A national strategy: implementation of the French Alzheimer

plan 2008-2012

18 January 2012

Dementia Strategy Conference Dublin

Florence Lustman, inspecteur général des finances

2

The main challenges of the plan

A commission chaired by Pr Ménard

10 members, 8 working groups, 100 people, 3 months

Report to the President on 8 november 2007

A financial effort on 5 years

200 M€ for research

200 M€ for medical care

1,2 billion euros for medico-social support

A new governance based on transparency

Direct reporting to the President of the French Republic every 6

months

Coordination and assessment

Steering committee every month

Supervisory committee every 4 month

3

Website : www.plan-alzheimer.gouv.fr

4

Let healthy ageing have a future

Plan Alzheimer 2008-2012

Family

caregiver

Respect guarantee the dignity

of the person with

Alzheimer ’s and

ethics of this key

social issue

Health

Person with

Alzheimer’s

3 axis

3 objectives

3 targets

Cure know the disease and

find a medical treatment

Take care look after and increase

quality of life for patients and

carers

Disease

Solutions explorer and organizer

Research Solidarity

5

Research

Foundation Plan Alzheimer

125 research projects – 81 M€ GWAS : new genes

IGAP

138 new researchers

Structuration

National epidemiologic data bank : 342 centers, 222 000 patients

Clinic epidemiology training for 614 doctors

3 cohorts (3C, MEMENTO, young patients)

Methodology support group

Imaging center

AAICAD in PARIS – july 2011

6

Cohorts : patients, young patients, general

Methodology

support group

Imaging

standardisation center

Clinical

research

Therapeutical

research

Epidemiological

research

Basic

research

Human & social

research

Genomics

Clinical

trials

Biomarkers

Image bank Protocols

Biological

bank

Genetical

bank

National

database

Research teams

Control

groups

Training

Animal

models

7

www.neurodegenerationresearch.eu

8

http://www.espace-ethique-alzheimer.org

9

RESEARCHING TO CURE, CARE AND INCREASE QUALITY OF LIFE

Personal pathway for a person with dementia Alzheimer’s plan : 2012

General

practioner

Specialist Neurologists

Memory centres

Centre for young

Alzheimer ’s patients

MAIA

Home

Out of home : specialized structures

Home rehabilitation

Respite and support

platforms

Hospital

Nursing home

Person with

dementia

Simplifying

Assessing

Orientating

TAKING CARE DIAGNOSING

Breaking the diagnosis

Supporting

Family

caregiver

Training for professional and family

caregivers

10

10

Liberal neurologists

15

10

5

Memory centers

CM

CMRR 0 500 km 250

Source : DHOS 2009 & CNAM 2009

Paris and petite couronne

Places for diagnosis in France

11

National reference centre

for young Alzheimer ’s

patients

Local correspondants

National center for young patients with AD

12

Hospital

Rehab

Hospitals

Nurses

General

practitioner

Day care center

Social services Informati

on point

Home-

care

services

Neurologists

Alzheimer’s

disease center

council

services

Volunteers

Alzheimer’s

association

Home

workers

Outpatient

Physical

Therapy

SLP

Continuing

care

MAIA

13

Day care centers

Nombre d'AJ

52

26

13

AJ répondant aux obligations réglementaires

AJ ne répondant pas aux obligations réglementaires

Sources : Finess, Sélia, Enquête Alzheimer

Acceuils de jour installés au 31/12/2010-

Part des AJ répondant aux obligations réglementaires

Sourc

e c

art

ogra

phiq

ue :

Art

icque

Structures

Places

14

Alzheimer rehabilitation teams

15

Special care units in nursing homes

16

Measuring patients’ quality of life CLINICAL PRACTICE INDICATORS OF ALERT AND MASTERING OF

THE IATROGENICITY OF NEUROLEPTICS IN ALZHEIMER PATIENTS

Evolution de Alerte NLP chez PA & Malz de 2007 à 2010

2,80%3,0%2,9% 2,7%

15,50%

16,00%16,90%

16,10%

0%

5%

10%

15%

20%

25%

30%

2007 2008 2009 2010

Prescription chronique PA âgé de 65 ans et plus

Prescription chronique PALZ âgé de 65 ans et plus

17

Conclusion