When people begin to notice increasing forgetfulness as they grow older, it can quickly raise concerns that it might be the first sign of dementia. For situations like these, a programme called “Dementia Prevention” has been set up to help assess risks and support preventive action.
At the competence centre at the Hospital Centre of Luxembourg (CHL), people can undergo tests to determine whether their cognitive abilities are still within the normal range. At the same time, they can take part in activities designed to help reduce the risk of developing dementia.
Danielle Kies was diagnosed with Parkinson’s disease three years ago. Since then, she has been visiting the CHL twice a year to review her medication. The centre she attends is part of a national network specialising in neurodegenerative diseases, which also runs a dementia prevention programme. This network brings together several hospitals along with the Luxembourg Institute of Health (LIH).
Kies said in conversation with RTL that her doctor encouraged her to join in order to better understand her situation. She explained that she wanted reassurance that things were still on track, adding that if dementia is identified early enough, there may still be ways to slow its progression through targeted exercises. When the results show everything remains within a healthy range, she said, it immediately provides a sense of relief.
During the first phase of the programme, neuropsychologists assess whether any serious problems are present. Neuropsychologist Amna Skrozic explained that their role is to understand how potential cognitive difficulties manifest in everyday life before carrying out detailed testing.
She said the team evaluates functions such as memory and concentration through neuropsychological assessments to determine whether there are objective impairments or whether the difficulties people report are mainly subjective perceptions.
Depending on the results, participants may receive recommendations aimed at reducing their risk of dementia. Skrozic explained that the programme suggests a variety of activities designed to stimulate both mental and physical engagement. She said that these are organised through a voucher system, with participants receiving vouchers that allow them to take part in approved activities offered across the country.
After one year, participants return to the centre for a new evaluation. Kies said she tries to take part in as many activities as possible, adding that they not only help her remain active but also give her confidence that she is still on the right path.
Professor for neuroscience Rejko Krüger coordinates the dementia prevention programme. According to his estimates, more than 9,000 people in the Grand Duchy are currently living with Alzheimer’s disease, the most common form of dementia. In addition, around 3,000 people have Parkinson’s disease, and many of them may develop dementia later in life. Neurodegenerative diseases are therefore already widespread and the number of cases continues to rise.
One group at particular risk includes people experiencing what specialists call mild cognitive impairment. Krüger described it as subtle memory lapses, “like going down to the cellar and suddenly forgetting what you came for”. Identifying these early signs is crucial, he said, because it allows doctors to intervene and offer measures that may slow the progression of the condition and potentially prevent dementia from developing.
Dr Krüger explained that the precise causes of neurodegenerative diseases are not yet fully understood, which is why research continues worldwide, including in Luxembourg. He said that scientists currently know that certain proteins can clump together and accumulate on nerve cells in the brain. Researchers have identified which proteins are involved in diseases such as Alzheimer’s and Parkinson’s, with current research efforts aiming to prevent these deposits from forming in the first place, according to Dr Krüger.
Dr Krüger stressed that not all risk factors can be controlled. However, several scientifically established factors can be addressed through preventive action. He referred to these as “hope factors”, because they can be treated or modified.
Smoking, high blood pressure, elevated blood sugar levels, and high cholesterol are among the factors known to increase risk, but these can often be managed effectively through medication. Staying physically and mentally active also plays an important role in prevention.
According to Dr Krüger, maintaining social connections is equally important: taking part in social life and remaining engaged with others can help protect against dementia.
More recently, researchers have also identified hearing and vision loss as risk factors that can be treated. Scientists expect that additional risk factors will be identified in the future and incorporated into prevention programmes.
People who wish to join the programme are usually referred by their GP, who plays a key role in monitoring risk factors and coordinating preventive care.
Dr Krüger explained that up to 45% of dementia cases could potentially be avoided if multiple risk factors are addressed together. He said that the aim is to enable people to live longer and healthier lives. By delaying the onset of dementia for long enough, it may even be possible for some individuals never to experience the later stages of the disease.
For this reason, the programme now encourages people in their forties and fifties to become aware of their risk factors early on. To support this, researchers have developed a free app called Brain Coach, which allows users to assess their personal risk profile and receive practical advice.
Neurodegenerative diseases remain incurable, but research around the world is working to develop treatments that can slow their progression.
Dr Krüger said that a clinical trial in Luxembourg is currently testing a new medication designed to stimulate antibodies that help remove the protein clumps associated with Parkinson’s disease. The aim is to support the brain and slow the development of dementia.
At present, six patients in Luxembourg are receiving the infusion as part of the study, and researchers hope the positive results seen in earlier trials will be confirmed, he said. If that happens, the treatment could potentially become available in pharmacies within three to five years, according to Dr Krüger.
Advancing research on neurodegenerative diseases is also the goal of the initiative called “Espoir en Tête” – Hope for the Mind – by the Rotary Club of Luxembourg. As part of this project, a roundtable discussion will take place at the Luxembourg Chamber of Commerce on Tuesday evening, 10 March. During the event, Dr Krüger will give a short talk on the theme of healthy ageing.
