Can we prevent Alzheimer s disease and other memory disorders?
|
|
- Stanley Nash
- 6 years ago
- Views:
Transcription
1 Can we prevent Alzheimer s disease and other memory disorders? Tiia Ngandu, MD, PhD Diabetes Prevention Unit, National Institute for Health and Welfare and Alzheimer s Disease Research Center,Karolinska Institutet, Sweden
2 Prevention of cognitive impairment and Alzheimer s disease Memory disorders Risk Factors Interventions
3 Dementia / Memory disorders Dementia: impaired memory and other cognitive functions, disability Causes: Alzheimer s disease 6-7 % Vascular cognitive impairment 15 % Lewy Body Disease 15 % Others 5 % Memory disorders
4 Occurrence of dementia Prevalence increases with age years 1.5% >85 years 35% >95 years up to 6% 35.6 million people with dementia in million in 25 2/3 in low and middle income countries (World Alzheimer Report 29)
5 Burden of dementia Patient Informal care (family) Medical care Social care (residential or nursing homes) Estimated total costs of 64 billion USD in 21 (1% of world s gross domestic product) (World Alzheimer Report 21)
6 Prevention of AD: postponing the onset of the disease Delay (years) US prevalence of AD (millions) Year Brookmeyer et al., 1998, Jorm 25
7 Managing Alzheimer s Disease A Lifelong Commitment Onset of MCI* Clinical diagnosis of AD % of end-stage AD1 Asymptomatic Preclinical Clinical phase phase phase Age (years) Estimated start of neuropathological changes *MCI - mild cognitive impairment Modified from PJ Visser, 2
8 FINRISK The FINRISK Study, North Karelia Project Aim: Integrate memory disorders into the existing framework
9 Risk and protective factors for dementia/ad Risk factors Cerebrovascular disorders Hypertension Hypercholesterolemia Obesity Diabetes mellitus Homocysteine Smoking Depression Head trauma Protective factors High education Physical activity Active lifestyle Moderate alcohol intake Antioxidants Fish oils Coffee Antihypertensives Statins NSAIDs? Estrogen?
10 What goes around comes around Risk relationship FACTOR Reverse causality DISEASE i.e. Cholesterol, Blood pressure, BMI CAIDE, Solomon A et al. Neurology 27, Neurobiol Aging 29 Honolulu Asia Aging Study, Stewart R et al. Arch Neurol 27 Kungsholmen Project, Qiu C et al. Stroke 24 Gothenburg Study, Skoog I et al. Lancet 1996, Gustafson D et al. Neurology 29 Life-course perspective is needed when assessing the risk factors for AD
11 ApoE4 Magnifies Lifestyle Risk for Dementia Physical activity PUFA intakequartiles SFA intake - quartiles Alcohol drinking Active Sedentary Active Sedentary IV III II I IV III II I I II III IV I II III IV Non-drinkers Infrequent Frequent Non-drinkers Infrequent Frequent 4 * 3.8 * APOE ε4 non-carriers APOE ε4 carriers 5.5 ** 5 * 7.1 ** 7.1 * Non-smokers Smokers Smoking Non-smokers Smokers 3.2 * ORs for dementia Kivipelto et al., JCMM
12 Midlife leisure time physical activity and dementia/ad Dementia AD OR (95% CI) (.25-.9) (.16-.8) Rovio, et al., Lancet Neurology 25 β- coefficient Total brain volume.21 (p<.1) Grey matter volume White matter volume β.15 (p<.1) Brain derived neurotrophic factor (BDNF): β.29 a marker of cognitive (p<.1) functioning? Rovio, et al. Neurobiol Aging 29 Komulainen,et al., 28
13 Leisure activities RR (95%CI) for dementia High mental score.71 ( ) High physical score.61 ( ) High social score.68 ( ) Karp et al, 25
14 6 The risks of unmarried life OR (95% CI) for MCI, AD and dementia in persons without partner at midlife Håkanson K et al., BMJ 29 Ref MCI AD Dementia Controlled for age, sex, education, APOE ε4, BP, cholesterol, BMI, occupation, occupational physical activity
15 Age Formal education Sex Systolic BP BMI Cardiovascular Risk Factors, Aging and Incidence of Dementia Total cholesterol Physical activity Dementia Risk Score < 47 years years > 53 years 1 years 7-9 years -6 years Women Men < 14 mm Hg > 14 mm Hg < 3 kg/m2 > 3 kg/m2 6.5 mmol/l > 6.5 mmol/l Active Inactive Kivipelto, Ngandu et al., Lancet Neurol 26
