**5. Future perspectives**

*Redirecting Alzheimer Strategy - Tracing Memory Loss to Self Pathology*

human and material resources to meet its objectives [41, 42].

and professionals involved in dementia assistance.

• Sensitization of public opinion, institutions, entities, and media.

• Promotion of volunteering and promotion of associations.

clinical psychologist or neuropsychologist, and social worker.

• Promote lines of research and intervention.

these professionals is key in dementia care process.

of patients and with society in general [43].

developed in relation to the healthcare process.

of dementia.

cols and joint procedures.

the improvement of diagnostic methods as well as therapeutic interventions, means that the assistance provided by a neurologist or psychiatrist or geriatrist is greater. The guiding principles of the assistance in the unit of memory are [1] universality and equality; [2] integrality and transversality, with coordination of all the members; and [3] efficiency and sustainability. This unit must be endowed with the

• Comprehensive care for affected people and support for caregivers in all phases

• Information, training, and advice to affected people, caregivers, associations,

• Adequacy of health and social resources, as well as the establishment of proto-

To fulfill these objectives, within the unit there should be another specialist doctor (neurologist, psychiatrist, and geriatrist), nurse manager of hospital cases,

In primary care, it should consist of a family doctor and nurse who manages primary care cases and social work. The coordination and communication between

Key aspects in the operation of the unit that should be considered:

To carry out all its objectives, you should use the tools, mainly new technologies, of which the health system has: digital clinical history, prescription "online," and telecare.

1.Management of communication at all levels: horizontal internal, between the members of the unit among themselves and with the other professionals of the organization; internal vertical, with the address of the hospital and primary care center; external with patients and relatives, with associations of relatives

2.Control of the satisfaction of all those who participate in the unit: patients and relatives, professionals, and the administration in relation to the activities

3.Establish indicators of care process, health outcomes, and specific situations: all this must be reflected in an annual report of the unit, which includes all the activity of the unit carried out, mainly in the care, research, and teaching areas.

The personalized attention in the chronic disease improves the indicators of physical and psychological health, as well as the ability to manage the disease with respect to usual care. The differences increase when they are more complete and more intense and integrated into the routine. Care with a more personalized and graduated approach allows to maintain the autonomy and integration of the patient in his environment [44, 45]. The coordination at the health level between primary and specialized care, with a social worker and in association with Alzheimer's patients'

**98**

The optimism generated by recent and anticipated developments in the understanding and treatment of Alzheimer's disease presents a great opportunity to innovate and adapt our services to incorporate the next exciting development in the field of dementia [46]. Almost 100 treatments are currently being investigated, often targeting individuals earlier in the disease process, and a very promising phase II work has been published about the antibody aducanumab [47]. Today, health services in Europe would not be prepared to treat patients with Alzheimer's disease that are subsidized by an effective treatment [48]. It seems likely that interventions will be available in the near future for people diagnosed with prodromal dementia. This would fundamentally transform how the Alzheimer's disease is perceived, diagnosed, and managed.

There are two key points: [1] equity in access of patients and caregivers and [2] specific preparation of professionals. There will be a need for substantial education and training for primary and secondary care professionals about new diseasemodifying treatment for Alzheimer's disease. In primary care this would need to focus on early symptoms and risk factors. In secondary care it would cover the safe and effective use of biomarkers. A reconfigured service would require seamless collaboration between disciplines, patient groups, and specialties in order to expand the dementia-focused clinical services to include an Alzheimer's disease service. While many people currently present with moderate or severe dementia, in the future, hopefully the majority of people will be diagnosed much earlier, even in the prodromal/preclinical stages. A distinct approach for the preclinical, prodromal, and dementia stages of Alzheimer's disease would be necessary.


Although in the near future we will have treatment for Alzheimer's disease, the social-health system will have to continue providing assistance in stages of dementia, in an integral and personalized way, adapting to the specific needs of each case that is determined by the type of dementia (frontotemporal, dementia by bodies of Lewy, and Korsakoff syndrome), characteristics of the patient, or caregiver environment.

*Redirecting Alzheimer Strategy - Tracing Memory Loss to Self Pathology*
