Day 1 :
Karolinska University Hospital, Sweden
Time : 10:00- 10:45 AM
Hans von Holst received his MD´s degree in 1976 and specialist in Neurosurgery 1982, Karolinska University Hospital. In 1985 he earned his PhD and Associate Professorship in Neurosurgery, Clinical Neuroscience, Karolinska Institutet and appointed as senior neurosurgeon 1988 - 2015. During 1991-1996 he was Chairman of the Dept of Neurosurgery and Division Manager of the Neuroclinics at Karolinska University Hospital, respectively. Between 1994-2014 he was appointed as Professor in Neuroengineering, KTH Royal Institute of Technology and visiting Professor at Karolinska Institutet 2006-2012, He has published over 150 original papers in reputed journals, reviews and books including editorial board member in several journals.
Increased intracellular water content defined as cytotoxic brain tissue edema is a serious secondary clinical complication to traumatic brain injury (TBI) and stroke and without knowledge to the etiology. Recently a hypothesis to the nervous tissue edema was presented suggesting that external dynamic and internal mechanical static impact forces caused protein unfolding resulting in an increased brain tissue water content and what happens with the metabolism in the long run. The hypothesis was confirmed by computer simulation tests. In this laboratory study we further evaluated the hypothesis by using the mature protein laminin LN521 upon the effects of both dynamic as well as static impact forces, respectively. The treated laminin solutions were then analyzed with denatured electrophoresis and Electron Microscopy showing aggregation and fragmentation of the laminin structures. The present laboratory results confirm earlier hypothesis and computer simulation suggesting for the first time that dynamic impact force in an accident and increased mechanical static force in stroke unfold mature proteins having the potential to increase the intracellular water content defined as cytotoxic brain tissue edema. The clinical condition resembles the phenomenon when elasmobranchs including white sharks prevent their cells from too high hydrostatic pressure in the deep sea. Thus, the present laboratory study results and knowledge from marine physics may be considered to improve the clinical treatment and outcome of TBI and stroke patients. This opens up new perspectives how vascular dementia in TBI and Stroke should be looked upon when it come sto clinical treatment.
Brain Institute of Louisiana, USA
Time : 10:45-11:30
Dr. Foundas is a Cognitive and Behavioral Neurologist currently working as the Executive Director of the Brain Institute of Louisiana. She has worked as Professor of Neurology at Tulane University, Vice-Chair of Clinical Research at LSU, and Chair of Neurology at UMKC. Her clinical practice focuses on patients with cognitive disorders. Her research addresses questions about speech and language, motor control, learning and memory. She has published over 200 scientific papers
The world population is aging. It is estimated that by 2050 there will be over 1.6 billion people worldwide aged 65 and over (17% of the world’s population). The greatest risk for dementia is increasing age. Vascular dementia (VaD) is one dementia subtype that occurs with increasing age. This diagnosis is found in about 20% of people with dementia. Many people with neurodegenerative diseases, like Alzheimer’s disease or Frontotemporal dementia, have microvascular disease and meet the clinical criteria for a mixed-type of dementia. These mixed-dementia patients often have a more malignant progression of their disease compared to individuals without microvascular disease. Our clinical and research team focuses on early intervention in individuals with mild cognitive impairment, including innovative treatment approaches to change the trajectory of cognitive decline. This talk will be divided into three parts. The first part will include an overview of the clinical and pathological heterogeneity of VaD. The second part will emphasize clusters of patients with vascular cognitive impairment, including major cognitive markers that seem to be prevalent across clinical subtypes. Finally, the third part will present preliminary data regarding our clinical approach that includes the innovative use of neural stimulation and photobiomodulation. Our clinical research team uses a two-pronged approach to:
(1) improve communication skills and functional independence in patients with a dementia diagnosis,
(2) facilitate early identification and treatment of at risk individuals. This discussion will focus on our innovative treatment approaches designed to enhance functional independence, improve communication skills, and reduce caregiver burden.
Founder, Executive Director Living Memories C.I.C.UK
Keynote: Archival materials are increasingly being incorporated into products and interventions as part of practice with older people
Time : 11:50 -12:35 PM
Brian is Executive Director of DiSC. An international media lawyer and digital media practitioner by background, he is managing the company and overseeing the development of the Living Memories and Heartwise+ projects.