16 Probability of dementia according to the risk score category SCORE Risk % % % % % Kivipelto, Ngandu et al. Lancet Neurology 26
17 Midlife risk profile, 2 years prediction CAIDE Dementia Risk Score Age, years < > Education, years Sex Women Men <14 > 14 Systolic BP, mmhg BMI, kg/m 2 < 3 > 3 Cholesterol, 6.5 mmol/l > 6.5 Physical activity Active Inactive % SCORE Kivipelto, Ngandu et al., Lancet Neurology 26
18 Randomized controlled trials
19 SUMMARY OF EARLIER RCT S INTERVENTION STUDIES FINDINGS Antihypertensives Statins Cholinesterase inhibitors Memantine Estrogen, Estrogen+Progestin Raloxifene DHEA SCOPE, SHEP, Syst- Eur, PROGRESS Heart Protection Study, PROSPER Cochrane review 28 Schumaker JAMA 23, 24 Cohcrane review 22 Ns, except protective in 1 follow-up study, and 1 study with history of vascular disease Ns Ns Increased risk/ Ns Ns Ns
20 SUMMARY OF EARLIER RCT S INTERVENTION STUDY FINDINGS NSAID s ADAPT 29 Increased risk Aspirin Price 28 Ns Ginkgo biloba DeKosky JAMA 28 Ns Multivitamins MAVIS 27 Ns Vitamin E Petersen NEJM 25 Ns Vitamin B and folate Kang 28 Ns McMahon 26 Vitamin C Ns Beta carotene Omega-3 fatty acids Ns Ns Cognitive training ACTIVE Positive effect on targeted function Physical activity Lautenschlager 28 Small positive Dr s Extra effect Social engagement Diet
21 Recipe for prevention trials? Timing; starting earlier may lead to better effects Target group; a healthy, too young population will require very long follow-up times and large sample sizes Outcome measures; cognitive impairment may be a better measure than conversion to dementia Ethical issues; placebo-controlled trials regarding pharmacological treatment of cardiovascular disease risk factors are not possible
22 AD is a multi-factorial disease: target several risk factors simultaneously for an optimal preventive effect RISK FACTORS APOE, Other genes Alcohol misuse Unhealthy diet Physical activity Adult life Mid-life Late-life Education Hypertension Dyslipidemia Obesity Vascular insults Diabetes Smoking Neuronal damage Transition Cognitive and social activity PROTECTIVE FACTORS Brain reserve? DEMENTIA 22
23 Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability Objective: To reduce cognitive impairment in an at risk population through a 2-year multi-domain life-style intervention Target population: 6-77 year old persons (n= 12) from previous population-based nonintervention studies (FINRISK, D2D) Time schedule: Screening began in September 29 and was completed in 211. The intervention will be completed in the beginning of 214
24 Study design: A multi-center (6 sites) single-blind RCT enrolling 12 persons randomized into 2 groups (multidomain intervention or regular health advice) for a 2-year period. Extended follow-up to 7 years. Multidomain intervention: i) nutritional guidance ii) increased physical activity iii) cognitive training and iv) intensive monitoring and management of vascular risk factors Primary outcome: Cognitive impairment 24
25 INCLUSION CRITERIA: persons at risk of dementia/ cognitive decline AND Dementia Risk score > 6 Based on risk factors assessed in earlier population surveys: Age, Education, Sex, SBP, Cholesterol, BMI, Physical Activity (Kivipelto et al., Lancet Neurology 26) Cognitive performance at the mean level or slightly lower than expected for age CERAD: 1) Word List Immediate Memory task (1 words x3) < 19 words AND/OR 2) Word List Delayed Recall < 75% AND/OR 3) MMSE < 26
