Communication from the Commission to the European Parliament and the Council on a European initiative on Alzheimer’s disease and other dementias {SEC(2009) 1040} {SEC(2009) 1041}
Date: 2009-07-22
Institutions: European Commission
Subjects: EU action, EU programme, disease of the nervous system, disease prevention, harmonisation of standards, health care, health care system, health costs, health policy, medical research

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COMMISSION OF THE EUROPEAN COMMUNITIES 

Brussels, 22.7.2009 
COM(2009) 380 final 

COMMUNICATION FROM THE COMMISSION TO THE EUROPEAN 
PARLIAMENT AND THE COUNCIL 

on a European initiative on Alzheimer’s disease and other dementias  

{SEC(2009) 1040} 
{SEC(2009) 1041}

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COMMUNICATION FROM THE COMMISSION TO THE EUROPEAN 
PARLIAMENT AND THE COUNCIL 

on a European initiative on Alzheimer’s disease and other dementias  

1. 

INTRODUCTION AND PROBLEM DEFINITION 

1.1. 

The context 

Dementia  is  a  decline  in  mental  ability  that  usually  develops  slowly,  causing  impaired 
memory, thinking and judgement, and personality may deteriorate. It predominantly (but not 
exclusively) affects those aged over 60 and is a major cause of disability among the elderly, 
and the increasing proportion of older people in many populations means that the number of 
dementia patients is also likely to rise. Dementias are a group of neurodegenerative diseases 
and are not just a part of the normal ageing process.  

The  most  common  type  of  dementia  in  the  EU  is  Alzheimer’s  disease  which  accounts  for 
around  50-70%  of  cases,  followed  by  the  successive  strokes  which  lead  to  multi-infarct 
dementia  (around  30%);  other  forms  include  Frontotemporal  dementia,  Pick's  disease, 
Binswanger's  disease,  Lewy-Body  dementia,  amongst  others.  A  project,  carried  out  by  the 
European  Union  patients'  platform  Alzheimer  Europe1  with  the  support  of  the  European 
Commission, also identified the most significant rare forms of dementia2.  

The  best  available  estimates3  indicate  that,  in  2006,  7.3  million  Europeans  (across  the  27 
Member  States)  between  30  and  99  years  of  age  were  suffering  from  different  types  of 
dementia (12.5 per 1 000 inhabitants). Within this group, more women (4.9 million) than men 
(2.4  million)  are  affected.  With  the  increase  in  life  expectancy,  especially  in  developed 
countries, dementia's incidence has increased dramatically and some current forecasts project 
a doubling of the number of persons affected every 20 years4,5.  

Of course, dementias do not only affect the people with the condition, but also those who care 
for them. If we estimate that in every family with a patient, on average three persons directly 
bear  the  brunt6,  this  means  that  an  estimated  19  million  Europeans  are  directly  affected  by 
dementias. 

Dementias  are  very  expensive  for  society  as  a  whole:  according  to  the  Dementia  in  Europe 
Yearbook  (2008),  the  total  direct  and  informal  care  costs  of  Alzheimer's  disease  and  other 

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http://www.alzheimer-europe.org/ 
http://ec.europa.eu/health/ph_projects/2002/rare_diseases/fp_raredis_2002_a4_03_en.pdf 
http://ec.europa.eu/health/ph_information/dissemination/echi/docs/dementia2_en.pdf 
Alzheimer’s  disease:  Scientific,  medical  and  societal  implications,  Synthesis  and  recommendations. 
Collective  expert  report  from  INSERM  (French  National  Institute  for  health  and  medical  research), 
2007. 
First  Results  from 
the  Survey  of  Health,  Ageing  and  Retirement 
http://www.share-project.org/t3/share/uploads/tx_sharepublications/BuchSHAREganz250808.pdf 
Alzheimer's 
real 
europe.org/?lm2=C5BA5EF2EE10 

in  Europe  (2004-2007) 

http://www.alzheimer-

dementia 

life--the 

disease 

survey 

carer's 

in 

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dementias in 2005 amounted to €130 billion for  the EU 27 region (€21 000 per patient/year); 
56% of costs were generated by informal care7. 

