9^thInternational Conference on
Dementia and Dementia Care

Solaphat Hemrungrojn , MD. has her proficiency in clinical dementia care , cognitive assessment and computerized cognitive training . She has built her experience after 20 years in dementia research , service , teaching both medical students and psychiatric residents in university hospital in Bangkok , Thailand. She and her team initiated cogntive fitness center in the university hospital with a tailor made individual cognitive training program for each elderly

A brain computer interface neurofeedback training system (NFT) has been first developed to enhance attention for ADHD children. There are many well results support this intervention in this specific group. Anyway not only ADHD children , but also aging population have suffering from attention problems. Most elderly have to cope with attention , concentration , memory and other cognitive decline , espectially when they have dementia. A game-based NFT system is a potential technology for improving cognitive function in both mild cognitive impairment and healthy groups. These 5 games espectially designed to boost up attention , concentration , executive function in elderly. Methods : 32 MCI patients and 26 healthy elderly diagnosed by senior neuropsychiatrists following DSM-IV criteria , Thai mental state examination and Montreal cognitive assesstment test underwent 20 sessions of 30 minute NFT interventions , 2-3 sessions per week. The study compared intervention group with 14 MCI patients Result : This study show a significant treatment effect of NFT interventions improve sustained attention and working memory in control group . Conclusion: Treatment with the NFT system improves sustained attention suggesting that this training potentially improve other cognitive fucntions such as executive functions and working memory in elderly.

Dr. Lucy Chapman was elected a Scholar in Medicine of Trinity College Dublin in 2010 and subsequently graduated in 2013 in the 93rd centile. She is undertaking a Masters in Health Informatics and has a keen interest in quality improvement in healthcare. Currently, she is a physician lead on the implementation of an electronic medical record at St. James’s Hospital and is pursuing future specialist medical training in the area of geriatric medicine.

Clinical Decision Support (CDS) is a process for assisting health-related decisions with relevant, ordered clinical knowledge and patient information1. The alignment of cognitive screening with information technology may offer a strategy to facilitate identification and management within an acute hospital. An audit of paper-based cognitive screening revealed objective screening was performed in only 21% of hospital admissions. Following this the validated 4 As Test (4AT) screening tool was incorporated into the electronic health record (Figure 1). The diagnosis of dementia was captured within a structured field. In line with NICE guidelines, cognitive screening was mandated using a hard stop on all inpatients admitted aged 65 years and over at 24 hours into admission3. An implementation strategy was undertaken using stakeholder workshops and clinical engagement. At 10am on June 27th 2018, the 4AT electronic tool was switched on. It triggered on all existing inpatients facilitating a point prevalence assessment of dementia and delirium across the institution. In the first 24 hours of switch-on, 324 4AT assessments were completed. The average length of stay amongst the sample was 51.9 days (SD 75 days) with an average age of 80 years (SD 8.1 years). Females were more common than males (54% versus 46%). Twenty percent of patients had a 4AT score of 4 or more suggestive of underlying delirium. A diagnosis of dementia was documented in 23% whilst 50% of these patients had a 4AT score of 4 or more. Furthermore, 20% of patients were identified as being at risk of previously undiagnosed cognitive impairment. Electronic CDS may offer a future path to augment hospital-wide screening for cognitive impairment and delirium detection. The capture of structured diagnoses could facilitate institutional awareness of cognitive impairment and delirium and enhance the delivery of patient-focused care.

Solaphat Hemrungrojn , MD. has her proficiency in clinical dementia care , cognitive assessment and computerized cognitive training . She has built her experience after 20 years in dementia research , service , teaching both medical students and psychiatric residents in university hospital in Bangkok , Thailand. She and her team initiated cogntive fitness center in the university hospital with a tailor made individual cognitive training program for each elderly

With the growing population of older people, falling is one of the common problems that increased their morbidity. While as the common task of daily life, such as walking is depend on both cognitive function and physical fitness. So the effectual way to reduce incident of falling is to strengthen the power of walking by increasing power of brain, body and their interaction. The i-ExC game (Interaction of exercise for physical fitness and cognition) seem to be a safe, efficacious tool to improve cognitive performance, physical fitness and both correlation function in the same time. Accordingly, the creative designed of i-ExC game is able to motivate the elderly to join for training with fun every day. The game also provide social opportunities with the friends, family so it would be more than game for elderly to adapt their limited range of body , brain , activities of daily living and social to be more powerful in their golden year of life.

