4th International Conference on Vascular Dementia June 30 - July 02, 2016 Valencia, Spain

Biography:

Yung Cho Yiu graduated from the University of Hong Kong in 1981. He was also nominated fellowship in various international colleges of physicians. He has been a specialist in Geriatric Medicine in Hong Kong for decades. Currently he is the Head of the Division of Geriatric Medicine and the Deputy Chief of Service of the Department of Medicine & Geriatrics in the United Christian Hospital, Hong Kong. His main interests are on cognitive impairment and urodynamics. He publishes widely in international journals. He has also validated the Hong Kong version of the Addenbrooke Cognitive Examination Revised (ACE-R).

Abstract:

Behavioral and psychological symptoms of dementia (BPSD) constitute an integral component of cognitive impairment including, vascular dementia. They could contribute significantly not to caregiver stress but also to escalating healthcare costs. Method: 100 consecutive patients attending a Memory Clinic, located in a district hospital in Hong Kong diagnosed to have vascular dementia were reviewed. The National Institute of Neurological Disorders and Stroke Association Internationale pour la Recherche et I’Enseignement en Neurosciences (NINDS-AIREN) criteria were used to establish the diagnosis of vascular dementia. The Global Deterioration Scale (GDS) was used to stage the severity of the disease. The assessment of BPSD was based on collateral clinical history, patients’ subjective experiences and objective behavior. Neuropsychiatric Inventorywas adopted as the assessment tool. Results: 62% were GDS stage and 38% stage 5. About 91% of stage 5 patients had BPSD and 8% in stage 4 patients. The prevalence of BPSD was about 40%. Amongst these, the pattern of various domains reviewed: individual behaviors include delusion (20%), hallucination (12%), depression (42%), apathy (21%), anxiety (16%), elation (12%), disinhibition (8%), aggression (11%), irritability (13%), aberrant motor behavior (11%), sleep and nighttime behavioral disorders (26%) and eating disorders (19%).

Conclusion: BPSD are frequent in vascular dementia of mild-to-moderate severity.Like other types of dementia, correct identification and evaluation of these symptoms is a crucial component of the clinical approach to vascular dementia.

Biography:

Daniela Fisichella is an Academic Researcher in International Law and International Organizations. Her teaching position covers all fields of Public International Law and European Union Law and currently, she teaches European Internal Market and Energy Law at the MA Course in Internationalization of Commercial Relations in Catania. Her main research interests are on European politics, EU Constitutionalism, International Human Rights. She’s the Scientific Supervisor of NMUN Project promoted by UniOne, a professional training centre recognized by the Sicilian Region.

Abstract:

A meaningful attention of International Law, and most of International Organizations, is drawn to mental health and to mental illness in XXI century. As a consequence of human rights huge extension, mental health is nowadays a target of international efforts striving to address both state behavior and international achievements. World Health Organization (WHO) is expressly engaged, but United Nations (UN) showed the path in early nineties, by UN General Assembly (UNGA) 46/119 of 17 December 1991. The protection of persons with mental illness and the improvement of mental health care, where mental health care and facilities are pointed out; and if mental illness couldn’t be defined, Principle 4 (Determination of mental illness) of this Resolution is crucial to direct next improvements layout. From there, UN and WHO have been carrying on a unique approach to mental health, as proved by binding and not binding international acts, surveys, guidelines – as the 2010 WHO mhGAP Intervention Guide - adopted as a result of states consultation. UNGA Resolution 70/1 of 21 October 2015, Transforming Our World: the 2030 Agenda for Sustainable Development, envisaging 17 Sustainable Development Goals (replacing past 8 Millennium Development Goals to be gained in 2015 at last) is the last step on the road of a global approach to health, intended as physical and as mental within an holistic view of human beings. As stated in Declaration’s Introduction, § 4, “no one will be left behind” and § 7 “A world with equitable and universal access to quality education at all levels to health care and social protection, where physical, mental and social well-being are assured.”. The paper aims to investigate mental health as an international legal issue on a broad sense, meaning it not only as lack of mental illness, but in a comprehensive view and vascular dementia prevention above other mental diseases is perceived in a global frame of domestic economic and social balance.

Biography:

David Gallego is graduated in speech therapy from Valladolid University, Spain, with 10 years of experience in the speech and therapy rehabilitation field related to brain damage (BD). He recently moved to Dublin, Ireland but keeps collaborating with hospital Miguel Domínguez from Galicia, Spain where he worked as head of the speech therapy service for the last 4 years. He also collaborates with the Speech Therapy School from Valladolid University and is collegiated in the Speech Therapy Association of Castilla León.