However, Alzheimer's disease remains under-diagnosed in the EU; according to the available 
epidemiological data, only half of those suffering from the disease are currently identified8. 

The importance of these conditions has long been recognised at European level, not only by 
the  Commission  but  also  by  the  Parliament  and  the  Council.  Resultant  action  has  included 
European Parliament Resolutions in 1996 and 19989, accompanied by budgetary provision for 
specific projects in this area10. The White Paper “Together for Health: A Strategic Approach 
for  the  EU  2008-2013”  of  23  October  2007  (COM(2007)  630)  outlining  the  EU  Health 
Strategy11 identifies the need for neurodegenerative diseases such as Alzheimer's to be better 
understood in the context of demographic ageing. Most recently, the Council has adopted two 
sets  of  Conclusions  on  combating  neurodegenerative  diseases  and  particularly 
Alzheimer's12,13, including calls for action by the Commission. 

The primary responsibility for tackling dementias lies with the Member States. However, in 
the area of health under Article 152 of the Treaty, the Community is to encourage cooperation 
between the Member States and if necessary to lend support to their action. Moreover, Article 
165 of the Treaty stipulates that the Community and the Member States shall coordinate their 
research  and  technological  development  activities  so  as  to  ensure  that  national  policies  and 
Community policies are mutually consistent. In close cooperation with the Member States, the 
Commission may take any useful initiative to promote coordination.  

The  specific  characteristics  of  Alzheimer's  disease  and  other  dementias  single  them  out  as 
areas  where  actions  taken  at  EU  level  can  bring  added  value  in  supporting  Member  States. 
The objective of this Communication is to set out actions providing support to Member States 
in  ensuring  effective  and  efficient  recognition,  prevention,  diagnosis,  treatment,  care,  and 
research  for  Alzheimer's  disease  and  other  dementias  in  Europe.  For  this  a  Joint  Action 
between the European Commission and the Member States as defined in the Work Plan for 
the implementation of the Second Health Programme (2008-2013)14 will be launched in 2010. 
This will in turn contribute to the overarching goal - an improvement in health outcomes, and 
therefore a growth in Healthy Life Years, a key Lisbon Strategy indicator15. 

1.2. 

The issues 

There are four key issues that Community action could help to address: 

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Alzheimer Europe (2008) Dementia in Europe Yearbook 2008 
Major  and  Chronic  Diseases  Report  2007,  Task  Force  on  Major  and  Chronic  Diseases,  DG  SANCO 
http://ec.europa.eu/health/ph_threats/non_com/docs/mcd_report_en.pdf 
Resolution  of  17  April  1996  on  Alzheimer’s  disease  and  the  prevention  of  disorders  of  the  cognitive 
functions in the elderly and Resolution of 11 March 1998 on Alzheimer’s disease. 
http://ec.europa.eu/health/ph_projects/alzheimer_project_full_listing_en.htm 
See http://ec.europa.eu/health/ph_overview/strategy/health_strategy_en.htm 
http://www.consilium.europa.eu/ueDocs/cms_Data/docs/pressData/en/lsa/104778.pdf 
http://register.consilium.europa.eu/pdf/en/08/st13/st13668.en08.pdf 
Decision  No  1350/2007/EC  of  the  European  Parliament  and  of  the  Council  of  23  October  2007 
establishing a second programme of Community action in the field of health (2008-13) 
See http://ec.europa.eu/health/ph_information/indicators/lifeyears_en.htm 

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–  People can act to help prevent dementia, especially vascular dementia and in some extent 
also Alzheimer's disease, and early diagnosis can ensure that interventions take place while 
they are most effective. But there is a lack of awareness of the importance of prevention 
and early intervention throughout the EU; 

–  There is a clear need for improved understanding of dementias, in particular of Alzheimer's 
disease  and  other  neurodegenerative  types.  Yet  there  is  very  limited  coordination  of 
research,  an  issue  with  particular  potential  for  European  added  value,  and  a  lack  of 
sufficient epidemiological data to help direct research and action in the future; 

