Alzheimer’s, 700,000 patients who don’t want to be forgotten
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In the time that allows a speaker a brief institutional greeting, someone in Italy has received a diagnosis of Alzheimer’s. And probably he received it too late, that is when the symptoms are already visible and the disease is in an advanced stage. “Maybe we don’t realize it, because the brain’s plasticity allows it to cope, at least for a while, with the progressive deterioration of some functions. But Alzheimer’s damage has already been underway for years in one patient”, explained Paolo Rossini, neurologist and national coordinator of the Interceptor program, during the institutional event “Alzheimer’s and neuroscience: a priority for the country”, at Palazzo Montecitorio in Rome, on the initiative of the honorable Annarita Patriarca, co-promoter of the Parliamentary Intergroup for Neuroscience and Alzheimer’s.
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The numbers of Alzheimer’s in Italy
In Italy today there are an estimated 1,200,000 cases of dementia, with an increase of almost 150,000 diagnoses each year and with a growth rate destined to grow significantly due to the progressive aging of the population. Alzheimer’s disease, which has 700,000 cases in Italy, is the third cause of death among the over 65s in Western Europe following complications related to the development of the disease and one of the main causes of disability in the over 60 population worldwide. From an economic point of view, in Italy the costs related to Alzheimer’s disease are estimated at 15.6 billion euros, of which 80% is directly supported by the patients’ families.
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Investments for early diagnosis
Interceptor, launched in 2018, is intended precisely to identify the cases most at risk of developing Alzheimer’s in order to be able to intervene very early. Because to date the results of drug research have been disappointing, even if the recent FDA approval of an innovative drug that appears to be able to slow the progression of the disease suggests a light at the end of the tunnel. The ideal – continues Rossini, borrowing a football metaphor – is in fact to have a long bench: many reserve players able to replace those who get hurt. However, if the reserve runs out, the team risks losing the match. In the case of Alzheimer’s, when the brain is no longer able to cope with the loss of function caused by the disease, drugs can do little to halt the decline.
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Precisely to avoid reaching the bench exhaustion, so to speak, early diagnosis is needed to start treating the disease before it’s too late. At the moment, in fact, we don’t have a cure, but only therapies capable of improving the symptoms of Alzheimer’s, recalls Alessandro Padovani, president-elect of the Italian Society of Neurology. Today, thanks to biological drugs, the main aim is to cleanse the brain of accumulations of beta-amyloid, the protein that causes the progressive deterioration of cognitive functions. But combined therapeutic approaches are needed, also made up of prevention and understanding of risk factors with plasma markers to identify the “responders” – continues Padovani – that is, the patients who will benefit most from the treatments. Not only that: we need a more efficient path for the management of patients with dementia, a network of dedicated centers in which neurologists and geriatricians can ensure continuous monitoring of drug efficacy and adverse events.
The political goals
Hence the birth of the Parliamentary Intergroup, whose objective, Patriarca recalled, is to generate a strong awareness on the part of the institutions regarding the need to consider these pathologies a primary public health problem, tackling the most critical issues in structural way. “We will focus on dialogue with national and regional institutions, the academic and scientific world – promises Patriarca – in order to promote legislative and regulatory solutions to ensure early and accurate diagnosis, effective and integrated care of patients with Alzheimer’s and from other neurodegenerative and neuroimmunological pathologies, and to support research in the field of Neuroscience in Italy”.
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“We hope that the wind of research is really changing – underlined Patrizia Spadin, president of AIMA Alzheimer – because up to now the economic impact and the difficulties of that million and a half Italian families that have to deal with Alzheimer’s factors have been largely underestimated”. In short, we need structural investments and in specialized personnel, and an “Alzheimer-proof” PNRR capable of giving support to family caregivers and promoting training among professional ones. Because, Spadin concluded, Alzheimer’s patients have been excluded from the political agenda for too long.
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