9^thInternational Conference on
Dementia and Dementia Care

Biography:

Brian Tran, MD the Medical Director and Lloyd Tran is the CEO of NeuroActiva, a clinical-stage biopharmaceutical company dedicated to the discovery, development, and commercialization of new drugs to treat Alzheimer’s disease. 

Abstract:

Biography:

Francesca Pistollato, Ph.D., currently works at the European Union Reference Laboratory for Alternatives to Animal Testing (EURL ECVAM) Joint Research Centre in Ispra (Italy), where she develops and supports the use of alternatives to animal testing in toxicology and regulatory testing and in biomedical research. She previously worked at the Physicians Committee for Responsible Medicine (PCRM), Washington DC, advocating for the use of a holistic, human-based approach for Alzheimer's disease research. Dr. Pistollato holds a master degree in nutrition and dietetics and published several works on the role of nutrition and lifestyle-related factors in the prevention of chronic degenerative diseases, such as Alzheimer's and dementia.  

Abstract:

Animal models of Alzheimer's disease (AD) have been extensively utilized in the last few decades in an effort to elucidate the pathophysiological mechanisms of the disease and to test novel therapeutic drugs. However, basic/fundamental and pre-clinical research successes have not translated into effective therapeutic treatments for AD patients. One of the possible reasons behind this translational failure may be the overreliance on animal models for AD, which have been shown useful to recapitulate some AD-associated features, such as amyloidosis and tauopathy, but have failed to deliver effective treatments for AD patients. On the other hand, the use and the implementation of human-based investigational methods, non-invasive neuroimaging technologies, and large scale epidemiological data set repositories, may contribute to the development of new preventive and treatment strategies. Here we present the challenges and opportunities in AD research and propose how we can mitigate this translational barrier by employing human-based methods to elucidate disease processes occurring at multiple levels of complexity (from gene expression to protein, cellular, tissue/organ to individual and population level). Novel human-based cellular and computational models are already being applied in toxicology and regulatory testing, and could be associated with noninvasive neuroimaging tools and epidemiological data to facilitate human-relevant data discovery.A paradigm shift towards human-based research, accounting for a multi-dimensional and multi-disciplinary approach is highly needed to tackle the ever-increasing prevalence of AD in the 21^st century.

Biography:

Smriti Gupta has research focus on glial-neuronal crosstalk to understand the pathophysiology of Alzheimer’s disease using glial-neuronal coculture (cellular) as well as in vivo model system. This study involves the metabolic basis behind the etiology of sporadic Alzheimer’s disease and provides the pathophysiological status of different metabolic pathways such as insulin signaling pathway, glucose uptake and cerebral energy homeostasis. Research findings indicated that under disease condition, glial cells make neuronal cells more vunerable for disease onset and progression. This study provided the clue for several potential molecules which can be considered as potential therapeutic targets.

Abstract:

Sporadic Alzheimer’s disease (SAD) is a progressive neurodegenerative disorder with dysfunctional insulin signalling and energy metabolism. Growing evidence supports that impairment in brain insulin responsiveness, glucose utilization and energy metabolism may be a major cause of amyloid precursor protein mishandling. A support for this notion comes from the studies where streptozotocin (STZ) induced brain insulin resistance in murine model, resulting into the SAD like brain pathology with cognitive decline. Intriguingly in vitro models have been used to understand the metabolic basis of SAD. However mechanistic effects of brain insulin resistance on neurons and glia are not well understood. To understand the status of insulin signalling pathway, glucose uptake, glucose metabolism and energy homeostasis, STZ induced glial-neuronal co-culture model of SAD has been established. Present study suggests that glial cells are more compromised for insulin signalling than neurons. The evidence has been supported by glial activation in co-culture SAD model system.  These changes were found to be correlated with amyloid deposition in this cellular model system which indicates that insulin signalling in glia may be a major regulator of amyloidogenesis in SAD brain.

Biography:

Experienced Psychiatrist with a demonstrated history of working in the medical practice industry. Skilled in Clinical Research, Epidemiology, Medicine, Clinical Trials, and Research. Strong healthcare services professional with a Fellowship focused in Cognitive Neurology and Dementia from EskiÅŸehir Osmangazi University.