–  There  are  good  practices  emerging  in  different  places  across  the  EU  with  regard  to 
diagnosis, treatment and financing of therapies for these conditions, but they are not being 
shared throughout the Union. This is all the more important given that the European Union 
is  and  will  be  confronted  with  staff  shortages  of  formal  carers,  and  problems  stemming 
from a lack of support for informal carers;  

–  Insufficient attention is being paid to rights of people suffering from a cognitive deficit . 
There is also a lack of recognition of the mental capital of older people, lack of knowledge 
and  understanding  by  the  general  public  of  what  Alzheimer's  disease  is,  and  a  stigma 
associated with dementias that can influence the health of these patients. 

2. 

OBJECTIVES AND COMMUNITY ACTIONS 

2.1. 

Acting early to diagnose dementia and to promote well-being with age 

Promoting good physical and mental health (e.g. developing a healthy cardiovascular system, 
encouraging  education  and  learning  throughout  life)  can  help  to  avoid  cognitive  decline 
leading  to  dementia.  Prevention  is  more  straightforward  for  vascular  dementia  than  for 
Alzheimer's disease because risk factors for strokes are well identified and similar to those for 
other cardiovascular diseases (such as coronary heart disease). These risk factors include high 
blood  pressure,  high  cholesterol  levels  and  smoking.  Given  that  half  of  all  dementia  cases 
have  a  vascular  component,  control  of  vascular  risk  factors  could  protect  against  the 
development  of dementia16. More targeted research is required  in order to better understand 
what  a  'healthy  brain  lifestyle'  is  an  issue  which  will  increase  in  importance  alongside 
demographic ageing.  

Understanding dementias, both for individual patients and families, and for public authorities, 
also depends on accurate and consistent diagnosis. Identifying and promoting best practice in 
early diagnosis of Alzheimer’s disease and other forms of dementia is necessary in order to 
make  best  use  of  available  interventions  at  the  most  effective  early  stages.  Through  earlier 
diagnosis and intervention it may be possible to delay late-stage progression of the diseases 
and thus postpone institutionalisation, thereby reducing the high cost of terminal (long-term) 
care.  Progress  has  already  been  made  at  EU  level  towards  developing  a  basis  for  early, 
accurate  diagnosis  that  also  allows  best  use  to  be  made  of  existing  treatments17.  The 

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Alzheimer Europe (2008) Dementia in Europe Yearbook. 
This  includes  the  Mini  Mental  State  Examination  (MMSE)  and  the  EU  Project  DESCRIPA 
(Development of Screening guidelines and diagnostic Criteria for Predementia Alzheimer's disease) – 
see http://www.biocompetence.eu/index.php/kb_1/io_2930/io.html. 

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Commission  will  support  further  work  in  order  to  develop  these  best  practices  for  early 
diagnostic procedures for Alzheimer’s disease and other dementias. 

Furthermore, there is growing evidence that mental activity and stimulation (through lifelong 
learning  as  well  as  through  social  interactions)  reduces  the  risk  of  developing  dementia, 
including  Alzheimer's  disease.  Conversely,  inactivity  appears  to  be  a  risk  factor.  There  is 
evidence to suggest that when people come to retire and do not make appropriate adjustments, 
retirement  acts  as  a  catalyst  for  age-related  cognitive  decline18.  This  could  be  countered  by 
more  flexible  retirement  or  post-normal  retirement  employment  (also  contributing  to  the 
sustainability  of  pension  schemes),  as  well  as  other  adjustments  in  health  and  social  care 
systems. 

A  European  Pact  for  Mental  Health  and  Well-being  was  established  by  the  EU  high-level 
conference "Together for Mental Health and Well-being" of 13 June 200819. Its launch is an 
opportunity  to  take  this  dimension  of  the  disease  into  account,  providing  a  framework  for 
awareness-raising  activities  and  the  exchange  of  good  practices  in  addressing  Alzheimer 
challenges,  as  a  strand  complementing  the  Pact's  focus  on  mental  health,  well-being,  and 
disorders. 