26 INTERVENTION SCHEDULE INTENSIVE INTERVENTION Recruitment (Dementia risk score) Screening (Nurse: CERAD; Physician) Baseline visit (NTB) RANDOMIZATION INTERVENTION KICK-OFF NUTRITIONAL COUNCELING: 7 group & 3 individual sessions PHYSICAL ACTIVITY: 1-2x/wk muscle strength & 1-4x/wk aerobic training COGNITIVE TRAINING: 9 group sessions, Independent training 3x/wk 6mo PHYSICAL ACTIVITY: 2-3x/wk muscle strength & 5-6x/wk aerobic training COGNITIVE TRAINING: 2 group sessions, Independent training 3x/wk 6mo MANAGEMENT OF METABOLIC AND VASCULAR RISK FACTORS 6 nurse visits, 4 physician visits Follow-up visit Follow-up visit Follow-up visit Month MINI- INTERVENTION Follow-up visit Follow-up visit REGULAR HEALTH ADVICE Follow-up visit
27 OUTCOMES Primary: Cognitive impairment (Neuropsychological Test Battery, Trail Making & Stroop tests) Secondary: Dementia (after 7 years) Depressive symptoms (Zung scale) Vascular risk factors, morbidity and mortality Disability (questionnaire, ADL + IADL) Quality of life (RAND-36, 15D) Utilization of health resources Blood markers (i.e. inflammation, redox status, lipid and glucose metabolism, NMR metabonomics) Brain MRI measures (n=1) and PET (n=9)
28 RELEVANCE OF A MULTI-DOMAIN INTERVENTION Will test to what extent a multi-domain intervention may delay cognitive impairment and dementia onset in people at an increased risk Is an innovative approach to delay cognitive impairment while simultaneously intervening upon several risk factors of other major diseases Will provide data urgently needed for health education and community planning
29 EDPI European Dementia Prevention Initiative FINGER prediva MAPT Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability Prevention of Dementia by Intensive Vascular Care Multidomain Alzheimer Preventive Trial
30 A 1 25% reduction in all seven risk factors could potentially prevent million AD cases worldwide. July 211
31 CONCLUSIONS Can we prevent/delay memory disorders? Vascular factors: Hypertension Diabetes Obesity Starting from middle age Special focus on ApoE e4 carriers Be active and maintain an active life Social integration Physical activities Mental activities
32 Acknowledgements Grant support: Academy of Finland, La Carita Foundation, American Alzheimer Association, Novo Nordisk Fonden, Alzheimer s Research and Prevention Foundation, The Social Insurance Institution of Finland, Juho Vainio Foundation Miia Kivipelto Tiina Laatikainen Markku Peltonen Antti Jula Jaana Lindström Satu Pajala Satu Ahtiluoto Jenni Lehtisalo Liisa Saarikoski Pirjo Saastamoinen Marko Grönholm Esko Levälahti Päivi Valve Hilkka Soininen Tuula Pirttilä Rainer Rauramaa Raimo Sulkava Alina Solomon Tuomo Hänninen Teemu Paajanen Jaakko Tuomilehto Timo Strandberg Riitta Antikainen Lars Bäckman Turku PET Centre Juha Rinne Anna Stigsdotter Neely 32
Lifestyle intervention to prevent cognitive impairment
Lifestyle intervention to prevent cognitive impairment Miia Kivipelto, MD, Geriatrician, PhD Professor, Director Karolinska Institutet, Center for Alzheimer Research and Karolinska University Hospital
More informationCurrent and Future Strategies in Alzheimer s Disease Treatment & Prevention
Current and Future Strategies in Alzheimer s Disease Treatment & Prevention Mary Sano, PhD Director, Alzheimer Disease Research Center Icahn School of Medicne at Mount Sinai School James J Peters Veterans
More informationNgandu, Tiia
https://helda.helsinki.fi Recruitment and Baseline Characteristics of Participants in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER)-A Randomized Controlled
More informationArticles. Published online March 12,
A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled
More informationAlzheimer s and Diet: New Research Frontiers
Alzheimer s and Diet: New Research Frontiers Ayesha Sherzai, MD Dean Sherzai MD, PhD(c) Co-Directors of Brain Health Center Department of Neurology Loma Linda University Health Our Aging Society FIGURE
More informationHOW TO PREVENT COGNITIVE DECLINE.AT MCI STAGE?
