Page 71 - Annual Report 2018

4. THE VALLECAS PROJECT

▄▀ 4.1. Introduction
Aging is one of the major risk factors for some of the great influence his/her family and social environ-
most prevalent diseases such as cancer, cardiovas- ment concerning affective, organizational and eco-
cular disorders or neurodegenerative diseases, but nomic aspects. In this sense, dementia should be
while the number of cases of the first two tends to understood as a social problem that must be ap-
stabilize, the number of patients with neurodegene- proached in a comprehensive manner.
rative pathologies, particularly dementia, continues
to grow exponentially. According to the demogra- The transition from a cognitively healthy stage to an
phic estimates of the National Institute of Statistics, AD-type dementia is a continuum in which some in-
in 2017 there are 8.7 million people in Spain aged 65 termediate stages, preclinical and prodromal can
or over (18.87% of the population) and it is estima- be recognized. These stages are characterized by
ted that in 2050 about 15 million Spaniards (approxi- the presence of an incipient cognitive impairment
mately one third of our population) will be over 65 that increases the probability of conversion to de-
years old. In fact, the combination of one of the hig- mentia in the future. An effective therapeutic inter-
hest life expectancies in the world and one of the lo- vention in these phases prior to AD could eventually
west birth rates make the Spanish population the slow the progression of deterioration and thus re-
oldest in Europe and one of the oldest in the world duce the prevalence of the disease. For this reason,
after South Korea and Japan. one of the challenges currently faced by research is
the development of useful tools that allow early
Dementia is a clinical syndrome characterized by a diagnosis of AD.
progressive cognitive impairment severe enough to
affect personal and social functioning of an indivi- Currently, there is no reliable method to predict sa-
dual. Alzheimer's disease (AD) is the leading cause fely which individuals in these preclinical stages have
of dementia in our environment. According to the an increased risk of converting to dementia. The
National Epidemiology Center, 7.3% of the popula- emergence in the last decade of various diagnostic
tion over 65 years could suffer from this disease no- neuroimaging techniques (eg, brain PET amyloid)
wadays. In total, AD constitutes about 75% of the has led to considerable progress in research, al-
etiology of dementias, either alone or in combina- though its use in regular clinical practice is not feasi-
tion with cerebrovascular disease. Because of incre- ble due to its high cost.
ased life expectancy and the progressive aging of
the population in Western countries, dementia re- The most recent descriptive epidemiological rese-
presents a huge challenge for public health systems. arch on dementias is allowing us to investigate how
In our country, it is estimated that by 2050 a third of prevalence and incidence are changing over time.
the population will be over 65 years, so that appro- To establish clear trends, these comparisons should
ximately one million Spaniards could have demen- be based on studies that use similar diagnostic and
tia by then. research methods consistently over time. It is impor-
tant to bear in mind that the main non-genetic risk
According to the Survey of Disability, Personal Auto- factors for the development of dementia are rela-
nomy and Dependency Situations developed by ted to lifestyle, which makes it particularly important
the National Institute of Statistics, the rate of disabi- to carry out studies in the Spanish population. Im-
lity stands at ninety dementia cases per thousand in- portant changes in our society and improvements in
habitants. However, the impact of dementia is not living conditions and education in recent decades
only produced directly on the patient, but also has a can have a decisive influence not only on physical

CIEN Foundation Annual Report 2018 / 71