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Dementia prevention-global priority PowerPoint Presentation

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Description : Check out this medical presentation on Neurology, which is titled "Dementia prevention: global priority", to check WHO Ministerial Conference on Global Action Against Dementia.

Tags : Neurology, Dementia prevention, WHO Ministerial Conference

Published on : Aug 18, 2021 | Views : 1723 | Downloads : 2

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WW-FINGERS Prof. Miia Kivipelto, MD, PhD Managing Director & Director of Research and Development Karolinska Institutet, NVS, Center for Alzheimer Research Karolinska University Hospital, Aging Theme University of Eastern Finland
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Dementia prevention: global priority WHO Ministerial Conference on Global Action Against Dementia, 2015 2016 2016 WHO Dementia Risk reduction guidelines2018
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Dementia and Alzheimer disease: importance of multidomain approach Modified from Kivipelto, Mangialasche et al., Oxford Ger Text Medicine 2017, Nature Neurology (in press) 3
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INTENSIVE INTERVENTION Nutrition Exercise Cognitive training Vascular risk monitoring years 2 REGEULAR HEALTH ADVICE N= 1260 60-77 years Presented at AAIC 2014
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Primary: NTB total score (Composite z-score) Red - intervention Blue - control Lines = estimates for change from baseline to 1 & 2 years Error bars = standard errors P-values = difference in trajectories over time between groups Ngandu, Kivipelto et al. Lancet 2015 Summary of primary findings 25% higher improvement p=0.03 83% higher improvement 150% higher improvement p=0.04 p=0.03 Memory (complex tasks) p=0.04 40% higher improvement Lower risk for cognitive decline 30% lower risk for functional decline (IADL) (Kulmala et al., manuscript) Better health related quality of life (Strandberg et al, Eur Ger Med 2017)
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World Wide FINGERS (WW-FINGERS) U.S. POINTER U.K. FINGER FINGER SINGER MIND FINGER Maintain Your Brain Canada Germany, Spain, Italy India Argentina Mexico Japan http://wwfingers.com Launched at AAIC 2017
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World Wide FINGERS (WW-FINGERS) http://wwfingers.com SINGER US-POINTER FINGER MIND-CHINA UK-FINGER ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? Implementation - Multidomain, pragmatic, individualised intervention - Group & individual sessions - Common outcomes -Cultural & local adaptations - Knowledge dissemination - Translation to practice Core Methods
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Structured Lifestyle Intervention Exercise (mostly aerobic): 4x per week primarily at a YMCA Nutrition: MIND diet (modified Mediterranean) Cognitive Stimulation: Computer cognitive training (Posit Science), group meetings to encourage social/intellectual challenge Guideline-Based Health Coaching: Frequent exams, blood tests, review of health numbers & goal-setting Self-Guided Lifestyle Intervention Education & Support: Group meetings 2-3 times per year for presentations and support, general information about healthy lifestyle Guideline-Based Health Coaching: Annual physical exam & blood tests U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk (U.S. POINTER) Target population 60-79 y, n 2000, normal cognition but increased risk 2-year intervention Global cognitive composite outcome
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A randomized controlled Multimodal INtervention to delay Dementia and disability in China (MIND-CHINA): Target population 60-79, n~3000 Cluster randomization (by village) Baseline examinations ongoing MRI substudy n~ 1000 Qiu C, Du Y et al,
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Target group: prodromal AD + vascular + lifestyle risk factors Intervention: combination of lifestyle + medical food Tools for combined prevention trials: lifestyle + disease-modifying drugs Multimodal preventive trials for Alzheimer’s Disease - MIND-AD (Soininen et al, Lancet Neurol. 2017)
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Data harmonization Introducing bioinformatics approach WW-FINGERS biorepository
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Impact: Personalised & effective dementia prevention MULTI-MODE E-helath & M-health tools An interdisciplinary global network and consortium to: Share experiences, research ideas and data Harmonize research methods in prevention trials Facilitate synergistic use of multinational data Plan joint dementia prevention initiatives Generate robust evidence on effective preventive approaches for various at-risk groups and settings Rapidly implement knowledge Formulate recommendations and guidelines for dementia prevention and future trials … MYB MIND-China US-POINTER MIND-AD (FI, SE, FR, DE) SINGER UK-FINGER
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Acknowledgements Grant support: Alzheimer Association, MetLIfe, Academy of Finland, Swedish Research Council, ALF grants, Social Insurance Institution of Finland, Ministry of Education and Culture of Finland, Novo Nordisk Foundation, Alzheimer’s Research and Prevention Foundation, EU 7th framework, AXA Research Foundation, CIMED, JPND, IMI, EiT-Health, Wallenberg Clinical grant, Stiftelse Stockholms Sjukhem Unit for Clinical Trials Turku PET Centre FINGER MIND-CHINA SINGER UK-FINGER US-POINTER All teams
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U.S. Study to Protect Brain Health through Lifestyle Intervention to Reduce Risk Rush University: Martha Clare Morris, Jennifer Ventrelle USC/ATRI: Rema Raman, Gustavo Jimenez,-Maggiora Robert Rissman Brigham & Women’s Hospital/Harvard: Kathryn Papp, Dorene Rentz Y-USA: Valerie Lawson Alzheimer’s Association: Maria Carrillo, Heather Snyder, Bill Fisher, Glenda Berry, Kenann Cassidy, Elizabeth Edgerly, Katherine Lambert, Claire Day Wake Forest: Laura Baker, Mark Espeland, Jeff Williamson, Nancy Woolard, Jing Su, Scott Rushing, Jeff Katula, Julia Robertson, Iris Leng, Dan Beavers, Jo Cleveland UC Davis: Rachel Whitmer, Charlie DeCarli, Sarah Farias FINGER team: Miia Kivipelto, Tiia Ngandu, Alina Soloman Industry Partners: Posit Science Digital Cognition Technologies, Cogstate Wellpepper, FitBit, YMCA Study Team
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SINGapore intervention study to prevEnt coGnitive impairment and disability (SINGER) study RCT of multidomian interventions in elderly patients at risk of cognitive decline Cognitive (X Xu) Diet (CJ Henry) Exercise (E Chew) Vascular risk modification (C Chen) Target population: at risk/MCI N ~150 Duration 6 months Feasibility study prior to larger scale study (funded by NUS Centre for Healthy Ageing) FINGER vs SINGER adaptations
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16 European Dementia Prevention Initiative FINGER Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (Kivipelto et al.,Lancet 2015) Pre-DIVA Prevention of Dementia by Intensive Vascular Care (van Charante et al., Lancet 2016) MAPT Multidomain Alzheimer Preventive Trial (Andrieu et al, Lancet Neurol 2017) www.edpi.org Data pooling & joint analyses > 6000 participants Lessons learned so far: Timing: start early! Target populations: Focus on at-risk individuals! Interventions: Do the right things & Do enough of them!