initiatives launched in July 2009:
– Council recommendation for Joint Programming of research on
neurodegenerative diseases
– Commission Communication on a European initiative on Alzheimer’s
disease and other dementias
• European Parliament resolution of 19 January 2011 on a
European initiative on Alzheimer´s disease and other dementias
• „Alzheimer Plans“ – Norway, France, UK….
• AE – patients and caregivers´organisation – role of caregivers
(70-80% persons with dementia in their care)
14

15. Prevention of dementia
• „Healthy and active ageing“ – be
active, positive, work and movement…
• Physical and mental activity
• Diet (prevention of cardiovascular
factors, antioxidants, flavonoids,
vitamins…curcuma, green tea, wine…)
• Medication: gingko biloba (memory
complaints, MCI), calcium inhibitors
(NILVAD)
•

16. Five-Country Alzheimer’s Disease Survey
• Designed and analyzed by the Harvard School of Public Health
and Alzheimer Europe
• Fieldwork conducted via telephone (landline and cell phone) by
TNS, an independent research company based in London
• Nationally representative random samples of adults age 18 and
older in five countries (Slides by Dianne Gove)
• Survey supported by a grant to Alzheimer Europe from Bayer
AG. Bayer was not involved in the design of the survey or the analysis of the findings
Interview Total
Dates Interviews Margin of Error
France February 7-14, 2011 529 +/-4.3%
Germany February 7-19, 2011 499 +/-4.4%
Poland February 7-10, 2011 509 +/-4.3%
Spain February 8-13, 2011 502 +/-4.4%
U.S. February 7-27, 2011 639 +/-3.9%
• .

17. Public Attitudes about What Disease They Are
Most Afraid of Getting, Top Three Choices
France
Cancer 41%
Alzheimer’s 27%
Stroke 18%
Germany
Cancer 44%
Alzheimer’s 23%
Stroke 14%
Poland
Cancer 43%
Heart disease 13%
Alzheimer’s 12%
Spain
Cancer 49%
Alzheimer’s 24%
Stroke 17%
U.S.
Cancer 40%
Alzheimer’s
22%
Heart disease
10%

18. Public’s Experience with Knowing Someone with
Alzheimer’s Disease
Know or have known someone with Alzheimer’s
France 72%
Germany 73%
Poland 54%
Spain 77%
U.S. 73%
And that person is/was a family member
France 30%
Germany 34%
Poland 19%
Spain 33%
U.S 42%

19. Public’s Perception of Whether Alzheimer’s Is a Fatal Disease
Yes, is a fatal disease
France 44%
Germany 33%
Poland 34%
Spain 42%
U.S. 61%
No, is not
50%
France
62%
Germany
55%
Poland
53%
Spain
35%
U.S

20. Public Attitudes about Wanting to See a Doctor If They Were
Exhibiting Signs of Confusion and Memory Loss
Yes, would want to see doctor to determine if Alzheimer’s
France 88%
Germany 90%
Poland 85%
Spain 95%
U.S. 89%
No, would not want to see doctor
France 11%
Germany 7%
Poland 9%
Spain 4%
U.S 10%

21. Public Attitudes about Wanting a Family Member Who Was
Exhibiting Signs of Confusion and Memory Loss to See a Doctor
Yes, would want family member to see doctor to determine if
France Alzheimer’s
94%
Germany 98%
Poland 97%
Spain 99%
U.S. 98%
No, would not want family member to see doctor
France 6%
Germany 1%
Poland 2%
Spain 1%
2%
U.S

22. Public Attitudes about Wanting to Be Told
If A Doctor Believed They Had Alzheimer’s Disease
Yes, would want to be told
France 97%
Germany 98%
Poland 96%
Spain 94%
No, would not want to be told
3%
France
Germany 2%
Poland 2%
Spain 5%
This question not asked in U.S.

23. Public Attitudes about Wanting a Family Member to Be Told
If a Doctor Believed That Family Member Had Alzheimer’s Disease
Among those who said would want family member to see doctor
Yes, would want family member to be told
France 84%
Germany 87%
Poland 80%
Spain 81%
No, would not want family member to be told
France 10%
Germany 9%
Poland 11%
Spain 13%
This question not asked in U

24. Public’s Interest in Getting a Test Before Exhibiting Symptoms to Determine If
They Were Likely to Get Alzheimer’s in the Future, Should Such a Test Become
Available
Very likely to get such a test
France 26%
Germany 23%
Poland 30%
Spain 39%
U.S. 30%
Somewhat likely
France 39%
Germany 28%
Poland 48%
Spain 32%
U.S 35%
Not too/not at all likely
France
33%
Germany 48%
Poland 20%
Spain 27%
U.S 35%

25. Public’s Perception of Whether There Is Or Will Be an Effective Medical or
Pharmaceutical Treatment to Slow the Progression of Alzheimer’s Disease in
the Next Five Years
There is an effective treatment now
France 40%
Germany 42%
Poland 63%
Spain 27%
U.S. 47%
There will be an effective treatment in next five years
France 31%
Germany 14%
Poland 7%
Spain 26%
U.S 24%
Is not an effective treatment now/will not be one in five years
France 18%
Germany 19%
Poland 8%
Spain 18%
U.S 18%

32. Children book – The Magic Tape
Recorder
Supported by Krka