With the progressive ageing of the general population, we are faced with a worrying scenario of an increase in the prevalence of cognitive disorders and dementia of a neurodegenerative nature in the near future. For this reason, the European Academy of Neurology has recently launched a global initiative (Brain Health) to promote brain health with the aim of preventing dementia.
In this context, the IRCCS San Gerardo dei Tintori Foundation - University of Milan-Bicocca is launching a new outpatient clinic dedicated to subjective cognitive decline (SCD). Subjective cognitive decline is a condition, very common after the age of 55-60, in which the person feels that his or her cognitive performance (often in the area of memory, but not only) has deteriorated compared to a previous state, while neuropsychological tests do not show significant differences with respect to what is expected for the age and schooling. Basically, this is a condition in which the person is healthy, but which can be an alarm bell, because in some cases it can be the telltale sign of a pathological process for which our tests are not yet sensitive enough.
Access to this outpatient clinic will only be possible after an initial assessment by the UVA (Unità Valutativa Alzheimer) del Centro per i Disturbi Cognitivi e le Demenze (CDCD), which has been operating at the San Gerardo Neurology Clinic for some time.
In this new service, the visit starts with a detailed anamnesis to characterise the disorder and assess the risk factors for cognitive decline. The percentage risk of developing dementia is then estimated, if possible, and personalised preventive measures are proposed to reduce this risk, or new investigations are prescribed if indicated. If objective cognitive decline, however mild (mild cognitive decline or MCI), is detected, the person is offered the option of continuing to attend the UVA outpatient clinic.
The Outpatient Clinic, like the other sectors of the Neurology Unit, is also involved in research activities sponsored by universities and the IRCCS. This includes an important project under the National Plan for Recovery and Resilience (PNRR). In fact, the Ministry of Universities and Research has funded the major Age-It project (Ageing Well in an Ageing Society), which involves 27 Italian research centres. As part of this project, the University of Milano-Bicocca, with Prof. Carlo Ferrarese, is coordinating a complex activity (IN-TEMPO study) aimed at preventing cognitive decline through multidimensional interventions (diet, physical activity, cognitive stimulation, strict control of vascular risk factors), in line with similar international studies.
In this general context, other studies coordinated by Milano-Bicocca are being carried out, such as the CAPE study, which is evaluating the potential of new magnetic resonance imaging methods for analysing cerebral blood flow compared to the analysis of cerebral metabolism carried out by PET, with the aim of validating new methods for the early diagnosis of neurodegenerative diseases and studying the biological progression of these disorders. The CogniChess study will test whether learning traditional board games (chess and Go, a popular game in the Far East) in a group setting can improve cognitive performance in people with SCD or MCI and have benefits on depression and quality of life.