Dementia and its impact

1. Dementia and its impact Iva Holmerová

2. Dementia history 1907 – 1 case of dementia Über eine eigenartige Erkrankung der Hirnrinde. Allgemeine Zeitschrift für Psychiatrie 64:146-148 ALOIS ALZHEIMER Neurofib. klubka Amyloid. plaky

4. OSKAR FISCHER • 1876- 1942 • (Slaný - KZ Teresienstadt) • Worked in the Department of Pathology, Psychiatric Department, Charles University in Prague Oskar Fischer, 1876 - 1942

5. Oskar Fischer. Die presbyophrene Demenz. 1910. 275 cases, plaques in 56 cases older 50 let. Plaque stages I – VIII. Club – shaped neurites.Michel Goedert. Oskar Fischer and the study of dementia. Brain 2008.

6. Director of Mental Hospital Dobřany(1880-1886) Chief of Psychiatric Department, Charles University in Prague (1886-1921) „Relation of senile brain atrophy and aphasia“ 1892 – first description of „Pick´s disease) Arnold Pick (1851-1925)

7. Prevalence of serious diseases and age(FR PRES 2008, P.Amouyel)

8. Disease burden H.Brodaty (Paris Alzheimer, 2008): - 19th century – infections • 20th century – cardiovascular and oncological diseases • 21st century – neurodegeneration

9. World report on Alzheimer´s 2010 • 2010 – world´s costs of dementia – 1% GDP • The care for persons dementia being a state – then 18th largest enomomy • Being a company then bigger than Wal-Mart or Exxon Mobil… • One of the most important group of diseases BUT: investment in research, prevention and therapy uncomparably lower than in other diseases…

10. Socioeconomic burden of AD in Europe (2007, Eurocode) • Average costs of care of an „average“ dementia patient in EU 22- 30 thousand euro per year • Total costs in EU-27 130 billions euros • 56% informal care • 44% health, social and long-term care (professional)

11. Personswithdementia - numbers(dle ADI 2008, EuroCoDe) EU 2011 8 100 000 CZ 2011 110 000 - 140 000 Globally 39 000 000 Czech Republic: 2000 – 88 000 2005 – 95 000 2010 – 111 000 2015 – 124 000 2020 – 138 000 2025 – 157 000 2030 – 180 000 2035 – 202 000 2040 – 213 000 2045 – 218 000 2050 – 227 000

12. Causes of dementia • Alzheimer´s disease – the most frequent cause • Vascular factors – the next most frequent cause of demetia (vascular), important co-factor of dementia manifestation (also in neurodegeneration) • Other neurodegenerative diseases (FTLD, LBD…) • curable causes of dementia and pseudodementia cca 1% (hypothyroidism, NPH, depression…)

13. Syndrom of dementia (ABC) • ADLs – impairedself-sufficiency • Behavioral and psychologicalsymptoms • Cognitiveimpairment

14. Making dementia a European priority • Adoption of European Parliament Written Declaration by 59.24% of MEPs – call for European Action Plan 80/2008 • European Commission Initiatives launched in July 2009: • Council recommendation for Joint Programming of research on neurodegenerative diseases • Commission Communication on a European initiative on Alzheimer’s disease and other dementias • European Parliament resolution of 19 January 2011 on a European initiative on Alzheimer´s disease and other dementias • „Alzheimer Plans“ – Norway, France, UK…. • AE – patients and caregivers´organisation – role of caregivers (70-80% persons with dementia in their care)

15. Prevention of dementia • „Healthy and active ageing“ – be active, positive, work and movement… • Physical and mental activity • Diet (prevention of cardiovascular factors, antioxidants, flavonoids, vitamins…curcuma, green tea, wine…) • Medication: gingko biloba (memory complaints, MCI), calcium inhibitors (NILVAD)

16. Five-Country Alzheimer’s Disease Survey • Designed and analyzed by the Harvard School of Public Healthand Alzheimer Europe • Fieldwork conducted via telephone (landline and cell phone) by TNS, an independent research company based in London • Nationally representative random samples of adults age 18 and older in five countries (Slides by DianneGove) • Survey supported by a grant to Alzheimer Europe from Bayer AG. Bayer was not involved in the design of the survey or the analysis of the findings • .

17. Public Attitudes about What Disease They Are Most Afraid of Getting, Top Three Choices France Poland Spain U.S. CancerAlzheimer’sStroke CancerAlzheimer’sStroke CancerHeart diseaseAlzheimer’s CancerAlzheimer’sStroke CancerAlzheimer’sHeart disease Germany

18. Public’s Experience with Knowing Someone with Alzheimer’s Disease Know or have known someone with Alzheimer’s France Germany Poland Spain U.S. France Germany Poland Spain U.S And that person is/was a family member

19. Public’s Perception of Whether Alzheimer’s Is a Fatal Disease Yes, is a fatal disease France Germany Poland Spain U.S. France Germany Poland Spain U.S No, is not

20. Public Attitudes about Wanting to See a Doctor If They Were Exhibiting Signs of Confusion and Memory Loss Yes, would want to see doctor to determine if Alzheimer’s France Germany Poland Spain U.S. France Germany Poland Spain U.S No, would not want to see doctor

21. Public Attitudes about Wanting a Family Member Who Was Exhibiting Signs of Confusion and Memory Loss to See a Doctor Yes, would want family member to see doctor to determine if Alzheimer’s France Germany Poland Spain U.S. France Germany Poland Spain U.S No, would not want family member to see doctor

22. Public Attitudes about Wanting to Be Told If A Doctor Believed They Had Alzheimer’s Disease Yes, would want to be told France Germany Poland Spain France Germany Poland Spain No, would not want to be told This question not asked in U.S.

23. Public Attitudes about Wanting a Family Member to Be Told If a Doctor Believed That Family Member Had Alzheimer’s Disease Among those who said would want family member to see doctor Yes, would want family member to be told France Germany Poland Spain France Germany Poland Spain No, would not want family member to be told This question not asked in U.S.

24. Public’s Interest in Getting a Test Before Exhibiting Symptoms to Determine If They Were Likely to Get Alzheimer’s in the Future, Should Such a Test Become Available Very likely to get such a test France Germany Poland Spain U.S. France Germany Poland Spain U.S France Germany Poland Spain U.S Somewhat likely Not too/not at all likely

25. Public’s Perception of Whether There Is Or Will Be an Effective Medical or Pharmaceutical Treatment to Slow the Progression of Alzheimer’s Disease in the Next Five Years There is an effective treatment now France Germany Poland Spain U.S. France Germany Poland Spain U.S France Germany Poland Spain U.S There will be an effective treatment in next five years Is not an effective treatment now/will not be one in five years

32. Children book – The Magic Tape Recorder Supported by Krka