Archival materials are increasingly being incorporated into products and interventions as part of practice with older people. One area of this work involves the use of archival films, videos, photographs, and television and radio broadcasts in tools for reminiscence activities with older people, in particular individuals living with dementia.Interest in the well-being benefits of this work is based on the demonstrated ability of these multi-sensory materials to stimulate memories of the past in the person with dementia, and to afford opportunities for increasing communication and social interaction with caregivers and others.One current application of archival film for reminiscence activities is the project being developed by Liv, drawing on a major proprietary archive covering social and industrial life in Britain from the 1940s onwards. It was a Finalist in the national UK Nursing Times Awards 2017. This presentation, including screening of examples of archive film, will describe the development of digital tools being produced from this material including a series of DVDs and an accompanying reminiscence guide of topics and questions for use by family members and practitioners. It will also discuss the interactive online platform being developed for the delivery of Living Memories reminiscence resources on mobile devices. Issues such as the tailoring of content to particular audiences, for example, men who may struggle to engage with more generically-targeted social activities for persons with dementia, will also be addressed. Experiences to date of employing these tools in settings such memory cafés, and with a variety of professional and other user groups will be reported. A related Twitter feed (@memorytriggers) to help younger people communicate with those who grew up in the 1940s-60s will also be described.
Case Western Reserve University School of Medicine, USA
Time : 12:35 -13:10 PM
Shu G. Chen, PhD, received his PhD in 1992 from the State University of New York at Buffalo, New York, USA. He is an Associate Professor of Pathology and Neurology at Case Western Reserve University School of Medicine. His research centers on the pathogenesis of Parkinson’s disease, Alzheimer’s disease and other neurodegenerative disorders. He has published more than 80 papers in scientific journals.
Neurodegenerative diseases such as Parkinson’s disease (PD) and Alzheimer’s disease (AD) are characterized by the deposition of misfolded protein aggregates in the central nervous system (CNS). Previous efforts have focused on the development of CNS-proximal clinical biomarkers, including PET neuroimaging and cerebrospinal fluid measures of alpha-synuclein, beta-amyloid and tau. However, these diagnostic techniques are often used in clinical studies on patients with advanced disease state, and are complex, invasive or expensive. Therefore, there remains an urgent need for reliable, inexpensive and minimally invasive peripheral biomarkers. Recent studies have revealed widespread peripheral involvement of PD- and AD-like pathology, often prior to clinical manifestations of the diseases. Indeed, alpha-synuclein and tau deposits have been observed in peripheral tissues in PD and AD, respectively. A formidable challenge is that the levels of these amyloidogenic protein aggregates in peripheral tissues are extremely low and thus only variably detectable using immunological methods. Therefore, highly sensitive analytical platforms are required as the new generation of biomarker assays specific for protein aggregates and amyloid fibrils. The real-time quaking induced conversion (RT-QuIC) has emerged as a robust, rapid and ultrasensitive technology for template-assisted amplification of misfolded protein aggregates in neurodegenerative diseases. Using the RT-QuIC technique, our recent studies have shown that disease-associated protein aggregates are readily detectable in peripheral tissues of patients affected by PD, dementia with Lewy bodies, and AD and other tauopathies. Validation of peripheral protein biomarkers will enable sensitive premortem diagnostic tests for PD, AD, and related disorders, and accelerate clinical trials for disease-modifying therapies.
- Special Session: ALZHEIMERSWIFE: Lessons Learned
Dr. Nancy Broz has a BA in English from Ursinus College, MA from Rowan University in Supervision and Curriculum, and an ED. D. from Temple University in English Education. She was a teacher and administrator in the Moorestown, NJ public schools until 2005, has taught for Rutgers University, Temple University and is now an adjunct professor for Fairleigh Dickinson University. Dr. Broz has also been a language arts consultant for 30 years.
- Dementia | Alzheimers Disease | Neurodegenerative Diseases | Dementia Nursing
Hans Von Holst
Karolinska University Hospital, Sweden
University of South Florida, USA
Title: Impact of an African Drumming for Dementia program on African Americans with Mild Cognitive Impairment and Early Alzheimer’s Disease and their Caregivers
Time : 14:30-14:50
Dr. Kyaien Conner is an assistant professor at the University of South Florida in the College of Behavioral and Community Sciences. Dr. Conner has completed a post-doctoral fellowship in Clinical Training in Geriatric Psychiatry and has been a researcher with the NIH funded Late Life Depression Center in Pittsburgh, PA. Dr. Conner’s research examines health disparities facing older adults from racial/ethnic minority backgrounds and develops and tests novel strategies to eliminate disparities and ensure culturally relevant treatments for older adults living with dementia. Her approaches are community-based, and build upon the strengths and resources available in communities.