The  European  Commission  launched  in  2007  the  "Communication  on  Ageing  Well  in  the 
Information  Society"  of  14th  June  2007  (COM(2007)  332)20  with  a  number  of  concrete 
actions. These include specific actions in the Information and Communication Technologies 
(ICT)  part  of  the  FP7,  ,  as  well  as  large  scale  pilot  projects  with  regions  under  the 
Competitiveness and Innovation programme specifically addressing ICT solutions for elderly 
people with cognitive problems and mild dementia and as well as their carers. In addition, a 
joint  research  and  innovation  programme  has  been  launched21  between  the  EU  and  23 
European  countries  on  new  ICT  products  and  services  for  ageing  well,  where  solutions  in 
support of Alzheimer's disease can be developed. 

•  Actions: 

•  To  incorporate  the  'dementia  dimension'  into  the  European  Union's  ongoing  and  future 
actions on health prevention, especially those related to cardiovascular health and physical 
activity.  

•  To  produce  set  of  recommendations,  which  would  help  the  citizens  to  prevent  dementia 

diseases. 

•  To include the 'dementia dimension' in flexible European policies on retirement and in the 
framework  for  action  on  older  people  in  the European  Pact  for  Mental  Health  and  Well-
being. 

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http://www2.ulg.ac.be/crepp/papers/crepp-wp200704.pdf 
http://ec.europa.eu/health/ph_determinants/life_style/mental/docs/pact_en.pdf 
http://ec.europa.eu/information_society/activities/health/docs/policy/interop-com2007-332-final.pdf 
Decision No 742/2008/Ec of the European Parliament and of the Council of 9 July 2008, OJ L 201/49 
of 30.7.2008. 

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2.2. 

A shared European effort to better understand dementia conditions: improving 
epidemiological knowledge and coordination of research 

Reliable prevalence and incidence data on dementias are also essential if Member States are 
to  be  able  to  make  appropriate  plans  and  provision,  taking  into  account  the  major 
consequences  for  public  finances  across  Europe.  The  Commission  will  continue  to  work 
towards reliable prevalence and incidence data according to age and based on the “European 
Collaboration  on  Dementia  (EuroCoDe)”  project22  methodology.  In  particular, 
the 
Commission will develop actions under the Health Programme on better prevalence data, risk 
factors  and  how  to  address  them,  and  validation  of  new  criteria  for  early  diagnosis.  In  the 
future,  the  planned  European  Health  Examination  Survey  (EHES)23  will  also  be  able  to 
provide valuable information through its cognitive test module, providing data with a strong 
predictive value on the evolution of this problem. Synergies will be sought within the Seventh 
Framework  Programme  for  research  and  technological  development  (FP7)24,  with  particular 
reference to the Health Theme of the specific Programme "Cooperation", which has research 
on  the  brain  and  related  diseases  as  a  dedicated  research  area  and  research  into  ageing  as  a 
cross-cutting issue. 

Community research efforts in this area have been stepped up in FP7 within the Health Theme 
through  the  areas  of  brain  research  and  public  health  research,  covering  issues  such  as 
understanding  disease  mechanisms,  patient  mental  health,  prevention  strategies  for  healthy 
ageing,  and  equality  of  access  to  care.  In  the  face  of  the  major  challenges  to  public  health 
presented  by  Alzheimer’s  disease  and  other  dementias,  promising  areas  of  research  may  be 
supported, in particular by fostering increased coordination between fundamental and clinical 
research. Examples of areas of potential interest are research into the pathophysiology of the 
disease, including epidemiological and clinical trials, research in health economics, the social 
sciences and humanities to help understanding of the psychological and social aspects of the 
disease, and research into social care models including sharing of best practices in the training 
of dementia caregivers, reflecting the broad consensus that patient care should not be limited 
to pharmacological treatment but should also include non-pharmacological approaches. 

