Cities Around the World Need to Prepare for Innovations in Dementia, according to a New Report from the Global Coalition on Aging (GCOA), Alzheimer’s Disease International (ADI) and Lien Foundation.
Partners launched the Dementia Innovation Readiness Index to Challenge Cities to Develop and Adopt Innovations Across the Global Dementia Community, on October 8, 2020.
The Global Coalition on Aging (GCOA) and Alzheimer’s Disease International (ADI), in partnership with Singapore’s Lien Foundation, presented findings from the 2020 Dementia Innovation Readiness Index showing that cities have largely failed to support innovation in dementia comprehensively, though bright spots exist.
By mid-century, the number of those aged 65 or older set to double, and nearly two-thirds of the world’s population will live in urban areas, up from just over half today. The number of older people in cities is growing faster than in rural areas, according to the OECD.
Given these shifts across society, the need for local leadership to address dementia is clear, yet the Index findings suggest that cities around the world have not fully leveraged opportunities to support the development or adoption of innovations in dementia care, treatment and support and should take a leadership role in dementia innovation readiness. Rated on a 0-10 scale, the top five performing cities in the Index overall were London (8.4), Glasgow (7.8), Manchester (7.7), Amsterdam (7.5), and Vancouver (7.5). Top-performing cities tend to be in high-income countries with some level of nationalized healthcare, and a national plan in place that helps to promote innovation at the city-level.
Among the 30 cities profiled, assessments reveal that London and Glasgow lead in strategy and commitment and community support for individuals living with dementia, as local associations play a pivotal role in the formation of the national response on dementia.
“This year’s Dementia Innovation Readiness Index establishes the foundation for high impact, action-oriented initiatives to promote collective action from governments, industry, NGOs, academics and other leaders,” said Michael W. Hodin, PhD, CEO, GCOA. “Cities must rise to the challenge presented by global aging and build the capacity and opportunity to improve health outcomes for people living with dementia because they are at the forefront of innovation in their communities.”
Measured against 26 indicators and across five categories, including strategy and commitment, early detection and diagnosis, access to care, community support, and business environment, findings revealed that while leadership is present throughout the global community to meet the overwhelming demands for quality dementia care, significant gaps persist.
“The Index gives us a snapshot of how prepared some of our major cities are to embrace dementia innovation,” said Paola Barbarino, CEO, ADI. “During COVID-19 we have seen how important cities have been in managing the pandemic. With their large concentration of population, cities have an opportunity and a challenge to drive best practice. From a policy perspective, the Index provides a call to action for local and national governments to drive policies to better the lives of those affected by dementia and their loved ones.”
The Index’s main findings include:
- Cities must take charge to execute against national dementia plans. Tasking ministries, agencies, civil servants, or other permanent policy bodies with implementing a plan at the local level can help to ensure dementia remains front-and-center, even as political leadership changes, and when plans are backed by adequate funding, they are a key enabler of dementia innovation.
- • Cities must advocate for flexible and transparent funding models enabling regions and cities to adapt national programs and frameworks to local contexts.
- • Cities need to know where they stand with regard to the number of people in the community living with dementia. Accurate, early diagnosis can help to ensure that people living with dementia are able to access high-quality care; that the progression of their disease is appropriately managed and monitored; and that they will be able to expediently access innovations in treatment and care as they become available.
- National-level efforts to improve diagnosis rates for dementia should be aligned with the local community. One of the most common misconceptions about dementia is that it is simply a normal part of aging, and cities must be ready to deploy population-specific messaging, screening tools, and other resources that are adaptable to the diverse communities residing there.
- Post-diagnostic support is a highly localized but under-addressed opportunity for cities. City stakeholders can collaborate across the medical, social, and policy fields to ensure that locally tailored post-diagnostic support is in place and that healthcare professionals and other community service providers have the knowledge and training to connect people with relevant programs.
- Local governments and service providers must ensure that there is a sufficient supply of affordable and high-quality community-based care providers — including day care, respite care, and in-home care — so that people living with dementia are able to access needed resources. In areas where the care workforce is insufficient to adequately support people living with dementia, local stakeholders can help to build the workforce through training, increased access to educational and vocational services, as well as immigration, thus creating local jobs while solving for the impending care crisis.
- Cities should engage and fully leverage non-profit Alzheimer’s and dementia associations as experts in the community.
- Dementia-friendly principles are the tools and practices that make an organization, community, or society-at-large more accessible and livable for people with dementia, but they also enhance cities and improve quality of life for all citizens.
- Cities have a role in enabling new and existing funding models for dementia research. For example, venture capital funding (through organizations like the Dementia Discovery Fund) and social impact bonds by cities can spur innovation. Such efforts will serve as a catalyst for breakthrough research and offset the perceived risk brought by slow therapeutic progress and growing investor hesitancy toward dementia.
The Index also identifies examples of leading practices – in cities large and small, developed and developing – across the five key areas of the Index, which can serve as a model for others in the global community.
“Aging and urbanization are the twin defining trends of our time,” said Radha Basu, Research Director, Lien Foundation. “As societies age and dementia becomes more common, this Index issues a clear call to city-level leaders and help cities learn from each other on how to best manage this great, global challenge to health and social care.”
Insights from the Index were informed by input from interviews and surveys with global key opinion leaders and subject matter experts (including scientists, advocates, researchers, clinicians, business leaders, and people living with dementia). As well as
secondary research that was gathered from global authorities including ADI, the Organisation for Economic Co-operation and Development, the World Health Organization, and other publicly available sources.