Persons of African decent living in the United States have a disproportionately high rate of Alzheimer’s disease (AD), experience a high-rate of AD-related health disparities, are underrepresented in AD research and are less likely to be evaluated and treated during early stages of the disease. There is an urgent need to develop, implement and assess culturally relevant non-pharmacological interventions which may help to improve daily functioning and quality of life of African American patients living with AD. African drumming may be particularly beneficial for African Americans living with AD. This culturally relevant approach to a music intervention has the potential to impact behavioral expressions AD, social and cognitive functioning,while simultaneously enhancing pride and self-esteem. In this presentation, I will present the results of a pilot open trial which examined the African Drums for Dementia program among individuals living with Mild Cognitive Impairment (MCI) and early stage Dementia (N= 30) and their caregivers (N=30). Overall satisfaction, with the program was high among individuals living with AD and their caregivers. Further, the African Drumming for Dementia had a positive effect on memory recall, mood, quality of life, and self-esteem among patients and among caregivers this intervention improved mood, self-perceived community and support, quality of life, self-esteem and reduced caregiver burden. Results from this pilot trial provide preliminary evidence that African Drumming is an in-expensive, innovative, and culturally meaningful therapeutic mechanism that can result in measurable improvements for people, African Americans in particular, with dementia and their caregivers. Implications for practice and future research in this area will be discussed.
President, Malaysian Association of Psychotherapy
Time : 14:50-15:10
Dr. Edward Chan has completed his Masters in Nutritional Medicinewith theSociety for Advancement of Hormones & Healthy Aging Medicine Malaysia, Masters in Learning from Lancaster University, UK andDoctorate in Psychology from the Intercultural Open University School of Medicine. He is the principal consultant of WellLab, a premier laboratory diagnostic testing organisation. He has published numerous papers in reputed journals and has been serving as an editorial board member of repute.
Traditional lipid profiles do not identify the risk of VD that are caused by the presence of small dense LDL and IDL particles. Dangerous LDL particles may hide behind normal cholesterol levels and, conversely, elevated cholesterol levels do not inevitably have to be associated with a VD risk. Studies (eg Reitz et.al. 2004) have shown that the classical lipid profiles of patients with coronary artery diseases do not significantly differ from those of healthy persons. LDL cholesterol, the lipid that is mostfrequently associated with vascular dementia, is heterogeneous and consists of up to seven sub-fractions. Large circulating LDL particles are less atherogenic.This paper analyses subjects’ lipoprotein into five major classes: chylomicrons, very low density lipoprotein (VLDL), intermediate density lipoprotein (IDL), low density lipoprotein (LDL) and high density lipoprotein (HDL).Half of subjects without vascular dementia have higher cholesterol levels. A considerable portion of vascular dementia patients have low cholesterol levels. Individual differences exist in particular with respect to the LDL levels and here, even more importantly, in the size distribution of the LDL particles. The small LDL particles in particular have a very high atherogenic potential. It is less important how much cholesterol a patient has, but which type of cholesterol is elevated and which size distribution the cholesterol particles have. These are the parameters the risk assessment and thetreatment should focus on.
Morejoy is an International Dementia Nurse of the year 2010 award winner, awarded by Stirling University and RCN. She is also a runner up of The Guardian Public Servant of the year 2010. She pioneered a bespoke Community Dementia Palliative Care service in Westminster which saved the NHS more than a quarter of a million in the first year of inception. She has been a Queens Nurse since 2013. She is an International speaker having presented in conferences such as International Conference on Sexually Transmitted Diseases and HIV/Aids (ICASA).
Qualifications: RGN, RMN, QNI, MSc Health Research, Dementia Champion, Founder Africa Dementia Services operating under Regeneration Centre International charity.
Visiting Lecturer at Greenwich University London since 2012, Operations Director LANH professionals LLP since 2016. Aspiring to do a PHD Study on Dementia and service development.
There is little research done so far to inform us on Dementia in Africa. However, it is known from personal stories of the ADS group and the small outreach team in Zimbabwe reports that people who are living with a cognitive impairment are perceived as witches, bewitched or demon possessed. This means that they are neglected and missed from the main stream clinical care. Africa Dementia Services aims to build work around providing dementia awareness to the public, and professionals training, information materials, research opportunities, supportive services and eventually building of Dementia villages.