Within the Health Theme of the specific Programme "Cooperation", the third activity entitled 
“Optimising  the  delivery  of  health  care  to  European  citizens”  provides  for  European  public 
health  research  to  contribute  to  building  the  necessary  basis  both  for  informed  policy 
decisions  on  health  systems  and  for  more  effective  strategies  of  health  promotion,  disease 
prevention, diagnosis and therapy. To date, two calls for proposals have addressed the impact 
of ageing, resulting in projects that will entail research on health systems and long-term care 
of the elderly, organisation of dementia care, a road map for ageing research, ageing cohorts, 
and health outcome measures and population ageing. Further research should be developed in 
the light of these projects as well as Member States' priorities. 

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http://ec.europa.eu/health/ph_projects/2005/action1/action1_2005_10_en.htm 
http://ec.europa.eu/health/ph_information/dissemination/reporting/report_en.htm 
Decision  No  1982/2006/EC  of  the  European  Parliament  and  of  the  Council  of  18  December  2006 
concerning the Seventh Framework Programme of the European Community for research, technological 
development  and  demonstration  activities  (2007-2013)  (OJ  L  412,  30.12.2006,  p.  1)  and  Council 
Decision  2006/971/EC  of  19  December  2006  concerning  the  specific  programme  ‘Cooperation’ 
(HEALTH)  implementing  the  Seventh  Framework  Programme  of  the  European  Community  for 
research, technological development and demonstration activities (2007 to 2013) (OJ L 54, 22.2.2007, 
p. 30). 

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First  steps  are  being  taken  to  promote  cooperation  in  public  research  efforts  targeting  key 
priorities related to neurodegenerative diseases, in particular  Alzheimer’s,  at European  level 
through  a  Joint  Programming  approach25.  This  approach  involves  Member  States  engaging 
voluntarily  and  on  the  basis  of  a  variable  geometry  in  the  definition,  development  and 
implementation of a common strategic research agenda (SRA) based on a communal vision of 
how  to  address  today's  major  societal  challenges.  Neurodegenerative  diseases  have  been 
identified by Member States as an area where the social demand is high and where a common 
initiative,  implemented  through  Joint  Programming,  would  improve  hugely  on  the  current 
fragmented  efforts  in  the  European  Research  Area.  Currently,  resources  are  split  between 
numerous and diverse funding agencies spread over the 27 EU Member States and without a 
strong  alignment  to  policy  making.  This  creates  the  risk  of  wasteful  duplication  of  public 
research  funding  at  EU  level.  A  joint  European  effort  is  therefore  needed  to  develop  a 
common  vision  of  research  needs  and  measures  to  be  implemented  in  this  field  in  order  to 
promote  the  cooperation  at  EU  level,  design  and  upscale  novel  approaches  commensurate 
with  scientific,  medical  and  social  unknowns,  avoid  unnecessary  duplication  of  efforts  and 
increase the efficiency and effectiveness of national and Community R&D spending.  

To  this  end,  alongside  this  Communication,  the  Commission  is  presenting  a  proposal  for  a 
Council  Recommendation  on  a  pilot  Joint  Programming 
initiative  on  combating 
neurodegenerative diseases, in particular Alzheimer's, for pooling and coordinating the efforts 
of European basic and clinical researchers in this field. The purpose of this Recommendation 
is  to  develop  a  new  approach,  through  cooperation  and  collaboration  between  national 
research programmes, for more effectively tackling common European challenges in the area 
of neurodegenerative diseases, in particular Alzheimer's disease, hence making better use of 
Europe's limited public R&D funds. The approach would entail Member States to develop a 
common  vision  of  how  research  cooperation  and  coordination  at  European  level  can 
contribute  to  better  understand,  detect,  prevent  and  combat  neurodegenerative  diseases,  in 
particular  Alzheimer´s,  and  to  develop  and  implement  a  strategic  research  agenda  to  realise 
this  vision.  It  invites  the  Commission  to  provide  complementary  supporting  measures  to 
support  the  pilot  Joint  Programming  initiative,  which  would  include  the  support  to  the 
management  structure  and  the  establishment  of  the  SRA,  the  provision  of  data,  information 
and analysis on the state of the art in this field in Member States and at European level. 

