DESK REVIEWS | 10.01. Is there a published government policy, statement or document detailing the government’s plan or programme for dementia research?

DESK REVIEW | 10.01. Is there a published government policy, statement or document detailing the government’s plan or programme for dementia research?

There is a national research plan called “Priority Research Agenda of the Ministry of Health” (Agenda de Prioridades de Pesquisa do Ministério da Saúde – APPMS). This Agenda outlines the need for research in the health area in Brazil. Among the priority topics, there is the need to investigate the epidemiological profile of people living with dementia living in Brazil as well as to understand risk factors associated with dementia (Brazilian Ministry of Health, 2018a). The APPMS was published in 2018 and it will cover the next 2 to 3 years.

References:

Brazilian Ministry of Health. (2018a). Agenda de Prioridades de Pesquisa do Ministério da Saúde. http://bvsms.saude.gov.br/bvs/publicacoes/agenda_prioridades_pesquisa_ms.pdf

No. The most relevant document is the Mental Health Review Report published by the Food and Health Bureau (2017a) in 2017 that aims at making recommendations for mental health policy. In one of the main chapters about dementia, the need to invest in research for assessing the effectiveness of prevention programmes, strategies on dementia care, interventions and knowledge transfer, have been raised. The need for regular territory-wide prevalence studies of dementia to inform service planning has been emphasised and listed as one of the 10 recommendations for dementia. Yet, there is still no detailed government plan or programme for dementia-specific research.

References:

Food and Health Bureau. (2017a). Mental Health Review Report.  Retrieved from https://www.fhb.gov.hk/download/press_and_publications/otherinfo/180500_mhr/e_mhr_full_report.pdf.

While there are no documents detailing this, three bodies of the Government of India (GOI) have dedicated funding towards research on dementia. The Indian Council of Medical Research (ICMR), Department of Biotechnology (DBT), and Department of Science and Technology (DST) under GOI have specific funding initiatives to conduct research in the field of dementia. The multi-centre Dementia Science Programme of the DBT is a major initiative of the Government to examine prevalence, incidence, and risk factors for dementia in India (Bhatt, 2020). The DST supports many projects in the field of cognitive science (including dementia) through the Cognitive Science Research Initiative (CSRI), which was initiated in 2008 (DST, 2022). The Indian Council of Medical Research has just completed a multicentric research project to develop and adapt a neurocognitive test battery to diagnose dementia in five Indian languages, for literates and illiterates (Iyer et al., 2020). These bodies of the government have funded several research studies on dementia over the last two decades, focusing mainly on basic biology, epidemiology, diagnosis, and brain imaging.

References:

Bhatt (2020). DBT’s multi-centric Dementia Science Programme. Vigyan Samachar. Available from: https://vigyanprasar.gov.in/wp-content/uploads/DBT%E2%80%99s-multi-centric-Dementia-Science-Programme-10apr20.pdf

Department of Science and Technology (2022). Cognitive Science Research Initiative (CSRI). Available from: https://dst.gov.in/cognitive-science-research-initiative-csri

Iyer, G. K., Paplikar, A., Alladi, S., Dutt, A., Sharma, M., Mekala, S., … & Ghosh, A. (2020). Standardising Dementia Diagnosis Across Linguistic and Educational Diversity: Study Design of the Indian Council of Medical Research-Neurocognitive Tool Box (ICMR-NCTB). Journal of the International Neuropsychological Society26(2), 172-186. https://doi.org/10.1017/S1355617719001127

Yes, the National Strategy for Dementia, published in 2015 by the Department of Health includes 7 main planned actions, one of which is on dementia research implementation and the application of findings at national level (basic, clinical, epidemiological, and social research). The document names Badan Penelitian dan Pengembangan Kesehatan / Litbangkes (Institute for Research and Development in Health), Lembaga Ilmu Pengetahuan Indonesia / LIPI, Akademi Ilmu Pengetahuan Indonesia / AIPI, DIKTI (Ministry of Research, Technology and Higher Education of the Republic of Indonesia), and other research centres as responsible institutions for the research programs.