Africans are prone to sickle cell anaemia and other blood conditions which may result in Vascular dementia.
Consultant Psychiatrist, India
Time : 15:30-15:50
Dr Amarnath Mallik Consultant Psychiatrist Kothari Medical Centre, Calcutta
Cognitive Impairment is the hallmark of Dementia. Behavioral disturbances are universally experienced by persons with dementia throughout the course of the illness. Behavioral and Psychological symptoms of dementia (BPSD) causes a significant negative impact on quality of life , health care outcomes , caregiver stress and burden. Behavioral and psychological symptoms of dementia(BPSD) is the collective term used to describe the group of non cognitive symptoms experienced in dementia. These can include psychosis, agitation and mood disorder and affects 50% - 80% of patients to varying degrees ( Ashlen.P. et al) (Lyketsos CG). Behavioral disturbances can often trigger hospitalization resulting in increased hospital length of stay (WancataJ.2003).The various types of dementia are classified according to the different disease process affecting the brain. The most common cause of dementia is Alzheimer’s Disease, accounting for around 60% of all cases. Vascular dementia and dementia with Lewy bodies are responsible for most other cases. Alzheimer’s Disease and vascular dementia may co-exist and are difficult to separate clinically. Dementia is also encountered in about 30% - 70% of patients with Parkinson’s Disease.Vascular dementia is a consequence of ischemic or hemorrhagic damage of area of the brain involved in memory and cognition.Alzheimer’s disease and related dementias are among the most costly and distressing medical conditions for patients and their caregivers. (Hebert LE etal 2013).
Founder&President: Maria Rosaria Maglione Foundation o.n.l.u.s, Italy
Title: Nose-to-Brain Nerve Growth Factor Delivery to Protect the Human Brain in Frontotemporal Dementia/CBS: A pilot study
Time : 15:50:16:10
Dr. Alberto de Bellis, Neurosurgeon, is the Founder and Chairman of Maria Rosaria Maglione Foundation onlus, non-profit organization for Neuroscience based in Naples-Italy. The MRM Foundation runs in honor of the founder’s mother, Maria Rosaria Maglione, who suffers from Frontotemporal Dementia. The activity of the MRM foundation is mainly aimed at research and health care for neurodegenerative diseases and in support of partner foundations operating in Kenya-Africa, such as the Gallmann Memorial Foundation and the African Neurological Diseases Research Foundation. The main research activities of the MRM foundation are focused on the study of the Nerve Growth Factor and its possible neurotherapeutic applications.
Nerve growth factor (NGF) is the Founding Member of the neurotrophins family of proteins, known for playing a critical protective role in the development and survival of sympathetic, sensory and basal forebrain cholinergic neurons in mammals, including humans. NGF has a neuroprotective action in Alzheimer’s and Parkinson’s disease, as showed by several studies in animal models and humans. NGF can be delivered to the CNS via nasal route and has a neuroprotective action in case of neurodegenerative diseases and brain injury. Furthermore, recent studies have shown an active link between the nasal pathway and the spinal cord in the delivery of NGF to the CNS, thus demonstrating the neuroprotective ability of NGF to support injured neurons in a mouse model of spinal cord injury. Intranasal delivery of NGF has so far been sufficiently investigated in animal models and only recently in humans, as demonstrated in a recent study on long-term intranasal administration of NGF in two patients affected by Frontotemporal Dementia associated with corticobasal syndrome (FTD/CBS) and in another study on intranasal administration of NGF in a Brain Injury. These studies demonstrated the neuroprotective role of NGF administered nasally. Intranasal administration is the most effective and non-invasive way to deliver NGF to the CNS. These neuroprotective properties of NGF make it a strong candidate for the future treatment of neurodegenerative diseases and other pathologies of CNS (brain injury, spinal cord injury, ischemic damage) when administered via nasal route. NGF would not be able to cure the FTD/CBS but these observations support the hypothesis that NGF slows down the usual decline of the disease. However, these studies reinforce the concept that neurotrophins are able to reach and protect the CNS via nasal ruote and open the way for new lines of research. Hence, these findings suggest the ability of NGF to protect CNS neurons when administered via nasal spray.
Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo, Russia
Time : 16:10-16:30
Dr. Stanislav Semenov has a leading researcher. Experience in MRI and CT for over 20 years, doctoral thesis was defended in 2003, 2009-2014 worked as head of diagnostics department of Research Institute for Complex Issues of Cardiovascular Diseases, under his direction were protected 7 doctoral theses. In 2003 at the I International NABI Congress he was awarded diploma I degree in poster session, participated in ESNR, ECR. He has more than 150 publications (including 7 Scopus). He is co-author of the National (Russian) Leadership "Radilogical diagnostics and therapy of head and neck diseases", 2013.
Purpose. We aimed to estimate of brain morphological pattern and cognitive status changes and after CABG in long-term postoperative period.
Material and methods. The study included 75 male patients (62.5±5.5y) with initial Bek scale is not more than 16, MMSE is not less than 24, FAB scale 11 points. Before and 5 years after CABG patients were examined in STAI, MMSE, FAB scales and brain MDCT.
Results. Five years after CABG there was significant reduction in STAI (initial - 20.0 [17.0, 23.0], after - 22.0 [19.0, 27.0], p <0.05), the preservation of cognitive status on the MMSE (initial - 28 [27, 29], after - 27 [26; 28], p <0.05) and FAB (initial - 16 [14, 17], after - 17 [16, 17], p <0.05). Only 2 patients developed dementia. III ventricle width pre/after - 6.86±1.91 mm / 8.45±2.18 mm, p = 0.001, ventriculocranial index Evans – 29% / 31%; the presence of leukoaraiosis was detected in 18 (31.03%) patients / 44 (66.67%), p = 0.001, cysts and gliosis were found in 2 (3.45%) patients / 24 (36.36%), p = 0.0001.
Conclusion. During 5 years after CABG the majority of patients revealed the worsening in the cerebral morphological structure in the form of enlargement of its ventricular system, increase in the number of patients with leukoaraiosis, cysts and gliosis areas. These structural changes in the brain on MDCT indicate a progression of chronic cerebral ischemia in the long-term postoperative period, despite the preservation of cognitive status in screening neuropsychological testing.
Palo Alto University, Palo Alto, California, USA
Title: Therapeutic implications of integrating validation therapy for the management of capgras syndrome in patients with vascular dementia
Time : 16:30-16:50
Shannon Frank-Richter is a graduate student in the MA Psychology Counseling program at Palo Alto University in Palo Alto, California, USA. She is a member of Chi Sigma Iota, Psi Chi, and Phi Theta Kappa honor societies. She graduated Summa Cum Laude with a B.S. in Psychology & Social Action, and Magna Cum Laude with an AA in Liberal Arts. Her research and treatment interests are in counseling for parents of children with autism, and caretakers for loved ones suffering from chronic illnesses. Ms. Frank-Richter is married, has two teenage sons, and a mother with vascular dementia
Patients in each domain of dementia may experience hallucinations, delusions or misidentification syndromes. One form of misidentification syndrome, called Capgras Syndrome, also known as Imposter Syndrome, occurs when a patient believes that their primary caretaker is duplicated and searches for the “real” person (Sinkman, 2008). This phenomenon occurs when the pathway between the occipital face area of the brain and the amygdala is obstructed. Typically seen in patients with schizophrenia or bipolar disorder, Capgras Syndrome is also significantly prevalent in patients with dementia (Cummings, Miller, Hill, & Neshkes, 1987). The patient recognizes the significant person, but the emotional connection from the amygdala does not receive the signal that the recognized face is the actual significant individual; therefore, continues to search for the person who meets the “significant” criteria. The delusion is frightening to the patient and upsetting to the caretaker, who is usually the spouse or close relative. In patients with vascular dementia (VaD), somatic impairments in vision and/or ambulation can exacerbate fear during Capgras episodes. The importance of caretakers to undertake a subjective and supportive perspective within the patient’s experience during a Capgras episode cannot be overstated. Validation therapy, which contradicts the natural inclination to reason the objective reality, must be exercised to restore a sense of safety to the patient’s reality. Compassionate and creative measures, such as voice, tactile, and natural supports, are what comprise the most effective techniques in validation interventions for VaD patients with Capgras Syndrome
Society of Emotional Intelligence UK
Title: Promoting excellence within dementia care: maintaining emotional intelligence and wellbeing of staff working within dementia care management
Time : 17:10-17:30
Jacqueline A Hinds is a Chair Person of the Society of Emotional Intelligence UK. She is also Board Chair and International Liaison for International Society of Emotional Intelligence, USA. She is Certified Emotional Intelligence Coach (CEIC) and Leadership Consultant. She has worked within the National Healthcare Service for over 10 years, in two of the largest merged healthcare organizations in UK and Europe (Imperial College Healthcare NHS Trust and Barts Health NHS Trust). She is a published Author, having written a paper on transformation in healthcare and role of emotional intelligence. She has a wealth of knowledge and expertise within the human resource development arena (HRD), working with people at all levels, establishing and enabling them to be emotionally intelligent during mergers and organizational changes. She is now an independent Consultant working on various training initiatives and coaching assignments, around emotional and cultural intelligence. She is also in collaboration with Culture Dementia, UK on training projects within healthcare and the community.