Abstract:

Cognitively impaired patients especially with Alzheimer’s disease (AD) can be successfully screened using cognitive screening tools especially in combined versions and best specificity was observed with the combination of the MMSE (Mini-Mental State Examination) and CDT (Clock Drawing Test) in patients with AD. But some disadvantages are observed like as insensitivity to the earliest changes in highly educated individuals or insensitivity to mild AD. Test Your Memory (TYM) introduced as an alternative for common tests in this filed specially in order to meet the criteria of minimal operator time to administrate, test a reasonable range of cognitive functions and to be sensitive to mild AD that makes it unique in this era.100 subjects were recruited for the study from patients referred to our dementia clinic between December 2015 and August 2016. In addition to history taking and general physical examination, specialized neurological examination and structured psychiatric interview was done by specialized neurologist and psychiatrist in the field of dementia. Also laboratory workup, neuroimaging and neuropsychological assessment using MMSE, CDT and TYM-TR was completed in all patients. In this study we compared equivalent cognitive domains in Test Your Memory – Turkish Version (TYM-TR) neuropsychological test with the same domains in the Mini Mental State Examination (MMSE) test in previously clinically diagnosed demented patients according to DSM-5.The analysis of sub-scores of equivalent cognitive domains using paired T-Test demonstrated that there are significant differences in detecting cognitive deficits in registration, recall and visuospatial (only in Letter M drawing item) domains between two tests and the TYM-TR test is more sensitive in detecting cognitive deficit in the mentioned cognitive domains than MMSE test. Also according to Pearson Correlation there are significant relationships between all equivalent cognitive domains.There is emerging need to replace MMSE with some more efficient screening tools for early diagnosis of subtle neurocognitive changes in highly educated patients. TYM-TR is suitable screening tool in detecting subtle cognitive deficits in early stages of neurocognitive disorders. More complex screening tests can eradicate the ceiling effect of more simple tests but they have more floor effect in encountering with sever demented patients. Comparing these two test with more detailed neuropsychological batteries could highlight the limitations of complex and simple tests in various situations.

Biography:

Peter worked for a US IT company, resigning to look after his wife who was diagnosed with Vascular Dementia at the age of 59. After she began living in a nursing home he wanted to use his experiences to improve the lot of others affected by dementia. He campaigned to get the plight of carers recognised, helped design the implementation plan for the UK Dementia Strategy, and served two terms on the Board of the Dementia Action Alliance. With others he built a charity, YPWD, to support people affected by young onset dementia where he is now a trustee. He is on the Dementia Programme Board overseeing the implementation of Government strategy for dementia. He also helped form, and is on the steering group of, the Young Dementia Network, on the Carer’s Advisory Panel of the charity Dementia Carers Count, and a member of the Thames Valley Dementia Network.

Abstract:

A diagnosis of dementia so often leads to social isolation, exclusion from “normal” activities, unmanageable carer stress and unplanned calls on NHS resources. It needn’t be like that. Providing quality respite for carers knowing the person they care for is receiving support that makes life meaningful and worthwhile helps alleviate these problems. The charity YPWD in Berkshire, UK delivers activities reflecting typical community life – art, sport and exercise, gardening, music and drama. Group activities take place within the community bringing “normality” and reducing stigma. Education courses for patients and carers run in parallel. Outcomes include longer time to residential care need, fewer unplanned medical interventions, some stabilization in MMSE scores, and expressions of greater wellbeing by patients and carers. The empowerment realized has delivered self-help peer support between both groups. YPWD delivers these services to those affected by young onset dementia, but it is equally applicable across the dementia spectrum.

Biography:

Lena Chauhan is the Co- Founder of Rise IQ, which involves Creating Solutions for Mental Health. Prior to setting up RiseIQ, she was the Co-founder of a Health- tech start-up. She is a trained as a medical navigator to help empower patients and introduced the service to financial institutions. Her mission is to create awareness about Dementia

Abstract:

A recent YouGov survey commissioned by Alzheimer’s Research UK in 2015 revealed that, when asked what they think dementia is and who it affects, just 23% of British adults specifically mentioned brain disease or degeneration… This left a huge majority believing something else to be going on Research was carried out with families affected by dementia and the public to get a better grasp on how dementia is perceived If we don’t understand in detail the level and depth of public awareness of dementia, we won’t be able to communicate effectively with people or help to educate and address misconceptions. Across the groups – regardless of their make-up – north, south, east, and west –a consistent observation was made that was certainly food for thought. The main groups questioned didn’t recognise that dementia was caused by diseases – like Alzheimer’s – in the brain. They didn’t think about Alzheimer’s in the same way they thought about cancer. To be reductive, they didn’t think Alzheimer’s was a “physical disease”. The obvious follow-on question to ask was “what is it then?” A variety of answers were offered here: a part of ageing, just getting old, crossed wires, forgetfulness, but evidently people don’t feel these symptoms are disease-driven. This misunderstanding around the physicality of the diseases that cause dementia – Alzheimer’s is most common – If we can help people understand that we are dealing with aggressive and physical diseases, and not “craziness” or natural decline, it might help emancipate people to seek and talk about a diagnosis. There should not be shame in having these diseases, in the same way we don’t shame people with cancer or heart disease. The terminology used around dementia doesn’t help us. Dementia is often referred to as a disease in itself, which isn’t quite right. We need simple language and easy analogies to enable us to understand what is going on. A point where we get the “aha” moment and realise that it’s something we can learn to understand and manage. If I can briefly mention the Contented Dementia Trust- run by the fabulous Penny Garner. She paints a picture of the memory of someone with and without symptoms of Dementia by describing a photograph album There is no mention of Hippocampus! Every single person who I have presented this analogy to has understood it completely and they themselves feel empowered at having basic understanding of the symptoms displayed. It doesn’t need to be a scientific understanding. Make it real and make it life like and relatable- Once people get it – their minds by default open up to listen. The mood changes A large percentage of the UK population living with Dementia are from socially disadvantaged backgrounds.   They also represent a large portion of the cost to the Social and NHS services. These explanations would and have led to a better understanding for them. Another statistic that occasionally appears in the press is that dementia is “the most feared health condition” - sounds like a 911 warning! particularly in the over 55s. So, we have a situation where there is a lot of anxiety around dementia, but perhaps not a strong grasp of what is actually going on in the condition.

