Society and Ethics Research Group, Wellcome Connecting Science, Hinxton, UK.
Cambridge Public Health, University of Cambridge, Cambridge, UK.
Alzheimers Res Ther. 2021 Oct 11;13(1):173. doi: 10.1186/s13195-021-00885-6.
Brain Health Services are a novel approach to the personalized prevention of dementia. In this paper, we consider how such services can best reflect their social, cultural, and economic context and, in doing so, deliver fair and equitable access to risk reduction. We present specific areas of challenge associated with the social context for dementia prevention. The first concentrates on how Brain Health Services engage with the "at-risk" individual, recognizing the range of factors that shape an individual's risk of dementia and the efficacy of risk reduction measures. The second emphasizes the social context of Brain Health Services themselves and their ability to provide equitable access to risk reduction. We then elaborate proposals for meeting or mitigating these challenges. We suggest that considering these challenges will enable Brain Health Services to address two fundamental questions: the balance between an individualized "high-risk" and population focus for public health prevention and the ability of services to meet ethical standards of justice and health equity.
脑健康服务是一种针对痴呆症的个性化预防的新方法。在本文中，我们考虑了如何使这些服务能够最好地反映其社会、文化和经济背景，并在这样做的过程中公平和公平地获得降低风险的机会。我们提出了与痴呆症预防的社会背景相关的具体挑战领域。第一个集中在脑健康服务如何与“有风险”的个人接触，认识到影响个人痴呆风险的一系列因素以及降低风险措施的效果。第二个强调了脑健康服务本身的社会背景及其提供公平获取风险降低的能力。然后，我们详细阐述了应对这些挑战的建议。我们建议考虑这些挑战将使脑健康服务能够解决两个基本问题：公共卫生预防中个体化“高风险”和人群重点之间的平衡，以及服务满足正义和健康公平的伦理标准的能力。