Abstract:

Introduction:

One of the most common clusters of manifestations of cognitive impairment associated to vascular dementia is related to the handling of language. Regarding rehabilitation approaches, spaced repetition based techniques offer advantages in cases on mild and severe cognitive deterioration because they allow the automation in the use of Word families of key importance in daily communication for patients with severe impairment in cognitive processing. Objective: To analyze the effectiveness of spaced repetition based rehabilitation of speech language in vascular dementia.

Method:

2 patients diagnosed of mild vascular dementia and 1 patient diagnosed of severe vascular dementia were submitted to rehabilitation using spaced repetition exercises with vocabulary organized into Word families related to basic actions and events from their daily life. Each patient was stimulated with three groups of twenty words each and supported by graphic material. Measures in the naming of words when confronted with the item were made pre-rehabilitation and post-rehabilitation monthly over a period of 8 months.

Results:

All patients improved in denomination of chosen items and kept that improvement during periodical assessments over the 8 month periodical though a slight declination in performance was observed from the 6th month. Case 1 named 8, 5 and 7 words at baseline. After rehabilitation, performance improved to 16, 12 and 15 and declined to 13, 11 and 12 after the 8 month period. Baseline in Case 2 was 6, 8 and 9 words and improved to 15, 18 and 13 after rehabilitation with a decline to 13,15 and 10 after the 8 month period. Case 3 performed 2, 4 and 7 at baseline and improved to 10, 13 and 11 after rehabilitation with a decline to 10, 11 and 9 after the 8 month period.

Conclusion:

Spaced repetition based exercises is a useful asset when dealing with vocabulary re-acquisition in patients affected by vascular dementia and offers a reasonable prognosis over time despite neurodegenerative factors.

Biography:

Harjinder Kaur is a Community Psychiatric Nurse for Wolverhampton City. In 2001, she was appointed as the Asian Link nurse with a specialist role to increase contact between specialist old age psychiatry services and older people from Black, Asian and Minority Ethnic (BAME) communities. She has played an important role in disseminating information about dementia and related conditions and in educating the South Asian community and professionals on the help available. Since her appointment, she has made remarkable efforts to ensure that the BAME communities residing in Wolverhampton have fair access to services and has consequently increased the diagnosis rates of dementia within these often hidden and marginalised communities.

Abstract:

There is a current estimate of nearly 25,000 people with dementia from Black, Asian and Minority Ethnic (BAME) communities in England and Wales. This number is expected to grow to nearly 50,000 by 2026 and over 172,000 people by 2051. This is nearly a seven-fold increase in 40 years. It compares to just over a two-fold increase in the number of people with dementia across the whole United Kingdom (UK) population in the same time period. BAME communities in the UK are not just getting older but they are also growing in numbers. It is therefore extremely important to have a tool that is suitable to assess dementia amongst these communities so that diagnosis is made early and that patients get the support and treatment they need and require. Currently, this area of work is underdeveloped and a ‘culturally appropriate’ diagnostic tool is yet to be developed. This presentation discusses current diagnostic tools for Vascular Dementia arguing the case for the Rowland Universal Dementia Scale (RUDAS) as a tool for diagnosing Vascular Dementia in BAME communities who may not only lack English fluency but also literacy skills. The information presented is based on the speaker’s experience of working with people from South Asian communities, to share good practice and raise awareness about some of the challenges and barriers for diagnosing Vascular Dementia. Though based in the UK, this information is transferable to other countries working with people from different cultural backgrounds.

Biography:

Saule T Turuspekova (MD, PhD) is a Neurologist of highest category and Professor of the Department of internship and residency in Neurology of KazNMU. In 1995, she completed PhD Thesis, “Vegetative-vascular disorders in cerebral manifestations of diabetes mellitus” and in 2010-Doctoral thesis - "The influence of small doses of ionizing radiation on the nervous system". She has published over 100 scientific papers which were presented at international conferences in many countries. She received state scholarship for talented young scientists of the Ministry of Science of the Republic of Kazakhstan. She served as the Coordinator of the Russian Youth Academy of Sciences (Samara), 2015-the personal physician of the Kazakhstan astronaut Aydin Aimbetov. She is the Member of the ESO, WSO, «Neurosciences», EAN.

Abstract:

Introduction:

Arterial hypertension (AH) is considered as one of the causes of vascular dementia. Brief Montreal Cognitive Assessment Scale (MoCA) can be sensitive to the detection of cognitive impairment (CI) in AH.

