Brain health services for the secondary prevention of cognitive impairment and dementia: Opportunities, challenges, and the business case for existing and future facilities - 18/03/25

Doi : 10.1016/j.tjpad.2025.100098

Giovanni B. Frisoni ^a,^⁎ , Federica Ribaldi ^a, Gilles Allali ^b, Théophile Bieth ^c, Andrea Brioschi Guevara ^b,^d, Stefano Cappa ^e,^f, Lisa Cipolotti ^g, Kristian Steen Frederiksen ^h, Jean Georges ⁱ, Frank Jessen ^j,^k,^l, Giacomo Koch ^m,^n,^o, Hugh Masters ^p, Augusto J. Mendes ^a, Lutz Frölich ^q, Valentina Garibotto ^r, Oriol Grau-Rivera ^s, Federico E. Pozzi ^t, Dorota Religa ^u,^v, Ayda Rostamzadeh ^j, Lenny Shallcross ^w, Susan D. Shenkin ^u,^x, Wiesje M. van der Flier ^y,^z,^aa, Meike W. Vernooij ^ab, Leonie N.C. Visser ^ac,^ad, Jeffrey L. Cummings ^ae, Philip Scheltens ^y,^af, Bruno Dubois ^c,^ag, Elena Moro ^h, Claudio L.A. Bassetti ^ah,^ai, Miia Kivipelto ^ac,^aj,^ak,^al
^a Memory Center, Department of Rehabilitation and Geriatrics, University Hospitals and University of Geneva, Geneva, Switzerland
^b Leenaards Memory Centre, Department of Clinical Neurosciences, University Hospital of Lausanne (CHUV), Lausanne, Switzerland
^c Institut de la Mémoire et de la Maladie d'Alzheimer, IM2A, Groupe Hospitalier Pitié-Salpêtrière, Sorbonne Université, Paris, France
^d Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
^e Federation of the European Societies of Neuropsychology (FESN) University Institute of Advanced Studies Pavia, Italy
^f IRCCS Istituto Auxologico Italiano, Milan
^g Federation of the European Societies of Neuropsychology (FESN), Switzerland
^h European Academy of Neurology (EAN), Switzerland
ⁱ Alzheimer Europe, Switzerland
^j Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
^k German Center for Neurodegenerative Diseases (DZNE), Bonn-Cologne, Germany
^l Excellence Cluster Cellular Stress Responses in Aging-Related Diseases (CECAD), Medical Faculty, University of Cologne, Germany
^m Department of Clinical and Behavioural Neurology, Santa Lucia Foundation IRCCS, 00179, Rome, Italy
ⁿ Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
^o Center for Translational Neurophysiology of Speech and Communication (CTNSC), Italian Institute of Technology (IIT), Ferrara, Italy
^p Brain Health Scotland United Kingdom
^q European Alzheimer's Disease Consortium, Switzerland
^r European Association of Nuclear Medicine (EANM), Switzerland
^s Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
^t Clinica Neurologica, IRCCS San Gerardo dei Tintori, Monza, Italy
^u European geriatric medicine society (EuGMS), Switzerland
^v Karolinska Institutet, Stockholm, Sweden
^w World Dementia Forum, London, UK
^x University of Edinburgh, Edinburgh, Scotland United Kingdom
^y Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, The Netherlands
^z Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
^aa Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
^ab European Society of Neuroradiology (ESNR), Switzerland
^ac Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
^ad Department of Medical Psychology, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
^ae Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV, USA
^af EQT Life Sciences, Amsterdam, The Netherlands
^ag Institut du Cerveau et de la Moelle Épinière, UMR-S975, INSERM, Paris, France Hôpital de la Pitié-Salpêtrière, France
^ah European Brain Council, European Academy of Neurology, Swiss Brain Health Plan, Switzerland
^ai Inselspital and Faculty of Medicine, University of Bern, Bern, Switzerland
^aj Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
^ak Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
^al The Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK

^⁎Corresponding author: Giovanni B. Frisoni, Memory Center, Department of Rehabilitation and Geriatrics, University Hospitals and University of Geneva, Geneva, Switzerland.Memory CenterDepartment of Rehabilitation and GeriatricsUniversity Hospitals and University of GenevaGenevaSwitzerland

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Abstract

A European Task Force has recently developed and published the concept and protocols for the setup of the innovative health offer of Brain Health Services for the secondary prevention of dementia and cognitive impairment (dBHS). dBHS are outpatient health care facilities where adult persons can find an assessment of their risk of developing cognitive impairment and dementia, have their risk level and contributing factors communicated using appropriate language supported by adequate communication tools, can decide to participate to programs for personalized risk reduction if at higher risk, and benefit from cognitive enhancement interventions. This health offer is distinct from that of currently active memory clinics. The ultimate aim of dBHS is to extend healthy life, free from cognitive impairment. Here, we (i) discuss the pertinent opportunities and challenges for those persons who want to benefit from dBHS, professionals, and wider society, (ii) describe the concepts, protocols, organizational features, and patient journeys of some currently active dBHS in Europe, and (iii) argue in favor of the business case for dBHS in Europe.

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Keywords : Brain health services (dBHS), Dementia, Secondary prevention, Preventive healthcare, Public health