EAMA CORE CURRICULUM HOW TO PREVENT COGNITIVE DECLINE.AT MCI STAGE? Sofia Duque Orthogeriatric Unit São Francisco Xavier Hospital Occidental Lisbon Hospital Center University Geriatric Unit, Faculty of
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,900 116,000 120M Open access books available International authors and editors Downloads Our
More informationExercise and Lifestyle Factors Can cognitive decline & dementia be prevented? Henry Brodaty
Partner logo here Exercise and Lifestyle Factors Can cognitive decline & dementia be prevented? Henry Brodaty Can we prevent dementia? The adult brain weighs about 1.3 kg Dementia shrinks it to 1/2 its
More informationORIGINAL CONTRIBUTION. Obesity and Vascular Risk Factors at Midlife and the Risk of Dementia and Alzheimer Disease
ORIGINAL CONTRIBUTION Obesity and Vascular Risk Factors at Midlife and the Risk of Dementia and Alzheimer Disease Miia Kivipelto, MD, PhD; Tiia Ngandu, BM; Laura Fratiglioni, MD, PhD; Matti Viitanen, MD,
More informationBGS Spring Risk Factors and Preventative Strategies for Dementia
Risk Factors and Preventative Strategies for Dementia Dr Blossom Stephan Senior Lecturer (in Risk Prediction) Newcastle University Institute for Ageing and Institute of Health and Society BGS Spring Meeting
More informationVascular and Degenerative Causes of Cognitive Impairment: How are they linked?
Vascular and Degenerative Causes of Cognitive Impairment: How are they linked? MCI Symposium, Public Education Forum Presented by: Rebecca Gottesman, MD PhD January 20, 2019 1 Disclosures I am an Associate
More informationState of the art. Global population aging, occurrence, and impact of Alzheimer s disease
Epidemiology of Alzheimer s disease: occurrence, determinants, and strategies toward intervention Chengxuan Qiu, MD, PhD; Miia Kivipelto, MD, PhD; Eva von Strauss, PhD D More than 25 million people in
More informationMEDICAL LIFESTYLE INTERVENTIONS FOR BRAIN HEALTH
MEDICAL LIFESTYLE INTERVENTIONS FOR BRAIN HEALTH Nicci Kobritz, President Center for Brain Health & Youthful Aging Home Health 1 Our Goal Reduce the impact of modifiable medical risk factors associated
More informationSection Editor Steven T DeKosky, MD, FAAN Kenneth E Schmader, MD
Prevention of dementia Author Daniel Press, MD Michael Alexander, MD Section Editor Steven T DeKosky, MD, FAAN Kenneth E Schmader, MD Deputy Editor Janet L Wilterdink, MD Last literature review version
More information김광일 서울대학교의과대학내과학교실 분당서울대학교병원내과
치매예방을위한만성질환관리전략 김광일 서울대학교의과대학내과학교실 분당서울대학교병원내과 A sharp rise in the death rate from Alzheimer s disease Ivan Casserly & Eric Topol, Lancet 2004 Potential for primary prevention of Alzheimer s disease Alzheimer
More informationThe role of geriatricians in management of dementia - from the viewpoint of life style modification -
Global Dementia Legacy Event Japan Roppongi Hills, Tokyo 2014.11.6 The role of geriatricians in management of dementia - from the viewpoint of life style modification - President, Federation of National
More informationDevelopment of the LIfestyle for BRAin Health (LIBRA) score. Sebastian Köhler, Kay Deckers, Martin van Boxtel, Frans Verhey
Development of the LIfestyle for BRAin Health (LIBRA) score Sebastian Köhler, Kay Deckers, Martin van Boxtel, Frans Verhey Maastricht University, School for Mental Health and Neuroscience, Alzheimer Centrum
More informationCoconut Oil, Vitamins and Alzheimer s: What Really Works?
