**4. Health model units of cognitive disorder and conduct**

Dementia is the paradigm of disease that practically in its entirety is diagnosed and/or followed by the national health systems (public and free). It is a disease that does not start abruptly and for which medicines are expensive. Patient assistance involves the neurologists and other specialists who directly assist patients with neurological problems. The growing complexity of neurology in general, as a specialty, with

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

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


To fulfill these objectives, within the unit there should be another specialist doctor (neurologist, psychiatrist, and geriatrist), nurse manager of hospital cases, clinical psychologist or neuropsychologist, and social worker.

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 these professionals is key in dementia care process.

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


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'

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*Healthcare Models in Alzheimer's Disease DOI: http://dx.doi.org/10.5772/intechopen.84630*

**5. Future perspectives**

Alzheimer's disease.

relatives, all tools being available (telephone, email, digital medical record, prescription "online"), is key for the success in monitoring patients and caregivers [37].

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.

and dementia stages of Alzheimer's disease would be necessary.

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,

• Healthcare systems will need to identify and engage with prodromal populations who might benefit from such interventions. These people may not be in contact with health services or, if they are, this will not be because of

• Realistic planning is needed now to direct the evolution of services to optimize appropriate patient access and prepare protocols for phase IV testing of these treatments to inform real-world practice and commissioning decisions.

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.

relatives, all tools being available (telephone, email, digital medical record, prescription "online"), is key for the success in monitoring patients and caregivers [37].