Promoting excellence in service and care for patients with dementia had a significant impact on the staff working within the dementia care management arena. Stress levels and burnout of caregivers without adequate support, has resulted in the essential need of respite by way of development and coaching to support and promote their health and wellbeing whilst they administer and provide essential and effective care to their patients. In the current healthcare climate, the effect of severe cuts in service provisions and staff shortages, whilst maintaining optimum levels of output, has left care givers somewhat jaded over a period of time. Some have gone to the extent of seeking other opportunities due to lack of job satisfaction and challenges around demanding work commitments; consistently taking them beyond their core working hours. The use of the emotional intelligence skills assessment profile (EISAP) model as a mode for developing dementia care management staff at all levels, although not referred to or identified as an integral part of their core clinical and non-clinical training or personal development plans, is none-the-less a skill that is interwoven throughout their practices and procedures delivering effective dementia care management. Caring for someone living with dementia, is unlike any other form of caring because of the emotional challenges and levels of complexity; EISAP allows the dissemination of complex situations in a relatively accessible way. With the rapid changes with health provisions and more cases of dementia patients being identified, the need for emotionally intelligent care givers is crucial in this day and age. By enabling caregivers to understand their emotions, emotional meanings and to, enable them to reflectively regulate these emotions whilst undertaking their roles effectively.
Saltlake Mindset, India
Time : 17:30-17:50
Debanjan Pan is a Fellow of the Indian Psychiatric Society, Member of the Indian Association of Child & Adolescent Mental Health, Member of The Alzheimer & Related Disease Society Of India, International Associate of The Royal College Of Psychiatrist (RCPsych) and Fellow of The American Psychiatric Association (APA). He completed his Post-graduate Oversees Specialty Training Fellowship (POST Fellow) in CAMH, St. Vincent's Hospital, Melbourne, University of Melbourne; Medical Graduate from RG Kar Medical College 1990; DCH from Calcutta University (1995); DPM from Calcutta University (2001) and; MD from Calcutta University (2005). Presently, he is serving as Director of Saltlake Mindset Organization (www.saltlakemindset.org) a noted mental health treatment unit in Kolkata, West Bengal, India. He is also attached as a Senior Consultant Psychiatrist at The South Heart Clinic and Diagnostic Center, Near Jadavpur and Theism Polyclinic, Dumdum. His interests include Child & Adolescent Mental Health and Cognitive Behavioral Therapy. He has presented several papers at AAGP 2012 & 2013; World ADHD Congress 2013; ISAD Congress, Berlin 2014; APA Congress, 2015 and; Toronto and European Congress of Psychopharmacology Vienna, Sept, 2016. He is a regular Columnist on topics of mental health related issues for common people in popular dailies (Aajkal, Bartaman, Pratidin) & other magazines like Saptahik Bartaman and Arogyo Katha.
Case: This is the case report of Mr. Ashoke 61/M, his chief concerns are forgetfulness and having problems in taking judgments.
Psychiatric History: Nothing significant other than chronic mild anxiety according to his wife. History revealed mild forgetfulness and difficulty in making plans since adolescence.
Present Medical History: Type-2 diabetes for last 14 years and hypertensive; had 2 brief episodes of probable TIA.
Past History: No significant medical illness.
Neuropsychological Testing: MMSE and MoCA (Montreal Cognitive Assessment) scores were 21 and 22 respectively consistent with a diagnosis of VCIND. However, as he has a longitudinal h/o some executive dysfunctions including working memory, he was walked through DIVA scoring and Conner’s Adult ADHD rating scale and the scores were significantly in favor of an Adult ADHD diagnosis (DIVA score >4 and Conner’s Adult ADHD rating scale t score >65).