Program by Phone March 13, 2018 Coconut Oil, Vitamins and Alzheimer s: What Really Works? Robert L. Russell, MD Medical Director, Kindred at Home, Indianapolis, IN 1 OBJECTIVES To discuss how lifestyle
More informationPartner logo here. Can Alzheimer s disease be prevented? Henry Brodaty
Partner logo here Can Alzheimer s disease be prevented? Henry Brodaty Dementia: quick facts Umbrella term, >100 causes Alzheimer s 50% of dementias Vascular 15-20% Mixed 15-20% Lewy body dementia; Fronto-temporal
More informationImplementing Type 2 Diabetes Prevention Programmes
Implementing Type 2 Diabetes Prevention Programmes Jaakko Tuomilehto Department of Public Health University of Helsinki Helsinki, Finland FIN-D2D Survey 2004 Prevalence of previously diagnosed and screen-detected
More informationDietary Supplements, Caffeine, and Cognitive Aging
Institute of Medicine Committee on the Public Health Dimensions of the National Academies Beckman Center of the National Academies Irvine, CA June 9, 2014 Dietary Supplements, Caffeine, and Cognitive Aging
More informationPractical Matters in the Care of A Person with Dementia
Practical Matters in the Care of A Person with Dementia 7 th Annual Neurology Update for Primary Care Deborah S. Hoffnung, PhD, ABPP CN November 16, 2018 1 Typical Aging, MCI/CIND, dementia Common Dementia
More informationDiabetes Mellitus: A Cardiovascular Disease
Diabetes Mellitus: A Cardiovascular Disease Nestoras Mathioudakis, M.D. Assistant Professor of Medicine Division of Endocrinology, Diabetes, & Metabolism September 30, 2013 1 The ABCs of cardiovascular
More informationEuroPrevent 2010 Fatal versus total events in risk assessment models
EuroPrevent 2010 Fatal versus total events in risk assessment models Pekka Jousilahti, MD, PhD,Research Professor National Institute for Health and Welfare, Finland Risk assessment models Estimates the
More informationLa demenza si può predire, prevenire e quindi trattare
ALZHEIMER: I NUOVI ORIZZONTI DELLA CURA AFFRONTARLO PRESTO AFFRONTARLO INSIEME Biella, 29 settembre 2010 La demenza si può predire, prevenire e quindi trattare Innocenzo Rainero, MD PhD Associate Professor
More informationMagnetic resonance imaging, image analysis:visual scoring of white matter
Supplemental method ULSAM Magnetic resonance imaging, image analysis:visual scoring of white matter hyperintensities (WMHI) was performed by a neuroradiologist using a PACS system blinded of baseline data.
