We searched MEDLINE, Embase, Google Scholar, and the Cochrane Library, as well as the internet (using Google and other search engines), for reports of dementia research priorities or challenges, published between January, 2000, and Dec 31, 2014, with no language restrictions, before the priority-setting exercise was done. We updated the search on June 1, 2016, for the Discussion. We developed and adapted our search strategies by combining PubMed Medical Subject Headings and free-text terms (ie,
Policy ViewResearch priorities to reduce the global burden of dementia by 2025
Introduction
Population ageing will lead to a dramatic increase in dementia prevalence across all world regions. By 2050, more than 131·5 million people are expected to be affected.1 Dementia is already a heavy burden for those living with the disease, their families, and society. The burden and global annual costs of US$818 billion are expected to increase substantially in the next few decades.1
An unprecedented coordinated global response is imperative to effectively address the burden and challenges of dementia. The public health approach to dementia called for by WHO in 2012 has rapidly gained widespread support among world leaders, researchers, and stakeholders.2 At the historic G8 Dementia Summit held in London in December, 2013, the G8 countries launched a Global Action Against Dementia. The 12 agreed specific commitments included the identification of strategic research priority areas and the development of a coordinated international research action plan,3 and culminated in the First WHO Ministerial Conference on Global Action Against Dementia in March, 2015, which brought together stakeholders (ie, policy makers, patients' representatives, funders, and advocates) and experts from research, clinical practice, and non-governmental organisations.
Since resources and funding for research are scant despite increases in recent years, research priorities need to be set to guide policy makers and funding organisations as they work to advance the dementia research agenda. In the past decade, several efforts, including the Grand Challenges initiatives, have been made successfully to identify research priorities in various specialties, from global health4 to chronic non-communicable diseases5 and mental health.6 These initiatives have had great merit in spurring research progress, because the identification of research priorities is crucial to inform governments, funding agencies, and the private sector about how to prioritise investments systematically. A fully transparent, systematic, rigorous, replicable, and fair prioritisation process, that is globally representative and involves all relevant stakeholders, is needed to guide a coordinated international response to the existing complex and sizeable challenges in dementia research. The Child Health and Nutrition Research Initiative (CHNRI) method was developed to respond to this need for methodological rigour and has been successfully used as a tool to assist decision making and consensus development in child health and nutrition,7 and subsequently in several other priority-setting exercises,8 including research into disability9 and global mental health.10
Past research prioritisation exercises in the specialty of dementia have been insightful and have used various approaches and methods, but they have not been done on a global scale. For example, in both the USA and Europe, unmet needs and research priorities for neurodegenerative diseases or Alzheimer's disease have been identified by non-systematic consultations with selected groups of experts,11, 12, 13 or with health and social care professionals and patients' and carers' representatives.14
In this Policy View, we report the research priorities that need to be addressed in the next 10 years to substantially reduce the global burden of dementia on patients, their families, and society. These priorities were identified through an adapted CHNRI exercise done under the auspices of WHO in preparation for the First WHO Ministerial Conference on Global Action Against Dementia. In panel 1, we list the aims of this Policy View. In panel 2, we describe the context, purpose, and remit of the present CHNRI exercise adapted to the specialty of dementia.
Section snippets
Current status of dementia research
Although no systematic analysis is available of global data that details the full scope of ongoing dementia research projects, research expenditures, and the number of individuals with dementia or their carers participating in research, many individual national and international efforts have been made to map assets devoted to dementia research. For example, the International Alzheimer's Disease Research Portfolio15 was launched in 2010 by the US National Institute on Aging and the US
Identification of dementia research priorities
WHO initiated a dementia research prioritisation exercise and entrusted an advisory group of internationally recognised experts and stakeholders in the specialty of dementia to lead the development of the scope, methods, and implementation of the exercise. The group was balanced in terms of sex, technical expertise, and regional representation, with inclusion of experts, advocates, and patients' representatives from low-income and middle-income countries (LMICs; appendix pp 2). Income category
Results
We identified 2004 experts (672 researchers and 1332 stakeholders; appendix pp 3–4). We successfully contacted 1386 (69%) experts, of whom 201 (15%) submitted their research questions. Experts were from 33 countries (23 high-income countries [HICs] and ten middle-income countries in the WHO regions of Europe, southeast Asia, Africa, the west Pacific, and the Americas), and they proposed 863 individual research questions, a mean of four questions each (appendix pp 3, 15–37). The consolidation
WHO dementia research prioritisation project
To address the reduction of the burden of dementia globally in the next 10 years, this Policy View presents priority scores for the 59 thematic research avenues and seven overarching research domains identified by the WHO dementia research prioritisation project. On the basis of potential for success, equity, burden reduction, and translation, six of the top ten research priorities, ranked by overall score, were focused on prevention, identification, and reduction of dementia risk, and on
Policy implications
The 59 thematic research avenues and the seven overarching research domains presented in this Policy View cover comprehensively the action points of the WHO call for action document that was adopted by more than 160 representatives, including 80 WHO Member States, on March 17, 2015, at the First WHO Ministerial Conference on Global Action Against Dementia held in Geneva, Switzerland. Indeed, the identified priorities provide a sound, balanced research agenda that spans substantially beyond the
Search strategy and selection criteria
References (32)
Global health research priorities: mobilizing the developing world
Public Health
(2012)- et al.
Research priorities for health of people with disabilities: an expert opinion exercise
Lancet
(2009) - et al.
A roadmap for the prevention of dementia: the inaugural Leon Thal Symposium
Alzheimers Dement
(2008) - et al.
Advancing Alzheimer's disease diagnosis, treatment, and care: recommendations from the Ware Invitational Summit
Alzheimers Dement
(2012) - et al.
International Alzheimer's Disease Research Portfolio (IADRP) aims to capture global Alzheimer's disease research funding
Alzheimers Dement
(2014) - et al.
Common Alzheimer's Disease Research Ontology: National Institute on Aging and Alzheimer's Association collaborative project
Alzheimers Dement
(2012) - et al.
A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial
Lancet
(2015) - et al.
Developing a national strategy to prevent dementia: Leon Thal Symposium 2009
Alzheimers Dement
(2010) - et al.
A roadmap for the prevention of dementia II: Leon Thal Symposium 2008
Alzheimers Dement
(2009) - et al.
Developing a global strategy to prevent Alzheimer's disease: Leon Thal Symposium 2010
Alzheimers Dement
(2011)
World Alzheimer report 2015: the global impact of dementia
Dementia: a public health priority
G8 dementia summit agreements
Public health. Grand challenges in global health
Science
Grand challenges in chronic non-communicable diseases
Nature
Grand challenges in global mental health
Nature
Cited by (253)
Towards the maximization of nanochannels blockage through antibody-antigen charge control: Application for the detection of an Alzheimer's disease biomarker
2023, Sensors and Actuators B: ChemicalPlasma proteomic profiles predict future dementia in healthy adults
2024, Nature AgingTelehealth interventions in occupational therapy with older adults: Results from a scoping review targeting better health promotion
2024, Australian Occupational Therapy JournalStakeholder Perceptions of Dementia in Colombia: A Qualitative Study
2024, Research Square
- †
First coauthors, contributed equally