The Future of Dementia - Changing Words and Evolving Stories

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1 The Future of Dementia - Changing Words and Evolving Stories 5th Annual Southlake Regional Health Centre Geriatric Clinic Day Peter J Whitehouse MD-PhD Case Western Reserve University University of Toronto

2 From Neurodegeneration to Brain Health October 25 and 26, 2013 Cleveland

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10 Neuroneologisms Ecopsychosocial to replace biopsychosocial we are getting the bio wrong; towards an evolutionary ecomedicine in a cultural context Intergenerativity a blend of innovation and integration to enhance resilience and sustainability

11 Intergenerativity: going between to create a resilient and sustainable beyond Thinking like a mountain

12 The Myth of Alzheimer s and other powerful stories TEDX

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14 Alzheimer s Language Games

15 Asymptomatic Alzheimer s disease Reisa Sperling ( its aging )

16 Neuropathology not definite but disengaged Brad Hyman it s aging

17 Lifelong management of amyloid-beta metabolism to prevent Alzheimer's disease. Sam S Gandy N Engl J Med 367(9):864-6 (2012) Pharma wants a statin for Alzheimer s

18 leveland Clinic researchers identify urgent need for Alzheimer's drug development ONDAY, 07 JULY 2014 esearchers at the Cleveland Clinic Lou Ruvo Center for Brain Health have conducted the first-ever analysis of clinical trials for Alzheimer's disease (AD), revealing an urgent need o increase the number of agents entering the AD drug development pipeline and progressing successfully towards new therapy treatments. The paper, "Alzheimer's Disease Drug evelopment Pipeline: Few Candidates, Frequent Failures," was published in the journal Alzheimer's Research & Therapy. A comprehensive look at all clinical trials underway shows: There are relatively few drugs in development for Alzheimer's disease. The failure rate for AD drug development is 99.6 percent for the decade The number of drugs has been declining since BUT Jeff Cummings himself said nicotinic agent will be next to be approved!

19 The Lancet: perhaps the problem is no one knows what translational research is

20 Alzheimer s Disease Research Summits May 2012 and February 2015

21 Forbes July 23, 2014 Howard Gleckman after AAIC

22 Dementia more language games

23 DSM-5 From Dementia to Major Neurocognitive Disorder

24 Saving Normal

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28 World Dementia Council lead by World Dementia Envoy

29 Thousands of dementia sufferers should be offered drug trials

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31 G7 - Global Dementia Legacy Event New Care and Prevention Models November 5-7, 2014

32 First Ministerial WHO Summit on Dementia Geneva 3-15

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34 Blackfriars Consensus prevention

35 THOMAS KUHN THE STRUCTURE OF SCIENTIFIC REVOLUTIONS 1962 FROM PARADIGM SHIFT TO METAPARADIGM SHIFT The Journal of Prevention of Alzheimer Disease Volume 1 Number

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37 Arc of life Early life experiences can influence diseases of aging

38 Food System/Diet Western Disease Cluster Illnesses Increase Risks of Neurodegenerative Disease Environmental Factors Sedentary builtenvironment/ transportation Fossil fuel energy Toxic Chemicals Socioeconomic stress/disparities Altered Biological Pathways Western Disease Cluster Diabetes Obesity Cardiovascular disease Metabolic syndrome Neurodegenerative Disease Alzheimer s/dementia Parkinson s* *Current evidence links environmental factors and the Western disease cluster to Alzheimer s disease. Evidence also clearly links environmental factors to Parkinson s disease, but does not at this point show a clear relationship between Parkinson s and all the diseases of the Western disease cluster.

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40 Ecopsychosocial Model of health

41 Socioeconomic inequality effects are hugh High Inequality Results in More US Deaths than Tobacco, Car Crashes and Guns Combined April 19, 2014 by Joshua Holland 400 A casket at the Museum of Funeral Customs, Springfield, Illinois, (Wikimedia Commons: Robert Lawton.) In 2009, the British Medical Journal (BMJ) published a study that revealed what seems to be a shocking truth: those who live in societies with a higher level of income inequality are at a greater risk for premature death. Here in the United States, our high level of income inequality corresponds with 883, 914 unnecessary deaths each year. More specifically, the report concluded that if we had an income distribution more like that of the Netherlands, Germany, France, Switzerland or eleven other wealthy countries every year, about one in three deaths in the US could be avoided.socio

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43 The Intergenerational School

44 Our Mission: The Intergenerational School creates, connects and guides a multigenerational community of lifelong learners and spirited citizens. Our Vision: TIS is a successful Intergenerational Learning Community that is transforming Cleveland, and the world, into a better and more equitable global community. TIS will serve as a model to encourage and assist other communities to create similar learning environments.

45 Art Music Physical Education Science/ Technology Traditional and Edible Forest Gardening Senior Marathon Training Club Basketball Program Future Business Leaders of America Girls with Soul Running Program Ballroom Dancing Youth Core Leadership Program Traditional and Edible Forest Gardening Afterschool Music Aftercare Yearbook Club TIS Educational Programs & Activities

46 Community Programmatic Partnerships

47 Intergenerational volunteering and QOL for persons with mild to moderate dementia

48 Intervention

49 Results

50 Qualitative results

51 Kay Fuller Freeway Fighter 1960 s environmental activist

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61 Cochrane Collaboration Dementia Group University of Oxford Music - finished Art - pending Dance -pending

62 Plain language summary There is no substantial evidence to support nor discourage the use of music therapy in the care of older people with dementia The specific focus was to assess whether music therapy can diminish behavioural and cognitive problems or improve social and emotional functioning. Ten studies have been included in this review which state that music therapy is beneficial for treating older people with dementia. However, the methodological quality of these small, short-term studies was generally poor, as was the presentation of results. No useful conclusions can be drawn.

63 Dance Exchange Kairos Alive

64 Anne Basting Timeslips and Penelope

65 Cracked:a new light on dementia Ring the bells that still can ring Forget your perfect offering There is a crack in everything That's how the light gets in. Leonard Cohen, "Anthem"

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69 DREAM BIGGER MAKE YOUR STORY A LEGACY PROJECT 1 World, 1 Book 7-Gen Resources Legacy Projects ENGAGE dreams / aspirations EXPLORE needs / interests ENABLE ACTION assets / strengths YOU 177 is a r/evolution in the way we think and solve problems that strategically empowers and connects youth, adults, and elders of all ages and abilities for inspired lives, stronger communities, and a sustainable world. 1 World, 7 Generations, 7 Billion People and YOU.

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