Dementia Appraisal: Overview of Good Clinical Practices, Barriers, and Gaps for Integrated Care

Introduction: The increasing prevalence of dementia and mild cognitive impairment is a priority for health systems and society in the coming years. The aim of this study was to provide an overview of good clinical practices, barriers, and gaps for integrated dementia care. Methods: An electronic search was conducted on PubMed database for the last five years for articles relevant to the scope of the study, conducted in humans, written in Portuguese or English, and open access. National and international guidelines and consensus documents recognized in Europe were also included.

Results: With increasing life expectancy and aging as major risk factors, the number of people living with dementia will become unsustainable for medical, social, and informal care. Ineffective care pathways lead to unnecessary medical interventions and suboptimal care. People with dementia should be involved in all stages of care and research. High-quality epidemiological data by disease severity and dementia subtype are needed. The development of novel technologies to improve clinical assessment of cognition and function that are sensitive and accurate in early stages of dementia and can be used in primary care is also an unmet need. A strategy to improve dementia care from diagnosis to end of life is lacking. Research into effective models of care and new treatment pathways with a more accurate selection of patients in early stages of the disease is crucial. Conclusions: There are currently several gaps in dementia care. Integrated care pathways, patient-centered approaches, and the establishment of a workforce based on a comprehensive and pragmatic framework are priorities that should be included in public health strategies.