Panel Discussion Dr Alice Powell, Prof James Burrell, Ms Madelaine Rañola, RN

In this podcast, we delve into the financial implications and logistical challenges associated with new dementia therapies, particularly focusing on treatments such as dananimab and lacanemab. We discuss the estimated cost of these therapies, which can exceed $77,000 over an 18-month treatment period, and the potential out-of-pocket expenses associated with necessary scans and clinical assessments. The lecture emphasizes the high costs of both FDA-approved medications and the required diagnostic imaging, which could price many patients out of receiving these promising therapies. The discussion acknowledges the burden this cost poses on patients and the healthcare system, while also suggesting that the eventual acceptance of this treatment into public funding channels may depend on accumulating evidence of cost-effectiveness from early intervention.

The conversation shifts to the effectiveness of these therapies in improving patient outcomes, with participants debating whether these treatments can restore independent living for individuals with mild dementia. The consensus is that while these drugs may not fully restore cognitive function, they could potentially slow cognitive decline significantly in early-stage patients, leading to better long-term outcomes. The notion of societal perceptions of dementia contrasts sharply with approaches to cancer treatments, thereby reinforcing the need for more appropriate frameworks around funding and support for neurodegenerative diseases, including those with early-stage symptoms.

Addressing the complexities of voluntary assisted dying within the context of dementia care, we explore the legislative barriers that complicate access to these options for patients who may progressively lose decision-making capacity. The nuanced legal frameworks make it challenging for individuals with dementia to qualify for voluntary assisted dying, which raises ethical questions about autonomy and cognitive rights in progressive diseases.

Further segments cover the operational aspects of healthcare funding mechanisms, such as transitioning patients from the NDIS to aged care services upon reaching 65 years of age. Participants outline how existing funding structures will adjust to the new legislation, ensuring no patient should experience a loss of financial support due to age transitions. This segment highlights the legislative evolution aiming to establish a more structured resource allocation for individuals with neurodegenerative conditions.

The diagnosis and identification of conditions such as Creutzfeldt-Jakob Disease (CJD) are thoroughly examined, with a focus on advancements in diagnostic testing and the importance of consensus among specialists for accurate diagnosis. Further points in the discussion address the rarity of certain diseases in Australia, underscoring the need for a broad understanding of variances in symptomology and diagnostic measures unique to neurodegenerative disorders.

The role of dietary interventions and lifestyle choices in dementia prevention receives attention, with participants referencing studies supporting physical activity and social engagement as protective factors against dementia. Despite the popularity of alternative treatments, such as turmeric and curcumin, the emphasis remains on evidence-based practices shown to effectively modify dementia risk.

Lastly, we explore the relationship between cognitive reserve and dementia risk, emphasizing how educational background and occupational complexity correlate with resilience to cognitive decline. The challenges in identifying dementia in patients with high cognitive abilities are discussed, illustrating how some individuals may maintain function longer only to experience a rapid decline once symptoms emerge.

Throughout, the engagement emphasizes the necessity for a comprehensive, informed