•  Actions: 

•  To 

improve  epidemiological  data  on  Alzheimer's  disease  and  other  dementias, 

implementing the conclusions of the EuroCoDe Project; 

•  To use the planned European Health Examination Survey to provide new Europe-wide data 

on the prevalence of people with early cognitive deficiencies; 

•  To adopt a proposal for a Council Recommendation on a pilot Joint Programming initiative 

on combating neurodegenerative diseases as a pilot, in particular Alzheimer's disease. 

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Council  conclusions  concerning  a  common  commitment  by  the  Member  States  to  combat 
neurodegenerative diseases, particularly Alzheimer's. 
http://register.consilium.europa.eu/pdf/en/08/st13/s13668.en08.pdf. 

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2.3. 

Supporting national solidarity with regard to dementias: sharing best practices 
for care of people suffering dementia 

The  ‘Open  Method  of  Coordination’  for  Social  Protection,  Social  Inclusion  and  Long-Term 
Care  with  associated  activities  (peer  review  process,  conference,  theme  for  the  next  joint 
report) can provide a platform for sharing best practice, in particular with regard to standards 
of care and for the financing of social protection for people with neurodegenerative conditions 
and their families. Furthermore, best practice on how to optimise support for family members 
that care for persons suffering from Alzheimer's disease and other forms of dementia should 
also  be  shared.  Alongside  this  the  Commission  will  also  support  the  development  of  good 
practices, where needed, by providing information on how ongoing Community programmes 
(in particular, the Structural Funds) can help finance such developments in Member States. 

Community  care,  home  care,  residential  care  and  day  care  are  labour-intensive  sectors  in 
which staff costs account for the majority of the overall expenditure. Labour supply in these 
areas is a major preoccupation for Member States, particularly in view of the medical, nursing 
and social care staff shortages. Provision of special training to nurses and family members of 
Alzheimer patients should be promoted. Therefore, the Commission will explore the scope for 
supporting  cooperation  on  development  of  concepts  and  solutions  both  nationally  and  at 
European  level,  promoting  a  holistic  approach  for  care.  It  will  also  focus  on  developing 
quality frameworks for medical and social care services for people with dementias through the 
Health Programme.  

The  empowerment  of  national  and  international  Alzheimer’s  associations  and  relevant 
patients’ organisations should ensure that patients and their representatives are duly consulted. 
It's  an  objective  of  the  second  Health  Programme  and  existing  national  dementia  strategies. 
The  EU's  PROGRESS  Programme  (2007-2013)26  combating  social  exclusion  and 
discrimination, promoting gender equality and the integration of people with disabilities will 
continue  to  provide  support  to  organisations  representing  patients  and  relatives..  Facilities 
provided by the EU Disability Action Plan (DAP) 2003-2010 will also be used as appropriate. 

•  Actions: 

•  To map the existing and emerging good practices related to treatment and care for persons 
suffering  from  Alzheimer's  disease  and  other  forms  of  dementia  and  to  improve  the 
dissemination  and  application  of  such  practices  (using,  when  possible,  the  Structural 
Funds).  

•  To  develop,  by  means  of  the  Open  Method  of  Coordination,  quality  frameworks  for 

medical and care services for people with dementias.  

•  To  use  facilities  provided  for  in  the  EU  Disability  Action  Plan  (DAP)  2003-2010  to 

support patients' organisations. 

26 

Decision  No  1672/2006/EC  of  the  European  Parliament  and  of  the  Council  of  24 October  2006 
establishing a Community Programme for Employment and Social Solidarity — Progress. 

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2.4. 

Respecting the rights of people with dementias 

The image of Alzheimer’s disease and other dementias in European society is a negative one, 
often associated with fear and helplessness that can influence the health of these patients. The 
gradual loss of capacity makes it difficult for people with dementia to maintain their place and 
active participation in society. Carers may also experience social exclusion resulting from the 
effects of dementia on their loved ones. However, maintaining social contact and remaining 
active  helps  preserve  autonomy  and  physical  and  mental  well-being  for  longer,  minimising 
the need for assistance and preventing social isolation and depression.  