Objective:

To evaluate the validity of the use of MoCA test for the detection of CI in patients with AH lasting no more than 10 years.

Material & Methods:

Observed 60 patients with a higher education (females -24, males -36) aged 40-60 years with AH lasting no more than 10 years. To determine the degree of CI, MMSE and MoCA were used.

Results:

80% of patients with AH are pre-demention CI which is identified in the application of MoCA-test, whereas MMSE was not informative. According to MoCA average value was 19.5±2.5 points and according to the MMSE - 30 points. At the same time moderate CI (22.5±2.5 points) detected in 56.6% of cases, heavy CI (16.5±2.5) was diagnosed in 23.3%. Among patients with a duration of up to 5 years of AH is well coped with the tasks of MoCA40%, 60% of detected light CI. In patients with AH from 5 to 10 years, MCI identified in 53.4% of cases (21±1.0 points), 46.6% of patients had a dementia (14-19 points).

Conclusions: The observed decline in cognitive function in patients with AH that can possibly be regarded as a predictor of dementia. These results make it necessary and justified to make use of MoCA-test for the universal screening for CI.

Biography:

Helen Fountain is the Reminiscence Officer at the Oxford University Museums Partnership. Following University, she began working in the Social Care sector in 1997, working with vulnerable young people at Coventry YWCA and with homeless people at Coventry Cyrenians, followed by a role with Coventry City Councils’ Social Services Department commissioning and monitoring support services for elder people. A part time role at the Herbert Art Gallery began to inspire the idea of the creative potential of partnerships between elder people and the heritage sector. Following her Master’s Degree in Museum Studies from the University of Leicester, she took up her current post in 2009. The role of Reminiscence Officer for Oxford University Museums has offered fantastic opportunities to devise and deliver museum activities for older people including a reminiscence outreach services, bespoke reminiscence projects, community exhibitions, intergenerational events and working with local NHS Partners to deliver reminiscence activities to older people in hospital settings. In 2015 she, along with the Oxford Institute for Population and Ageing carried out research into the impacts of her work, the findings are due to be published later this year. She is also a Dementia Champion with the Alzheimer’s Society Dementia Friends scheme.

Abstract:

Oxford University Museums Partnership has an excellent track record of delivering museum community engagement services to elder people in Oxford and Oxfordshire. The seminar will focus on how reminiscence and museum activities are used in a variety of ways (including oral history projects, artistic projects, drama projects and music projects) to engage with older people living with Dementia in community and healthcare settings. The seminar will offer delegates the opportunity to participate in practical skills sharing which will equip them with techniques for using reminiscence as a therapeutic activity for people living with Dementia. It will focus on the positive impact that participation in such activities can have on wellbeing, both for the older person and their carers, drawing on UK research findings to make the case for reminiscence as an activity for enhancing quality of life for elder people living with Dementia and their carers.

Biography:

Ann Marie Selfridge is the President of the A.C.T. Care Group. She is a graduate from the University at Albany in New York State. She worked as part of the Administration team in Nursing/Rehabilitation facilities in New York City and has received the following awards: Certificate of Special Congressional Recognition to Recognize Initiative, Service and Achievement for Voluntary Public Service from United States Congress, Recognizing Service to Developmentally Disabled Adults and Children- a citation from New York State Assembly. He has a dedication towards making a good life for people with developmental disabilities and received a certificate of Merit from the NYS Assembly. He also received Honor for being an Exceptional Friend to the Bensonhurst Center for Rehabilitation and Healthcare and Certificate of Achievement from Senator Martin J Golden. He also received Proclamation Recognizing Valuable Service to the Community from New York City Council Citation.

Abstract:

Adults Communicating Together, A.C.T. is a comprehensive educational/social program that focuses on strengthening the brain functions of people diagnosed with Alzheimer’s and Dementia. The A.C.T. program uses an innovative educational classroom model to engage participants with AD/D in exercises that promote learning and enhance cognitive stimulation. The A.C.T. Care Group recognizes the importance for people with AD/D to be involved in structured and closely managed educational/social groups that improves people’s ability to focus on their surroundings and increases participation in daily tasks to the highest possible levels. A.C.T Care professionals are trained to provide a nurturing and secure environment for all participants. The A.C.T. staff implements techniques that encourage people to maintain their health/hygiene, independence and ability to keep involved in activities of daily living. The A.C.T. program focuses on exercises in memory, physical movement and motor strengthening skills. Using a curriculum that provides repetitious consistency and structure, participants are able to successfully concentrate on tasks and keep aware of their surroundings. Participants have also demonstrated decreased wandering tendencies, less restlessness/anxiety, reduced episodes of incontinence and have desirable weight gains. The A.C.T. program goal is to increase health and cognitive functions, maximize independence, gain and maintain physical strength and provide an opportunity for people with AD/D to have a meaningful quality of life. The A.C.T. Team implements unique program strategies/methods, in an outpatient Social Adult Day setting that give people a chance to live at home with their families and remain active members in their communities.

