Megan Brooks

August 02, 2016

TORONTO ― Dementia prevention, risk reduction, and delivery of high-quality care are global dementia research priorities, according to an analysis by a global advisory group led by the World Health Organization (WHO).

There is a "growing need" to prioritize dementia research investments, said Hiral Shah, MD, from Columbia University Medical Center, in New York City, here at the Alzheimer's Association International Conference (AAIC) 2016.

According to the World Alzheimer Report 2015, globally, the number of people living with dementia is expected to rise from the current 46 million to 131.5 million by 2050. Global costs to treat dementia, estimated at about US$818 billion in 2015, are expected to soar to $1 trillion by 2018 and to $2 trillion by 2030.

To help advance the global dementia research agenda and investment priorities, the WHO led a research prioritization exercise.

More than 200 researchers and stakeholders provided research questions that were consolidated into 59 research avenues, which were scored by 162 researchers and stakeholders from 39 countries with regard to five criteria: potential for success, impact on burden reduction, potential for conceptual breakthrough, potential for translation, and equity.

The overarching research goals identified by the exercise are as follows:

  • Prevention and risk reduction

  • Diagnosis, biomarker development, and disease monitoring

  • Drug and nondrug treatment research

  • Quality and delivery of care for people with dementia and their caregivers

  • Physiology and progression of normal ageing and disease

  • Increasing public awareness and understanding

"The theme of dementia risk reduction was the most dominant and received the highest overall research priority score," Dr Shah and senior author Tarun Dua, MD, MPH, of the WHO, in Geneva, Switzerland, note in their meeting abstract.

Prevention, identification and reduction of dementia risk, and delivery and quality of care for dementia patients and their caregivers were the broad themes of six of the top 10 overall research priorities, they say.

In the extended top 20 priorities list, diagnosis and biomarker research and treatment development made up seven of the top priorities. Basic research into disease mechanisms was considered to have the greatest potential for conceptual breakthrough.

"Our hope is that the research priorities identified by this intensive and systematic international process will inform and motivate policy makers, funders, and researchers to reduce the global burden of dementia," Dr Shah added in a conference statement. "Future aims include identifying culture and system-specific research priorities and identifying gaps and opportunities for increased investment."

"Good Affirmation"

In an interview with Medscape Medical News, Robert J. Egge, chief public policy officer of the Alzheimer's Association, said, "We are very excited about what the World Health Organization is doing. This priority setting exercise is a good affirmation of what we all believe as a community that we need to focus on globally.

"Whether you are in a high-income country or low-income country, there are themes like aging populations, growing prevalence, and higher costs that are common throughout. What this priority setting exercise honed in are the commonalities between countries," he added.

In a statement, Heather M. Snyder, PhD, Alzheimer's Association senior director of medical and scientific operations, who is also a member of the advisory group for the project, said, "The urgency is clear, yet more governments still need to make funding dementia research a high priority."

Egge noted that, on a global basis, funding is "fundamentally driven by what's happening in the United States, and that's true for other developed countries. The United States does the lion's share when it comes to the precompetitive space, and there it's all about what the NIH [National Institutes of Health] is doing. And that's a very exciting story."

Since the National Alzheimer's Project Act (NAPA) was signed into law in 2011, funding has more than doubled to just under $1 billion, he explained. "That has not happened in a generation for any other disease that is already established. It's really unprecedented recognition," Egge said. "And what we saw this summer is that Congress is lined up to do another major step up in funding. Scientists have said globally that we need $2 billion per year to make adequate progress."

This work was led by the WHO with support from the UK Department of Health. The authors have disclosed no relevant financial relationships.

Alzheimer's Association International Conference (AAIC) 2016. Abstract 12426. Presented July 25, 2016.

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