Current capacity of Portuguese specialized dementia centers in the era of anti‐amyloid antibodies
Miguel Tábuas‐Pereira, Anuschka Silva‐Spínola, Catarina Agostinho, Luísa Alves, Rui Araújo, Catarina Bernardes, Mariana Branco, Cláudia Borbinha, Verónica Cabreira, Sónia Costa, Alexandra Dias Silva, João Durães, Pedro Faustino, Catarina Félix, Andreia Fernandes, Joaquim Ferreira, Miguel Gago, Cláudia Guarda, Cristina Ionel, Joana Jesus‐Ribeiro, Inês Laranjinha, André Leitão, Liliana Letra, Pedro Lopes das Neves, Luis F Maia, Álvaro Machado, Bárbara Martins, João Massano, Alexandre Mendonça, Marcelo Mendonça, Rita Miguel, Miguel Miranda, Joana Morgado, Camila Nóbrega, Maria Pereira Coutinho, Tiago Oliveira, Fernando Pita, Francisco Sabença, Sofia Rocha, Luis Ruano, Telma Santos, Frederico Simões do Couto, Ricardo Taipa, Vitor Tedim Cruz, Ana H Valverde, Ana Vélon, Ana Verdelho, Miguel Viana Baptista, Daniela Vieira, Marisa Lima, Tiago Gil Oliveira, Isabel Santana,Abstract
INTRODUCTION
Alzheimer's disease (AD) remains a major cause of cognitive decline and societal burden. The recent approval of disease‐modifying therapies (DMTs) lecanemab and donanemab represents a paradigm shift in AD treatment. We assessed the preparedness of Portuguese centers to implement DMTs.
METHODS
A nationwide survey‐based cross‐sectional service‐capacity study targeted memory clinics, focusing primarily on National Health System (NHS) centers. Data were collected on clinical capacity, diagnostic access, treatment capability, and research activity.
RESULTS
Among 51 responding units, 20 had organized memory clinics (17 in the NHS), covering 60.7% of the population. In 2024, these centers conducted 21,721 consultations, representing expert care for <10% of the total AD patients estimated to exist in Portugal. Bottlenecks included long waiting times and limited biomarker access (26.2% underwent cerebrospinal fluid or amyloid positron emission tomography). Nationwide, from experts’ estimates, 701 patients could currently start treatment.
DISCUSSION
Portugal's current NHS capacity appears insufficient for broad DMT implementation, requiring major investment in diagnostics, training, infrastructure, and research to ensure equitable and effective treatment access.