Biography:

Caitlin Hildebrand is an Adult and Gerontology Nurse Practitioner with significant experience in community based care teams, through the Program of All Inclusive Care for the Elderly (PACE), home health and hospice and quality improvement. With Masters in Health Administration and Nursing from University of California San Francisco and University of Pennsylvania, she is a published scholar on elder self-neglect and dementia. She has a passion for programs that support Aging in Place and a palliative approach to care for all frail people.

Abstract:

Elders with dementia are significantly more likely to neglect their own needs, and determining the role of cognitive impairment is a key factor in creating successful interventions for change. Community based care teams, be they clinic based, or from home health, are similarly confronted with the challenge of how to support independence while promoting wellness and safety. Through careful analysis of the multi-factorial nature of self-neglect, teams can create care systems that honour autonomy and prevent placement. Creativity, flexibility, and acceptance of the “dignity of risk” allow care providers to make an impact while supporting aging in place.

Reflecting on recent patients will allow a close intimate consideration of elders, who self-neglect and the risks and benefits of intervention.

Biography:

Elisabeth L orangeFürst has completed her PhD from The University of Oslo, Norway and Postdoctoral studies at The University of Uppsala, Sweden. Since 2001, she is Professor at the Department of Social Anthropology, University of Oslo. She has published more than 50 papers in reputed journals and anthologies as well as three books and one edited volume. She has also been the editor of a Norwegian Journal in Social Sciences

Abstract:

Eight years ago a 53 years old man was rescued from a cardiac arrest that lasted 3/4 of an hour, an incident that subsequently led to a severe brain damage and the diagnosis of dementia. This man was not just anybody, he was my husband. In this sudden moment, I was thrown into a situation of participant observation, trained as I was in anthropology.

In this paper, I present some reflections from a perspective of being a next of kin as well as social researcher. My phenomenological focus will concentrate on the amazing influence that music seems to have had on his recovery, especially the way it seems to have encouraged his emerging sense of self and identity. Even though he is suffering from severe cognitive problems with orientation in time, space and vision, he is physically on his feet, walking around in a rather stable manner. While it seems that music has been important for his condition from the start, the last five years he has attended therapeutical music lessons twice a week, singing songs accompanied by the teachers' guitar. Astonishingly he has been able to learn new melodies as well texts, and lately we have observed emotional responses to the music that he performs which has not been observed before.

Biography:

Tanya Clover has been involved in supporting organisational change across the health and social care sectors for over 20 years. Utilising her extensive knowledge of the practical application of person centered care models; she has a proven success record in directly influencing the experiences and outcomes for people living with dementia. Previously a Practice Development Consultant and Trainer for the University of Bradford School of Dementia Studies, she remains an accredited Dementia Care Mapping™ trainer for the University. She has spoken at the UK Dementia Congress and has published 2 articles relating to the use of Person Centred Thinking Tools.

Abstract:

Reform has taken place in England with the implementation of the Care Act (2014) and its expectation that all agencies, statutory and otherwise, must cooperate. Such cooperation, however, risks marginalising the most important voice, that of the abused person themselves. When acts of abuse in care settings are investigated, it often results in the dismissal or removal from roles of individuals deemed responsible for the acts. To prevent the reoccurrence of abuse we must look beyond the perpetrator to the systems that surround them. Protection will not come about simply from telling people what is right or wrong. If it were, society would enact laws and all abuse would cease. With the existing raft of legislation and human rights declarations worldwide we can see that this has not happened. Person-centred thinking tools are both a device and a process that can be used to drive and sustain change for individuals, teams, organisations, communities and societies. Their ultimate goal is to ensure that individuals have more choice and control through an ongoing loop of listening, learning and actions – in essence, realising their uniqueness as a person of equal standing to others. Person-centered thinking tools can support the transition from people living with dementia being passive recipients of care to their being recognised as equal and valued members of society. They herald a new progression, as services aspire to move beyond person centred support towards people living with dementia being attributed citizenhood.