Ageing Europe - It’s time we prioritised neurological conditions

Europeans are living longer than ever before – tangible proof of the phenomenal advancements in science and healthcare.^1,2 However, it comes with a paradoxical rise in nervous system disorders, with one in three of us set to face this challenge in our lifetime.^3,4

Addressing these conditions is not just urgent for individuals who battle these debilitating conditions every day. Indeed, ballooning numbers, due to Europe’s rapidly rising age profile, threaten the sustainability of our healthcare systems.^5,6,7,8 The scale of this challenge demands urgent prioritisation by clinicians, governments, policymakers, and healthcare systems across Europe.^7,8

Understanding nervous system disorders is like untangling a giant knot. The human brain is the last, and greatest, scientific frontier It’s been described as the most complex structure in the known universe, containing around 100 billion neurons and 100 billion other cells.^9,10 And every brain is unique, which is why people with the same neurodegenerative or psychiatric diagnosis often respond differently to a given treatment and can show a wide variability in outcomes for the same diagnosis.^11,12,13 It’s no wonder, then, that management and treatment of nervous system disorders is one of the biggest challenges facing medicine today.¹⁴

Europe spends an eyewatering €798 billion every year to address the complexities of nervous system disorders. To grasp the enormity of this expenditure, it surpasses the combined cost of cardiovascular and cancer care.¹⁵ And this doesn’t even include the cost of unpaid care put in by family members and other informal caregivers: in many low-income families across Europe, who cannot afford expensive nursing homes or home visits by professional caregivers, unpaid caregiving by family members (especially women) is the norm.^16,17

The number of Europeans living with, or dying from, nervous system disorders has risen dramatically over the past three decades.⁴ Premature deaths from a neurological condition or a mental illness have soared by 39%, while years lost to disability have surged by 15%.¹⁸ Behind these statistics are the personal stories of millions of individuals whose lives have been devastated; their impact transcends several aspects of life beyond just mental and physical health, affecting relationships, employment, and education.¹⁹

Bringing precision in persisting areas of need

My role immerses me in the world of neuroscience, and I genuinely believe we are standing at a tipping point. Before us lies a golden opportunity to defeat these cruel conditions, which rob so many people of their memories, their minds, and even managing the simplest of everyday tasks, notwithstanding the immense suffering they cause to them, their loved ones, and society at large. This is what inspires and motivates my team and me every day. At Johnson & Johnson, we are innovating with purpose, to lead where medicine is going. In neuroscience, this means adopting a precision approach aiming to tailor treatment to the individual patient and disease characteristics – a departure from the traditional ‘one-size-fits-all’ approach.

Innovation must tap into the power of human genetics, data science, biomarkers, and digital health. Diagnosing and treating earlier can make a world of difference and often lead to significant health improvements, such as better chances of survival, fewer complications and disabilities, improved quality of life, and lower healthcare costs.

Take Alzheimer’s Disease (AD), for example. By the time many patients are diagnosed, their Alzheimer’s has advanced to a moderate stage and their brains have already undergone extensive changes, where it’s too late for disease-modifying treatments.²⁰ By adding a precision neuroscience approach to foundational expertise in central nervous system disorders, we can work to identify disease subtypes in patients, tie targets of interest to diseases, and predict which individuals will best respond to a particular medication.

We know that rates of major depressive disorder (MDD) escalate in adolescence and as people get older.^21,22,23 Yet, MDD in older people is often underdiagnosed and undertreated due to its non-specific symptoms, or because it is confused with other comorbidities, such as heart disease, diabetes, or dementia.^24,22 Physical symptoms can cause or exacerbate depressive symptoms, but the reverse can occur also, where depressive symptoms can also exacerbate a chronic condition.²⁵

Older people with depression are two or three times more likely to have two or more chronic illnesses and two to six times more likely to have at least one limitation on their daily life activities, compared to younger groups.²⁶ Senior citizens often lose social connections, and economic support due to retirement, physical decline, and disability.²⁷ Social isolation is a significant risk factor in major depressive disorder (MDD).^28,22 Suicide rates are amongst the highest in Europe in older adults, and the risk keeps rising as they get older.^29,30

Compounding this is the fact that only 30-40% of people living with MDD achieve remission after being prescribed an initial antidepressant treatment.³¹ Senior citizens seem to experience treatment-resistant depression (TRD) at higher rates, as well, for reasons that are likely both biological and psychological.³²

The common thread between ‘now’ and ‘new’

What's clear to me is that no single entity has all the solutions. Innovation is currently fragmented and these silos are a missed opportunity to pool global multidisciplinary knowledge and expertise and scale resources. Only by working together can we truly innovate and identify effective solutions. Defeating nervous system disorders requires collaboration with and beyond the neuroscience community to turbo-charge change and deepen knowledge, so as to understand, diagnose, and treat neurological disorders, ultimately improving the quality of life for millions of Europeans.

Working together, we can truly accelerate innovation to end the suffering these diseases cause. History is watching us. We should not forget that understanding the brain is not just about tackling the burden; it is to allow people to thrive, to live healthily, to power our economies, and to build for future generations. This is about investing in the future by acting now. We are entering the golden age of neuroscience, and the promise of precision neuroscience is within our reach.

References

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