The Scottish Brain Health Service Model: Rationale and Scientific Basis for a National Care Pathway of Brain Health Services in Scotland

Craig W. Ritchie*, J. M. J. Waymont, C. Pennington, K. Draper, A. Borthwick, N. Fullerton, M. Chantler, M. E. Porteous, S. O. Danso, A. Green, L. McWhirter, G. Muniz-Terrera, S. Simpson, Gerard Thompson, D. Trépel, T. J. Quinn, A. Kilgour

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Abstract

In order to address the oft-cited societal, economic, and health and social care impacts of neurodegenerative diseases, such as Alzheimer’s disease, we must move decisively from reactive to proactive clinical practice and to embed evidence-based brain health education throughout society. Most disease processes can be at least partially prevented, slowed, or reversed. We have long neglected to intervene in neurodegenerative disease processes, largely due to a misconception that their predominant symptom — cognitive decline — is a normal, age-related process, but also due to a lack of multi-disciplinary collaboration. We now understand that there are modifiable risk factors for neurodegenerative diseases, that successful management of common comorbidities (such as diabetes and hypertension) can reduce the incidence of neurodegenerative disease, and that disease processes begin (and, crucially, can be detected, reduced, and delayed, prevented, or treated) decades earlier in life than had previously been appreciated. Brain Health Scotland, established by Scottish Government and working in partnership with Alzheimer Scotland, propose far-reaching public health and clinical practice approaches to reduce neurodegenerative disease incidence. Focusing here on Brain Health Scotland’s clinical offerings, we present the Scottish Model for Brain Health Services. To our knowledge, the Scottish Model for Brain Health, built on foundations of personalised risk profiling, targeted risk reduction and prevention, early disease detection, equity of access, and harnessing comprehensive data to assist in clinical decision-making, marks the first example of a nationwide approach to overhauling clinical, societal, and political approaches to the prevention, assessment, and treatment of neurodegenerative disease.

Original languageEnglish
Pages (from-to)348-358
Number of pages11
JournalJournal of Prevention of Alzheimer's Disease
Volume9
Issue number2
Early online date1 Dec 2021
DOIs
Publication statusPublished - Apr 2022

Keywords

  • Alzheimer’s disease
  • biomarkers
  • Brain health
  • functional cognitive disorders
  • neurodegeneration

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health

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