Born October 30, 1987, Iemma Rocco Stefano, PhDstu, currently works at at Manchester Metropolitan University (MMU), under the supervision of Prof. Mark Slevin. Mr Iemma holds a master degree (120 ECTS) on Adapted Physical Activity and another master degree (120 ECTS) on Neuro-rehabilitation. He possess a strong background in neuroscience, biology, anatomy, physiology, neurophysiology of different problems associated with the central nervous system. This wide academic background allow to him to develop a special Adapter Physical Activity for people with neurological disease.

Objective Ischemic stroke increases the risk of developing vascular dementia. C-reactive protein (CRP) is an acute phase protein which on tissue contact become dissociated into free sub-units or monomeric CRP (mCRP) concomitantly increasing which increases its pro-inflammatory and adhesion properties. Previous studies show that mCRP accumulated in the infarcted core and peri-infarcted zone after ischemic stroke and promoted the progression of dementia. Thus, here we investigated whether the use of an anti-mCRP antibody or appropriately structured small molecule could block mCRP induced inflammatory activity. Methods: The Dot blot technique was used to evaluate potential interactions between mCRP and 3 small molecular compounds (SMC) (acetylcholine, tacrine and nicotine). Cell viability assays were performed with the objective to determine if these compound showed any cytotoxic effects that could lead to cell death on differentiated human U937 macrophage-like cells. Cells were stimulated with mCRP and the levels of cytokines in cell culture supernatant were determined by enzyme-linked immunosorbent (ELISA). One monoclonal anti-mCRP antibody (3H12) and the three SMC were tested for their antiinflammatory activity after 2-hour pre-treatment. The relevant inflammatory signalling pathways were examined by Western blotting. Results: mCRP increased the concentrations of tumour necrosis factors-α (TNF-α), and interleukin-6 (IL-6) but not IL-10. 2-hour pre-treatment with acetylcholine significantly inhibited TNF-α release induced by mCRP (acetylcholine: 73.4% reduction compared to mCRP, P<0.001). Acetylcholine also decreased IL-6 production by mCRP by 66.74% (P<0.001). Western blotting revealed that acetylcholine inhibited the NF-kBp65 activation and p38 phosphorylation by mCRP. Conclusion: This study demonstrated that mCRP has a potent pro-inflammatory activity and acetylcholine inhibited its pro-inflammatory activity by down-regulating NF-kB p65 and MAPK p38 signalling pathways. mCRP might serve as a promising new target for the prevention and treatment of vascular dementia.

Sara is a psychogeriatric nursing lecturer at King Abdulaziz University and now a PhD candidate at the University of Southampton. Currently, she is working on a project to investigate nurses' perception and learning needs when caring for people with dementia using a diary-interview method. Her research interests include nursing education, psychogeriatric nursing care, and people with dementia care. "I aim to be capable of developing and communicating new knowledge in psychogeriatric nursing through designing and carrying out high-quality research and training".

Background: People with dementia in Saudi Arabia are being treated in acute hospital settings Nurses were not sufficiently provided with specific knowledge of dementia in their training. This was especially reflected in nurses working in the acute settings due to poor nurse education. Aim: This study aimed to explore registered nurses' knowledge, attitudes and perceptions toward people with dementia in Jeddah, Saudi Arabia using survey questionnaire and diary-interview methods. Method: The study surveyed Nurses (n=705) in the Hijaz region using the tested Dementia Attitude Scale and Dementia Knowledge Assessment Tool version 2. Of those (n=17) nurses completed a diary and follow up interview. Results: There is a lack of training and insufficient nurse education which affects nurses’ knowledge on dementia. Results show a dearth of knowledge affects their attitudes and perception when caring for people with dementia. These results depict nurses that have low competency which affects their practices and inadvertently increases nurses’ burnout. Conclusion: The study underpins the importance of nurses’ knowledge, attitudes and perceptions are important aspects of improving the quality of care for dementia care. Nurses’ knowledge, attitudes, and perceptions have been shown to be gained through experience, though experience is also critical.