Research activities planned in the strategy document include:

  • Research on nutrition for older people with cognitive dysfunction, and people with dementia;
  • Evaluation on national level of the impact of physical activities on dementia and of dementia risk factors;
  • The inclusion of questions in national surveys, such as Riskerdas (Riset Kesehatan Dasar/Basic Health Research), to obtain prevalence data on dementia and other cognitive problems;
  • Analysis of the socioeconomic impact of Alzheimer’s and other dementia conditions.
References:

Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI. (2013). Riset Kesehatan Dasar 2013 (Vol. 6). (https://doi.org/1 Desember 2013) https://pusdatin.kemkes.go.id/resources/download/general/Hasil%20Riskesdas%202013.pdf

Indonesia, A. I. P. (n.d.). Akademi Ilmu Pengetahuan Indonesia.

Lembaga Ilmu Pengetahuan Indonesia. (n.d.). Lembaga Ilmu Pengetahuan Indonesia.

Jamaica does not appear to currently have such a policy.

There is no published document illustrating Kenyan government’s plan or proposed funding towards dementia research or involvement of people with dementia in the research development process.

Mexico does not have government policies or programmes to support dementia research. With the objective of raising awareness on the need to increase research on dementia, ideally allocating public funds for this, the National Action Plan on Alzheimer’s and other Dementias includes a specific strategy (#6) that states the need to (Gutiérrez-Robledo & Arrieta-Cruz, 2014). The lines of action of Strategy 6 are:

  1. Include research on ageing, with emphasis on applied research studies to improve the treatment of dementia, as a priority within the demands of Health Sector Research Funds.
  2. Promote inter-institutional links with national and international scientific groups dedicated to research/work on dementia.
  3. Increase and strengthen research on dementia through collaborations among different scientific groups in Mexico that integrate the National Thematic Network: Ageing, Health and Social Development (part of the National Council of Science and Technology’s Thematic Networks Fund).
  4. Promote a public health research basis on aging by academic and scientific institutions, with particular emphasis on the subject of dementia.
  5. Develop new information and data sources for the generation of a permanent epidemiological surveillance system to closely monitor cases of dementia in the country.
  6. Establish an inter-institutional collaboration network for the molecular, clinical, and imaging diagnosis of dementias at national level.
References:

Gutiérrez-Robledo, L., & Arrieta-Cruz, I. (2014). Plan de Acción Alzheimer y otras demencias, México 2014. http://diariote.mx/docs/plan_alzheimer_WEB.pdf

The NZ Dementia framework released by the Ministry of Health in 2013, only mentions research once in the entire document when discussing governance considerations for dementia care provision by the District Health Board which “ensures that new models of care, good practice examples and research are shared locally, regionally, and nationally” (Ministry of Health, 2013).

The NZ Dementia action plan released in 2020 notes the need to “Increase investment in research on dementia, in particular on the epidemiology of dementia in New Zealand, on culturally appropriate ways of describing and approaching dementia for tangata whenua and within Aotearoa New Zealand, and on what works to support people living with dementia” 

References:

Ministry of Health. (2013). New Zealand Framework for Dementia Care. Wellington Ministry of Health.

This desk review did not find a published government policy, statement or document detailing the government’s plan or programme for dementia research. Although very limited, there are some research projects in SA on dementia for example:

“Strengthening responses to dementia in South Africa” (STRiDE) project:  Funded by the UK Research and Innovation’s Global Challenges Research Fund (GCRF), the STRiDE Project (2018-2021) aims to contribute to improving dementia care, treatment, and support systems so that people living with dementia are able to live well and family and other carers do not shoulder excessive costs, risk impoverishment or compromise their own health. STRiDE aims to help countries to develop or refine national plans for dementia and achieve its objectives through ten Work packages (WPs) across seven countries: Brazil, India, Indonesia, Kenya, Jamaica, Mexico, and South Africa (see https://stride-dementia.org/).