Alzheimer's, centres in the South dropper and 90% of patients will not have access to the new drugs
In the South, the number of facilities is about four times less than in the North, and in Italy as a whole, for almost a quarter of the specialist centres there are waits of more than three months for the first visit, while the Istituto Superiore di Sanità raises the alarm of inequality
Key points
A portrait announced by the chronicles and daily experience but which hurts nonetheless: to patients as well as to their families. And which questions a country like Italy, where there are already 1.2 million people with dementia, a number that will inexorably grow as the population ages. The tragedy of the disease is accompanied by the heavy shadow of the inequality of access to facilities for the elderly and to those, specialised, which formally took the place of the old Uva, the Alzheimer Evaluation Units. These are the Centres for Cognitive Disorders and Dementia (Cdcd), which are still a long way from forming an adequate network for taking care of the elderly and, above all, are very poorly staffed.
The first centres for the elderly, from RSAs to day care centres, are concentrated above all in the north and fade in number as one moves towards the south of the country. Where the figure is dramatic, with four times fewer facilities than in the North.
Then there is the huge issue of the new and expensive drugs on the way, capable for the moment of slowing down the spread of symptoms by a few months, but on which, in any case, Italy as a whole is not ready: with the current framework, the risk is that nine out of ten patients will be excluded from the possibility of benefiting from the new therapies - not reimbursed in Italy - that require very accurate protocols for taking charge.
10% of the elderly
These issues were discussed at the conference 'The Centres for Cognitive Disorders and Dementia and the Integrated Management of Dementia', organised at the Istituto Superiore di Sanità, which has always been a watchdog for the elderly population. "The subject of dementia is fundamental for public health because of its implications, not only clinical," says Iss president Rocco Bellantone. "Suffice it to say that it directly affects about 10% of the Italian population, including people with dementia and Mild-Cognitive Impairment and their families, and has an overall annual cost of 23.6 billion euros, 63% of which is borne by families. These data, together with all the work of the Dementia Observatory, are a useful compass for policy makers in developing strategies to tackle this problem'.
The survey
The survey carried out in 2022-2023 by the Iss's Dementia Observatory and presented at the conference was conducted on 3,607 RSAs and 1,084 Day Care Centres. It emerges that in Central Italy there are 1.5 fewer RSAs and Day Care Centres than in the North of the country, while in the South-Islands this value is about 4 times lower than in Northern Italy, for both types of facility.
In detail, the Iss explains that for Day Care Centres the value per macro-area varies from 699 people with dementia per CD in the North, to 1,108 in the Centre and 3,145 in the South-Islands. As far as RSAs are concerned, instead, the ratio is one RSA for every 224 cases of dementia in the North, one for every 332 in the Centre and one for every 884 in the South. Moreover, only 25% of the guests with dementia in a RSA have access to an Alzheimer module/nucleus, just as only 24% of day care centres are defined as Alzheimer.