The  disclosure  of the diagnosis to people with dementia is  of  great significance in allowing 
them to take an active part in decisions affecting their lives. Unfortunately, cognitive abilities 
steadily  decline  and  there  generally  comes  a  time  when  the  person  with  dementia  can  no 
longer manage entirely alone and where he/she will need help in making decisions of varying 
importance, such as financial management or medical decisions.  

Assistance  could  be  provided  by  a  guardian/lawful  representative,  but  national  laws  differ 
widely as discovered by Alzheimer Europe when it carried out its Lawnet projects27. In any 
case,  it  is  imperative  to  allow  the  person  suffering  from  dementia  to  articulate  his  or  her 
preferences, insofar as they are capable to do so. 

The  Commission  can  contribute  to  political  leadership  in  recognising  the  rights  of  elderly 
people  with  cognitive  disorders.  It  has  organised  the  first-ever  European  Conference  on 
Prevention  of  Neglect  and  Abuse  of  Elderly  People  (2008).  It  also  envisages  establishing  a 
European  Network  with  the  most  relevant  public  and  private  stakeholders  for  rights  and 
dignity  of  people  with  dementia  who  should  formulate  recommendations  on  dignity, 
autonomy  and  social  inclusion  as  a  means  to  preserve  physical  and  mental  health  of  these 
people.  This  should  contribute  to  political  leadership  in  the  EU  for  reducing  the  stigma 
associated with Alzheimer’s disease and other dementias and contributing to the well-being of 
these  patients.  The  proposed  European  Network  should  also  contribute  to  sharing  best 
practices on respecting the rights of vulnerable adults and tackling patient abuse. 

•  Action: 

•  To establish, using the facilities provided by the Health Programme, a European Network 
for rights and dignity of people with dementia, which should formulate recommendations 
on  dignity,  autonomy  and  social  inclusion,  and  to  share  best  practices  on  respecting  the 
rights of vulnerable adults and tackling patient abuse. 

3. 

CONCLUSIONS AND NEXT STEPS 

Public  health,  research,  social  protection,  and  rights  and  autonomy  constitute  the  four 
dimensions  of  action  that  should  respond  to  a  reality  in  our  societies.  The  European 
population  is  ageing  and  it  is  the  responsibility  of  all  to  ensure  that  people  can  age  with 
dignity,  keeping  in  good  health  for  as  long  as  possible  and  enjoying  the  same  rights  as 
everyone else. The Commission intends to use, for the purposes of this Communication, the 

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Alzheimer Europe (2002): Comparative analysis of legislation in Europe relating to the rights of people 
with dementia (available on www.alzheimer-europe.org). 

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different  legal  instruments  at  its  disposal  (Health  Programme,  Seventh  Framework 
Programme, EU Disability Action, Open Method of Coordination and Statistical Programme) 
in an integrated way that permits a high level of efficiency and coordination, and optimum use 
of resources. Community action can help to support the Member States in addressing the issue 
of  dementias  as  European  society  ages.  Ultimately,  the  Community  can  undertake  these 
supportive actions, but success in meeting this challenge will mostly depend on the primary 
role of Member States and civil society.  

To  this  end,  the  Commission  will  also  help  support  the  World  Alzheimer's  Day  (21 
September)  through  European  and  national  initiatives.  Working  in  partnership  and  on  the 
basis of the measures set out in this Communication, the Commission will thereby contribute 
to a collective effort seeking to maximise health in an ageing society throughout Europe. 

The  Commission  initiative  on  Alzheimer's  disease  and  dementias  should  aim  at  fostering 
cooperation  at  an  international  level  with  all  interested  countries  and  in  close  collaboration 
with  the  World  Health  Organisation.  International  cooperation  is  already  an  integral  part  of 
the Framework Programmes for Research. 

The  Commission  will  produce  by  2013  an  implementation  report  on  this  Communication  -
addressed  to  the  European  Parliament  and  to  the  Council-  at  the  end  of  the  Joint  Action 
between the European Commission and the Member States implementing the actions of this 
Communication. 

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