More informationMary Sano, PhD Mount Sinai School of Medicine James J Peters Veterans Affairs Hospital June 15, 2013
Preventing and Treating Alzheimer's Disease: Recruiting Patients for Clinical Trials Mary Sano, PhD Mount Sinai School of Medicine James J Peters Veterans Affairs Hospital June 15, 2013 Goals and Learning
More informationNutritional intervention in early Alzheimer s disease. Sasha Newsam, PhD Global Medical Affairs Manager Nutricia
Nutritional intervention in early Alzheimer s disease Sasha Newsam, PhD Global Medical Affairs Manager Nutricia Agenda Nutrition and brain function Single nutrient intervention Diet and risk of Alzheimer
More informationCan lifestyle prevent Alzheimer s disease? Henry Brodaty
Partner logo here Can lifestyle prevent Alzheimer s disease? Henry Brodaty Can we prevent dementia? The adult brain weighs about 1.3 kg Dementia shrinks it to 1/2 its usual size Elimination vs Postponement
More informationCognitive ageing and dementia: The Whitehall II Study
Cognitive ageing and dementia: The Whitehall II Study Archana SINGH-MANOUX NIH: R01AG013196; R01AG034454; R01AG056477 MRC: K013351, MR/R024227 BHF: RG/13/2/30098 H2020: #643576 #633666 Outline Lifecourse
More information10/1/2016. Prevalence and projections. Primary prevention of Alzheimer s disease and related disorders in a community health system
Primary prevention of Alzheimer s disease and related disorders in a community health system 2016 ISAPN MIDWEST CONFERENCE, October 7, 2015 Lisle, Ill. Anne Marie Fosnacht, MPH NorthShore University HealthSystem
More informationThe Association of Vascular and Neuroprotective Status Indicators with Cognitive Functioning
KUOPION YLIOPISTON JULKAISUJA D. LÄÄKETIEDE 433 KUOPIO UNIVERSITY PUBLICATIONS D. MEDICAL SCIENCES 433 PIRJO KOMULAINEN The Association of Vascular and Neuroprotective Status Indicators with Cognitive
More informationChapter 4. Cognitive decline precedes late-life longitudinal changes in vascular risk factors
Cognitive decline precedes late-life longitudinal changes in vascular risk factors P. van Vliet, R.G.J. Westendorp, D. van Heemst, A.J.M. de Craen, A.M. Oleksik J Neurol Neurosurg Psychiatry 2010;81:1028-1032
More informationPlacebo-Controlled Statin Trials EXPLAINING THE DECREASE IN DEATHS FROM CHD! PREVENTION OF CARDIOVASCULAR DISEASE IN WOMEN EXPLAINING THE DECREASE IN
PREVENTION OF CARDIOVASCULAR DISEASE IN WOMEN Robert B. Baron MD MS Professor and Associate Dean UCSF School of Medicine Declaration of full disclosure: No conflict of interest EXPLAINING THE DECREASE
More informationOptimizing risk assessment of total cardiovascular risk What are the tools? Lars Rydén Professor Karolinska Institutet Stockholm, Sweden
Optimizing risk assessment of total cardiovascular risk What are the tools? Lars Rydén Professor Karolinska Institutet Stockholm, Sweden Cardiovascular Disease Prevention (CVD) Three Strategies for CVD
More informationILSI Europe Satellite Workshop on Nutrition for the Ageing Brain: Towards Evidence for an Optimal Diet
ILSI Europe Satellite Workshop on Nutrition for the Ageing Brain: Towards Evidence for an Optimal Diet 03-04 July 2014, Milan, Italy Nutritional effects on cognitive ageing Trial data Dr. Ir. Ondine van
More informationLong-term follow-up studies suggest that elevated blood
Decline in Blood Pressure Over Time and Risk of Dementia A Longitudinal Study From the Kungsholmen Project Chengxuan Qiu, MD, PhD; Eva von Strauss, PhD; Bengt Winblad, MD, PhD; Laura Fratiglioni, MD, PhD
More informationB-Vitamins and the Ageing Brain
B-Vitamins and the Ageing Brain Helene McNulty PhD RD MRIA Director of the Northern Ireland Centre for Food, Nutrition and Health (NICHE) ulster.ac.uk Presentation Outline The Ageing Brain Evidence linking
More informationVascular Diseases. Overview: Selected Slides
Vascular Diseases Overview: Selected Slides Total deaths and change in vascular death rates
