Two million cases by 2050: the silent tsunami of cognitive decline (and the challenges it entails)

Life expectancy in our country is 84 years (longer for women and slightly shorter for men), the highest in the European Union. In just over a century, that figure has increased by a whopping 50 years . And rising… Because it's estimated that by 2035, women who are 65 will reach 87.7 years of age.

A priori, this is good news. But there's a downside: the health conditions at the time. Medical advances and lifestyle choices are responsible for the increased life span and the increasing number of centenarians in our country . But these figures also equate to an increase in the number of people with non-communicable diseases.

In fact, one of the greatest challenges facing Spanish society and healthcare is the increase in the number of people with cognitive impairment and dementia. Currently, this number is around 800,000 . However, according to a study recently presented by the Health Sciences Foundation , the number could reach two million by 2050.

Of the various diseases that cause cognitive decline, Alzheimer's is the most prevalent form in our country. It currently accounts for between 70% and 77% of cases. It is followed by vascular dementia, dementia with Lewy bodies, and frontotemporal dementias. These pathologies have a prevalence of 40% in people over 90 years of age.

This same report emphasizes the importance of prevention, as up to 40% of cases could be delayed or avoided if modifiable factors are addressed early. The reason is that pathological changes in the brain begin long before the onset of impairment.

José Antonio Serra Rexach, head of the Geriatrics Department at Gregario Marañón University Hospital and one of the authors of the study, states that "promoting a healthy lifestyle, a balanced diet (such as the Mediterranean diet), regular exercise, and cognitive stimulation are key to preserving brain health. In addition, it is important to consider other factors such as controlling hypertension and diabetes, reducing social isolation, and correcting hearing impairments."

“Early diagnosis not only allows for the initiation of treatment, but is also essential for planning the future of the patient and their environment. Improving access to diagnostic tests and reducing waiting times is key to more effective, person-centered care,” according to Ángel Berbel García, a member of the Spanish Society of Neurology (SEN) and co-author of the study.

Up to 40% of cases could be delayed or avoided by acting on modifiable factors in a timely manner.

However, the reality is that from the appearance of the first symptoms to medical confirmation , it takes an average of 28 months (more than two years). This delay is mainly due to a lack of awareness, social stigma, and unequal access to diagnostic tests such as neuroimaging or biomarkers.

Another reason for this prolonged delay is the lack of equity in access to specialized resources , which varies by autonomous community. "Specialized care for dementia is very unequal in Spain," says Berbel.

And he concludes: "While some regions have multidisciplinary memory units, others have few dedicated resources. We need a uniform and accessible model that guarantees comprehensive care from diagnosis to the advanced stage."

Life expectancy in our country is 84 years (longer for women and slightly shorter for men), the highest in the European Union. In just over a century, that figure has increased by a whopping 50 years . And rising… Because it's estimated that by 2035, women who are 65 will reach 87.7 years of age.