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The data collected by the National Health Fund clearly shows that alzheimer’s disease is not a rare disease in our country. Women are primarily at risk of developing dementia. And although the numbers are already alarming, according to the psychogeriatrist prof. Tadeusz Parnowski, it is actually even worse.
- Alzheimer’s disease belongs to the group of neurodegenerative diseases
- A person suffering from Alzheimer’s gradually loses cognitive abilities, and in an advanced stage becomes completely dependent
- Alzheimer’s cannot be cured
- More current information can be found on the Onet homepage.
One in five women aged 85+ in 2019 had Alzheimer’s
The National Health Fund systematically conducts analyzes of individual diseases based on its own data. On May 16, he published a report on Alzheimer’s and related diseases.
One in five women over the age of 85 had Alzheimer’s disease in 2019. There are more and more patients with this most common neurodegenerative disease – in five years there has been an increase in the number of patients by 12%, and the data of the Fund is still the tip of the iceberg. According to them, the diagnosis of Alzheimer’s disease and other dementia syndromes was made in 2019, 379 thousand. patients.
– We estimate that there are at least half a million patients in Poland – says prof. Tadeusz Parnowski, psychogeriatrist.
The NFZ report also includes this number. It results from the calculations of the Institute for Health Metrics and Evaluation. The Fund has “its” hard data from doctors who reported this type of diagnosis in their reports. And they do not always have to do it – if a patient with dementia is hospitalized, for example with a leg fracture, the diagnosis of Alzheimer’s disease does not have to be reported to the National Health Fund.
What specialists for Alzheimer’s patients?
On the other hand, says Dr. Jerzy Gryglewicz, an expert from the Lazarski University, access to doctors dealing with dementia syndromes leaves a lot to be desired in our country. Psychiatrists, neurologists and geriatricians have the greatest knowledge about the treatment of this disease, but not only that, as in virtually every field of medicine in Poland, there are too few of them, but these doctors also have narrower specializations.
– For example, advances in neuroscience are unheard of, and therefore specialists in the field most often deal with some part of it – for example, treating strokes, epilepsy or multiple sclerosis – says the expert.
This inevitably limits access to specialists for people with dementia. According to the data of the National Health Fund, these patients in Poland are most often looked after by primary care physicians – in 2019, over 176 thousand people were provided with help in POZ. patients diagnosed with Alzheimer’s or related disease. For comparison, in the same year, 40 thousand people benefited from the neurological clinic. patients with Alzheimer’s or related disease, and 2 were hospitalized in the neurological ward.
Prof. Parnowski believes that the primary care physician often does not have the appropriate tools to take good care of a patient with dementia. The diagnosis itself takes a lot of time – it is necessary to conduct a series of tests, a thorough neurological examination, ordering and interpreting imaging tests. Also, the primary care physician does not always have the latest knowledge about therapeutic options. According to the specialist, German research shows that the attachment of a large group of doctors to old drugs is still strong.
– There used to be nothing else, now we have better medicines – says the professor.
What medications for Alzheimer’s?
The dementia syndrome cannot be cured – the therapy is aimed at slowing down the progression of the disease. For this purpose, pharmacotherapy and broadly understood rehabilitation are used – physical activities improving coordination, puzzles, etc.
There are three active substances available in Poland for the treatment of dementia syndromes: donepezili hydrochloridum, rivastigminum, memantininum. The National Health Fund reports that in 2019, 271 have completed prescriptions for drugs used in the treatment of Alzheimer’s disease. patients, especially women. Pharmacists spent a total of 2 million packages. Half of them were reimbursed drugs.
The fund also checked the extent to which patients used them for two reimbursed drugs (donepezili hydrochloridum and rivastigminum). It turned out that in the one-year observation period, 29 percent. of patients completed prescriptions allowing for coverage of at least 80 percent. days of therapy with the first of them. The fund also indicates that 40% of patients continued the therapy with reimbursed drugs with the active substance donepezili hydrochloridum for at least a year. patients.
As for the second drug, the continuity of therapy was worse and largely depended on the form of the drug – for patches the indicator was better, but compared to donepezil – worse (24% of patients used them for at least 80% of treatment days, in the case of tablets – 11% of patients took them for at least 80% of treatment days). At the same time, for at least a year, rivastigmine was taken by 41 percent. patients if they were patches, and 36 percent. – if they were tablets.
– It’s not that bad – says prof. Parnowski.
Why is it important? Only regular intake of prescribed medications gives you a chance to improve. Unauthorized discontinuation of therapy may be associated with the lack of a therapeutic effect, and at the same time with the occurrence of side effects. The professor draws attention to a number of factors that affect whether a patient complies with medical recommendations. For those with dementia, medications are often administered by the caregiver. The professor’s experience shows that caregivers adhere to the administration of drugs to their patients. The situation is different for patients who live alone.
Plans for the future
Dr. Gryglewicz emphasizes that the social burden of dementia syndromes will increase and urgent action is needed. In his opinion, it is worth training GPs and sensitizing them to the problem of Alzheimer’s disease and related diseases. At the same time, it is necessary to create day houses for such sick people. He reminds that the project submitted about two years ago by President Andrzej Duda assumed the creation of this type of facility in each poviat. In turn, the National Transformation Plan announced in the announcement of the Minister of Health provides for the creation of the so-called memory support center.
Regardless of everything, according to the expert, family doctors should be mobilized to have knowledge about drugs used in dementia syndromes and other forms of support, and to create a dense network of Alzheimer’s clinics.
Justyna Wojteczek, Zdrowie.pap.pl
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