Biography:

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".

Abstract:

Background: Knowledge, attitude, and perception interact to influence each other differently. The concept of knowledge is ambiguous, however, in nursing, it can be defined as the cognitive ability to care for people since it underpins the role of nurses in healthcare. While perception is an understanding or interpretation of nursing behaviours. The interpretation can be based on people’s thoughts or from the viewpoints of the nurses. Though, nurses’ perception of their behaviour is significantly influenced by external factors such as knowledge and public opinion. Attitude is the tendency of individual thoughts, beliefs, and feelings relative to a psychological object. The performance of the nurse is influenced by attitude since feelings, beliefs, and behaviours occur in the long-term. Nurses attitudes drive their competence in their performance. The concept of attitude in nursing relates to how nurses feel, thought or belief about their profession and its part of what drives competency in nursing. Research question: what are nurses’ attitude, knowledge, and perceptions when caring for people with dementia globally? Method: a systematic search was conducted in scientific databases between November 2017 and April 2018 using specific keywords. Results: N=79 articles were included in the study and NVivo software been used to analyse the literature that emerged the following themes (1) Dementia Knowledge Improves Communications Skills, (2) Tools for Assessing and Improving Nurses’ Dementia Knowledge. (3) Nurses’ Attitudes in Acute Care Settings, (4) Nurses’ Attitudes toward End-of-Life Care, (5) Relationship Between Knowledge and Nurses’ Attitudes, (6) Approaches to Care and Nurses’ Attitudes, (7) Involving People with Dementia in Decision-making, (8) Managing Dementia with other Complications, (9) Nurses’ Perceptions on Their Care for People with Dementia, and (10) Nurses’ Perceptions Affected by Their Knowledge. Conclusion: Nurses attitudes, knowledge and perceptions are important facets that influence the competency of nurses in caring for people with dementia. It can have a profound negative impact on the person with dementia, their families, and the country.  Many policy-makers and policy-making organisations, including the WHO, have realised the importance of improving the care that is accorded to people with dementia. Improving care means gathering enough evidence, knowledge, and attitude of people who are directly involved with people with dementia or their close relations. 

Biography:

Abstract:

Among older people, dementia is the leading chronic disease contributor to disability and need for care. In India, person with dementia continue to live with their families. Dementia care is usually a joint effort by the adult members of the family who stay in the same household (Dementia India report, 2010). In this background, this study proposes to promote a healthy adjustment of the family to the disease, improving quality of life and encouraging the link between family and formal support systems through a multi component home based family care program for the families. The objective of the study is to develop a home based care program for the families of person with dementia and to assess the impact of the programme. The study design is Quasi-experimental design – pre and post assessment without control group. 40 caregivers of dementia patients undergoing treatment from the Geriatric Clinic outpatient department  of National Institute of Mental Health And Neurosciences, Bengaluru were taken through random sampling method.Socio-demographic sheet used to assess background information, The Perceived Stress Scale, Multidimensional Scale of Perceived Social Support, The Zarit Burden Interview and a Self-constructed questionnaire administrated at baseline and post intervention.Intervention modules developed through extensive literature review, opinions and views from field experts, organizations involved in the community and home based care and the family members of patients with dementia. Psychosocial intervention module for home based care programme covers the psychological, social and general health aspects in the broader term based on the family centred participatory and integrated approach. Results showed that home based programme was effective for the caregivers in reducing their unhealthy adjustments, stress and burden by increasing the awareness in caregiving process and meeting their personal and emotional needs. The quality of care for the dementia patients has enhanced through the improvement of physical, social and psychological wellbeing of caregivers. In conclusion, Communitybased care, preferably at home would be ideal, and evidence in support of such care is accumulating.With adequate training, these programs can even be offered by health and welfare sector personnel in the community.