title: Design of a comprehensive Alzheimer's disease clinic and research center in Spain to meet critical patient and family needs.
abstract: OBJECTIVE
  Alzheimer's disease (AD) affects people worldwide, and the prevalence is increasing as the population ages. There is an international effort to understand the biology of AD to develop primary and secondary prevention strategies, and to develop effective therapeutic interventions for individuals who are already symptomatic. One of the critically important pieces of all national plans to address AD is the call for the development of service models to deliver quality, effective care based on the best evidence available.
  
  
  METHODS
  We describe one type of care model developed by the Fundacio ACE, Institut Catala de Neurociencies Aplicades (Fundacio ACE, Barcelona, Spain) that integrates diagnosis, therapy, follow-up care, daycare, and a day hospital, and does so in the context of an active clinical research and educational program.
  
  
  RESULTS
  There were 13,048 individuals newly evaluated and diagnosed in Fundacio ACE between 1996 and 2011. Of these, 6132 had AD (47.0%), 3871 had mild cognitive impairment (MCI) (29.7%), and 1958 had no cognitive impairment (15.0%). Follow-up information is available on 4735 (47.3%) AD and MCI patients, and these data indicate that MCI develops into dementia at a rate of 222.6/1000 person-years. Apolipoprotein E (APOE) genotyping was available in 22.4% of the patients. The ε4 allele occurred in 45.7% of the AD patients, in 37.8% of the MCI subjects, and in 31.6% of those without cognitive impairment.
  
  
  CONCLUSIONS
  Fundació ACE can serve as a model system that can be adapted to other settings within their specific cultural, governmental, and legal constraints.
authors.affiliation: Alzheimer Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain. Electronic address: mboada@Fundacioace.com.
authors.forename: Mercè
authors.initials: M
authors.lastname: Boada
authors.affiliation: Alzheimer Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Lluís
authors.initials: L
authors.lastname: Tárraga
authors.affiliation: Alzheimer Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Hernández
authors.affiliation: Alzheimer Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain; Servei de Psiquiatria, Hospital Universitari Vall d'Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: Sergi
authors.initials: S
authors.lastname: Valero
authors.affiliation: Alzheimer Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Alegret
authors.affiliation: Alzheimer Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain.
authors.forename: Agustín
authors.initials: A
authors.lastname: Ruiz
authors.affiliation: Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Oscar L
authors.initials: OL
authors.lastname: Lopez
authors.affiliation: Alzheimer's Disease Research Center, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: James T
authors.initials: JT
authors.lastname: Becker
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D000554:Ambulatory Care Facilities; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D003695:Delivery of Health Care / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D013030:Spain
keywords: Alzheimer’s disease; Dementia; Natural history; Spain
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