More informationEffective Health Care Program
Comparative Effectiveness Review Number 188 Effective Health Care Program To Prevent Age-Related Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer s-type Dementia Executive Summary Background
More informationChapter 1. Introduction
The older people get, the bigger the chance of losing cognitive abilities and ultimately to develop dementia. Increasing age is the largest known risk factor of dementia, with a prevalence of 1% in people
More informationGlycemic index, glycemic load, and the risk of acute myocardial infarction in middle-aged Finnish men:
Glycemic index, glycemic load, and the risk of acute myocardial infarction in middle-aged Finnish men: The Kuopio Ischaemic Heart Disease Risk Factor Study Jaakko Mursu, Jyrki K. Virtanen, Tiina H. Rissanen,
More informationCardiovascular Risk Assessment and Management Making a Difference
Cardiovascular Risk Assessment and Management Making a Difference Norman Sharpe March 2014 Numbers and age-standardised mortality rates from all causes, by sex, 1950 2010 Death rates halved Life expectancy
More informationMemory Care Monthly. Supporting Healthcare Professionals in Caring for the Aging November / December 2008
Memory Care Monthly Supporting Healthcare Professionals in Caring for the Aging November / December 2008 KEEP MEMORY ALIVE FOR THE COMING YEAR 2009 As the year comes to an end, we would like to remind
More informationPREVENTION OF CARDIOVASCULAR DISEASE IN WOMEN
1980 to 2000: Death rate fell from: 542.9 to 266.8 per 100K men 263.3 to 134.4 per 100K women 341,745 fewer deaths from CHD in 2000 Ford ES, NEJM, 2007 47% from CHD treatments, 44% from risk factor modification
More informationObjective 4/22/2019. Interaction of Cardiovascular Disease and Alzheimer s Disease: Implications for Cardiopulmonary Rehabilitation.
Interaction of Cardiovascular Disease and Alzheimer s Disease: Implications for Cardiopulmonary Rehabilitation Dereck Salisbury, PhD Assistant Professor, Clinical Exercise Physiologist Director: Laboratory
More informationInteraction of Cardiovascular Disease and Alzheimer s Disease: Implications for Cardiopulmonary Rehabilitation
Interaction of Cardiovascular Disease and Alzheimer s Disease: Implications for Cardiopulmonary Rehabilitation Dereck Salisbury, PhD Assistant Professor, Clinical Exercise Physiologist Director: Laboratory
More informationPrevenzione cardiovascolare e cambiamento degli stili di vita. Gian Franco Gensini
Prevenzione cardiovascolare e cambiamento degli stili di vita Gian Franco Gensini Main causes of death worldwide at all ages (year:: 2005) 17.5 milion Preventing Chronic Diseases A vital investiment. WHO
More informationNutraceuticals and Cardiovascular Disease: Are we fishing?
Nutraceuticals and Cardiovascular Disease: Are we fishing? ACC Rockies 2013 March 20,2013 Sheri L. Koshman BScPharm, PharmD, ACPR Assistant Professor, Division of Cardiology, University of Alberta sheri.koshman@ualberta.ca
More informationTrends In CVD, Related Risk Factors, Prevention and Control In China
Trends In CVD, Related Risk Factors, Prevention and Control In China Youfa Wang, MD, MS, PhD Associate Professor Center for Human Nutrition Department of International Health Department of Epidemiology
More information11/12/2018. Acknowledgements. Risk factors for Alzheimer s disease
Is it Possible to Reduce My Risk for Alzheimer's Disease? An Overview of Current Risk Reduction Strategies Dorothy Farrar Edwards PhD, Professor of Medicine and Kinesiology Core Leader: Outreach, Recruitment
More informationGuidelines on cardiovascular risk assessment and management
European Heart Journal Supplements (2005) 7 (Supplement L), L5 L10 doi:10.1093/eurheartj/sui079 Guidelines on cardiovascular risk assessment and management David A. Wood 1,2 * 1 Cardiovascular Medicine
More informationDementia and Cognition in Older Adults: Year in Review
