Dementia prevention in memory clinics: recommendations from the European task force for brain health services

Giovanni B Frisoni; Daniele Altomare; Federica Ribaldi; Nicolas Villain; Carol Brayne; Naaheed Mukadam; Marc Abramowicz; Frederik Barkhof; Marcelo Berthier; Melanie Bieler-Aeschlimann; Kaj Blennow; Andrea Brioschi Guevara; Emmanuel Carrera; Gaël Chételat; Chantal Csajka; Jean-François Demonet; Alessandra Dodich; Valentina Garibotto; Jean Georges; Samia Hurst; Frank Jessen; Miia Kivipelto; David J Llewellyn; Laura McWhirter; Richard Milne; Carolina Minguillón; Carlo Miniussi; José Luis Molinuevo; Peter M Nilsson; Alastair Noyce; Janice M Ranson; Oriol Grau-Rivera; Jonathan M Schott; Alina Solomon; Ruth Stephen; Wiesje van der Flier; Cornelia van Duijn; Bruno Vellas; Leonie N C Visser; Jeffrey L Cummings; Philip Scheltens; Craig Ritchie; Bruno Dubois

doi:10.1016/j.lanepe.2022.100576

Dementia prevention in memory clinics: recommendations from the European task force for brain health services

Lancet Reg Health Eur. 2023 Jan 31:26:100576. doi: 10.1016/j.lanepe.2022.100576. eCollection 2023 Mar.

Authors

Giovanni B Frisoni¹, Daniele Altomare¹, Federica Ribaldi¹, Nicolas Villain^{2

3}, Carol Brayne⁴, Naaheed Mukadam⁵, Marc Abramowicz⁶, Frederik Barkhof^{7

8}, Marcelo Berthier⁹, Melanie Bieler-Aeschlimann^{10

11}, Kaj Blennow¹², Andrea Brioschi Guevara^{10

13}, Emmanuel Carrera¹⁴, Gaël Chételat¹⁵, Chantal Csajka¹⁶, Jean-François Demonet^{10

17}, Alessandra Dodich¹⁸, Valentina Garibotto¹⁹, Jean Georges²⁰, Samia Hurst²¹, Frank Jessen^{22

23

24}, Miia Kivipelto^{25

26

27

28}, David J Llewellyn^{29

30}, Laura McWhirter³¹, Richard Milne^{4

32}, Carolina Minguillón^{33

34

35}, Carlo Miniussi^{18

36}, José Luis Molinuevo^{33

37}, Peter M Nilsson^{38

39}, Alastair Noyce⁴⁰, Janice M Ranson²⁹, Oriol Grau-Rivera³³, Jonathan M Schott⁴¹, Alina Solomon^{42

43

28}, Ruth Stephen⁴², Wiesje van der Flier^{44

45

46}, Cornelia van Duijn^{47

48}, Bruno Vellas⁴⁹, Leonie N C Visser^{25

50}, Jeffrey L Cummings⁵¹, Philip Scheltens^{44

52}, Craig Ritchie⁵³, Bruno Dubois^{2

3}

Affiliations

¹ Memory Center, Department of Rehabilitation and Geriatrics, University Hospitals and University of Geneva Geneva, Switzerland.
² Institut de la Mémoire et de la Maladie d'Alzheimer, IM2A, Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, Paris, France.
³ Institut du Cerveau et de la Moelle Épinière, UMR-S975, INSERM, Paris, France.
⁴ Cambridge Public Health, University of Cambridge, Cambridge, UK.
⁵ Division of Psychiatry, University College London, London, UK.
⁶ Genetic Medicine, Diagnostics Dept, University Hospitals and University of Geneva, Geneva, Switzerland.
⁷ Radiology & Nuclear Medicine, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
⁸ Queen Square Institute of Neurology, University College London, London, UK.
⁹ Unit of Cognitive Neurology and Aphasia, Centro de Investigaciones Médico-Sanitarias (CIMES), University of Malaga, Malaga, Spain.
¹⁰ Leenaards Memory Centre, Department of Clinical Neurosciences, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
¹¹ Infections Disease Service, University Hospital of Lausanne (CHUV), Lausanne, Switzerland.
¹² Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden.
¹³ Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.
¹⁴ Stroke Center, Department of Clinical Neurosciences, University Hospitals and University of Geneva, Geneva, Switzerland.
¹⁵ Normandie University, UNICAEN, INSERM, U1237, PhIND Physiopathology and Imaging of Neurological Disorders, Cyceron, Caen, France.
¹⁶ Center of Research and Innovation in Clinical Pharmaceutical Sciences, University Hospital and University of Lausanne, Lausanne, Switzerland.
¹⁷ French Clinical Research Infrastructure Network, INSERM, University Hospital of Toulouse, France.
¹⁸ Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, Italy.
¹⁹ Division of Nuclear Medicine and Molecular Imaging, University Hospitals of Geneva and NIMTLab, University of Geneva, Geneva, Switzerland.
²⁰ Alzheimer Europe, Luxembourg.
²¹ Institute for Ethics, History, and the Humanities, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
²² Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
²³ German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany.
²⁴ Excellence Cluster Cellular Stress Responses in Aging-Related Diseases (CECAD), Medical Faculty, University of Cologne, Germany.
²⁵ Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
²⁶ Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
²⁷ Theme Aging, Karolinska University Hospital, Stockholm, Sweden.
²⁸ The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK.
²⁹ College of Medicine and Health, University of Exeter, UK.
³⁰ Alan Turing Institute, Exeter, UK.
³¹ Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, UK.
³² Engagement and Society, Wellcome Connecting Science, Hinxton, UK.
³³ Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.
³⁴ IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
³⁵ CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.
³⁶ Centre for Medical Sciences (CISMed), University of Trento, Rovereto, Italy.
³⁷ H. Lundbeck A/S, Denmark.
³⁸ Department of Clinical Science, Lund University, Sweden.
³⁹ Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden.
⁴⁰ Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
⁴¹ Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK.
⁴² Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
⁴³ Division of Clinical Geriatrics, NVS, Karolinska Institutet, Stockholm, Sweden.
⁴⁴ Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, the Netherlands.
⁴⁵ Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands.
⁴⁶ Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands.
⁴⁷ Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
⁴⁸ Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
⁴⁹ Gerontopole and Alzheimer's Disease Research and Clinical Center, Toulouse University Hospital, Toulouse, France.
⁵⁰ Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, the Netherlands.
⁵¹ Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV, USA.
⁵² EQT Life Sciences, Amsterdam, the Netherlands.
⁵³ Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.

Abstract

Observational population studies indicate that prevention of dementia and cognitive decline is being accomplished, possibly as an unintended result of better vascular prevention and healthier lifestyles. Population aging in the coming decades requires deliberate efforts to further decrease its prevalence and societal burden. Increasing evidence supports the efficacy of preventive interventions on persons with intact cognition and high dementia risk. We report recommendations for the deployment of second-generation memory clinics (Brain Health Services) whose mission is evidence-based and ethical dementia prevention in at-risk individuals. The cornerstone interventions consist of (i) assessment of genetic and potentially modifiable risk factors including brain pathology, and risk stratification, (ii) risk communication with ad-hoc protocols, (iii) risk reduction with multi-domain interventions, and (iv) cognitive enhancement with cognitive and physical training. A roadmap is proposed for concept validation and ensuing clinical deployment.

Keywords: Cognitive enhancement; Dementia; Memory clinic; Prevention; Risk assessment; Risk communication; Risk reduction.

Publication types

Review

Abstract

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