Alzheimer’s Disease: A Chronic Illness
The Alzheimer’s Disease Plan: France
Dr. Ménard served as author of a report on the National Plan on Alzheimer’s and Related Diseases 2008-2012, commissioned by French President Nicolas Sarkozy. The report’s multiple objectives included advising on ethical concerns, research approaches, therapeutic methods, and care delivery. While efforts to further the patient-oriented national initiative continue, Dr. Ménard described the progress made in creating a national plan aimed at enabling researchers from differing domains (clinical care, research, government) to collaborate in long-term efforts to improve Alzheimer’s disease (AD) care at international, national, and local levels.
The initiative represented formal recognition that Alzheimer’s and related dementias meet criteria distinguishing key health priorities, according to Dr. Ménard. Specifically, dementia affects a large number of people; significant Disability-Adjusted Life Years are lost (DALYs); the incidence and prevalence of AD within an aging social demographic are growing; dementia produces significant emotional and practical difficulties for families and caregivers; and the condition requires complex medical and social care with correspondingly high costs.
The need for a national plan was also brought into focus as research better defined the growing burden of dementia in France. Dr. Ménard presented comparative data suggesting that the impact of AD compared to other illnesses such as cancer and cardiovascular disease is growing in significance, and in women specifically is now the most burdensome, producing the most DALYs lost.
The plan combines a concerted financial effort (200 million euros for research, 200 million euros for medical care, 1.2 billion euros for medico-social support) with a broader initiative to develop insights into the disease process and efforts to improve the quality of life of people with dementia and their caregivers. The committee reports to the Inspector General of Finance, and the Steering Committee and supervisory committees meet regularly. Finally, there is a working session with the President every 6 months.
The French national plan aims to facilitate the work of multidisciplinary centres. The goal is to attract new medical research teams and connect their work with existing teams, encourage young researchers to pursue dementia-related themes, and advance a national policy supporting PhD and postdoctoral researchers. There is also federal support for a scientific foundation aimed at attracting national and foreign researchers. The aim is to harmonize interprofessional efforts to coordinate the talents of those in different disciplines such as patient care, coordination and conducting of clinical trials, neuropsychology, neuroimaging, and biomarkers study.
The bulk of the research investments under the 2008-2012 Alzheimer plan is earmarked for basic research and biomarkers (70 million euros) and clinical research (45 million euros).
As a major component of the plan involves improving quality of life for patients and caregivers, part of the initiative includes developing better respite care services, funding facilities where families can be housed and patient day centres, and financing two training days for caregivers. Other initiatives include funding of memory clinics.
According to Dr. Ménard, the plan reflects a local vision that directly involves individuals, in addition to facilitating noninstitutional care programs.
Dr. Ménard concluded that the promise of such plans is that research and clinical advancements made in AD prevention and management will serve other chronic disease models and better patient care overall.