Discussion: VCIND (Vascular Cognitive Impairment Not Dementia) is a likely diagnosis with history of diabetes, hypertension and TIAs (even if his TIAs are image negative), but given a chronic persistent h/o mild cognitive impairment since adolescence, a differential diagnosis of Adult ADHD should be considered. Hence, those cases of VCIND (Vascular Cognitive Impairment Not Dementia) and MCI (Minimal Cognitive Impairment) with chronic h/o memory impairment, ADHD should be excluded.
Dementia Alliance for Culture and Ethnicity, UK
Time : 17:50-18:10
David Truswell has worked in community based mental health services in the UK for over thirty years developing services for people with complex care needs and enduring mental health problems in a career spanning the voluntary sector, local authority services, and the NHS at a senior level. He has two Master’s level degrees, including a distinction level MBA. From 2009 – 2011, he was the Dementia Implementation Lead for Commissioning Support for London, working with commissioners across London to improve dementia services. He is currently Executive Director of the Dementia Alliance for Culture and Ethnicity (www.demace.com) a UK social enterprise developed by local and national voluntary organisations working with dementia and is an independent Writer and Researcher on dementia support and services for Black, Asian and minority ethnic communities. His book on the subject is due for publication in February 2019. He is also the Director of somefreshthinking Ltd., a healthcare consultancy working on service redesign and change management in health and social care services.
While there is recognition of the challenges that dementia brings to the UK national health economy, less well understood is the impact of dementia as a health issue for UK Black, Asian and minority ethnic communities. In a recently published book on the subject with contributions from academic researchers and the experience of carers and people living with dementia in these communities the presenting author considers not only the shared characteristics that are typical of the experience of all minority ethnic communities in the UK but also throws a spotlight on the details for different communities. These include the African-Caribbean, Irish, South Asian, Chinese and Jewish. The presentation will review some of the key findings and conclusions from the book and their relevance for awareness raising, carer support and access to services and deconstructing some of the stereotypes and assumptions about minority communities’ response to dementia.
King Saud University, Saudi Arabia
Title: Association of IL-6 and TNF-α gene polymorphisms with the risk of Alzheimer’s disease in Saudi subjects
Time : 18:10-18:30
Reem almutairi currently master student in biochemistry department, collage of science, king saud university, riyadh, saudi arabia. i have got the license of health professional classification under the name (laboratory technician). from saudi commission for healthspecialties. i am working as volunteer researcher assistant in biochemistry department.
Alzheimer’s disease (AD) is a progressive neurodegenerative disorder and the most prevalent type of dementia. In Saudi Arabia although the exact percent about the spread of AD has not been estimated, but the experts believe that there are approximately 50,000 patients in Saudi Arabia, most of them being females. Many of the studies illustrate the role of the inflammation in development of AD, however no such study has been done on Saudi AD patients. Thus, the aim of this study was to investigate the association of inflammatory mediator’s, interleukin-6 (IL-6), Tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) with increased the risk of Alzheimer’s disease (AD). Further, the association between the level of IL-6, TNF-α and CRP with the genetic variation in IL-6 (-174 rs1800795 G/C and -572 rs1800796 C/G), and in TNF-α (-308 rs1800629 A/G and -1031 rs1799724 C/T) and their role in occurrence of AD in among Saudi ethnic population was investigated. A total of 47 Saudi subjects with age (65-90 years) were enrolled for the study, 24 (14 male, 10 female) diagnosed as AD patients and 23 (11 male, 12 female) served as normal controls. The level of biomarkers (IL-6, TNF-α and CRP) were assessed by ELISA (Quntikine®ELISA). Single nucleotide polymorphism (SNP) in selected genes was analyzed by RT-PCR using TaqMan Assay. This study showed that TNF-α was higher in AD patients with CC and GC genotypes for IL-6 gene SNPs rs1800796 (P=0.062) and rs1800795 (P=0.066) respectively. The level of IL-6 was also found to be significantly low among AD patients with AG genotype comparing to AD patients with GG genotype for -308 A/G (rs1800629) of TNF-α gene (P=0.040). In conclusion; the level of inflammatory cytokines IL-6 and TNF-α may play role in the progression of AD depending on specific genotypes among Saudi AD patients