Dementia and Cognition in Older Adults: Year in Review 2008 2009 Advances in Internal May June 2009 Bree Johnston, MD MPH Professor of Clinical bree.johnston@ucsf.edu Methodology Clinically important for
More informationAssociations of CAIDE Dementia Risk Score with MRI, PIB-PET measures, and cognitio
UEF//eRepository DSpace https://erepo.uef.fi Artikkelit Terveystieteiden tiedekunta 2017 Associations of CAIDE Dementia Risk Score with MRI, PIB-PET measures, and cognitio Stephen R info:eu-repo/semantics/article
More informationA Self-Report Risk Index to Predict Occurrence of Dementia in Three Independent Cohorts of Older Adults: The ANU-ADRI
A Self-Report Risk Index to Predict Occurrence of Dementia in Three Independent Cohorts of Older Adults: The ANU-ADRI Kaarin J. Anstey 1 *, Nicolas Cherbuin 1, Pushpani M. Herath 1, Chengxuan Qiu 2, Lewis
More informationReview Article Total Cholesterol and the Risk of Parkinson s Disease: A Review for Some New Findings
SAGE-Hindawi Access to Research Parkinson s Disease Volume 2010, Article ID 836962, 6 pages doi:10.4061/2010/836962 Review Article Total Cholesterol and the Risk of Parkinson s Disease: A Review for Some
More informationProf.dr. Frans J Kok. Nutrition & Health Perspectives over the Life course
Prof.dr. Frans J Kok Nutrition & Health Perspectives over the Life course Midlife Early life Midlife Late life Double Burden of Malnutrition Global population in 2015 and 2060 Modern Science and Technology
More informationMidlife Healthy-Diet Index and Late-Life Dementia and Alzheimer s Disease
Original Research Article This is an Open Access article licensed under the terms of the Creative Commons Attribution- NonCommercial-NoDerivs 3.0 License (www.karger.com/oa-license), applicable to the
More informationMidlife vascular risk factors and Alzheimer s disease in later life: longitudinal, population based study
Midlife vascular risk factors and Alzheimer s disease in later life: longitudinal, population based study Miia Kivipelto, Eeva-Liisa Helkala, Mikko P Laakso, Tuomo Hänninen, Merja Hallikainen, Kari Alhainen,
More information2003 World Health Organization (WHO) / International Society of Hypertension (ISH) Statement on Management of Hypertension.
2003 World Health Organization (WHO) / International Society of Hypertension (ISH) Statement on Management of Hypertension Writing Group: Background Hypertension worldwide causes 7.1 million premature
More informationASSeSSing the risk of fatal cardiovascular disease
ASSeSSing the risk of fatal cardiovascular disease «Systematic Cerebrovascular and coronary Risk Evaluation» think total vascular risk Assess the risk Set the targets Act to get to goal revised; aupril
More informationThe CAIDE Dementia Risk Score App: The development of an evidence-based mobile application to predict the risk of dementia
Alzheimer s & Dementia: Diagnosis, Assessment & Disease Monitoring 1 (2015) 328-333 Diagnostic Assessment & Prognosis The CAIDE Dementia Risk Score App: The development of an evidence-based mobile application
More informationHeart Disease Genesis
Heart Disease Genesis The Ultimate Lecture on CAD origins Petr Polasek MD FRCPC FACC Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be reproduced, copied, stored,
More informationIschemic Heart and Cerebrovascular Disease. Harold E. Lebovitz, MD, FACE Kathmandu November 2010
Ischemic Heart and Cerebrovascular Disease Harold E. Lebovitz, MD, FACE Kathmandu November 2010 Relationships Between Diabetes and Ischemic Heart Disease Risk of Cardiovascular Disease in Different Categories
More informationRisk Factor Reduction and Dementia Prevalence Deborah E. Barnes, PhD, MPH
Risk Factor Reduction and Dementia Prevalence Deborah E. Barnes, PhD, MPH Associate Professor Psychiatry and Epidemiology & Biostatistics University of California, San Francisco San Francisco VA Medical
More informationInternational model for prevention of chronic disease: Finland experience
International model for prevention of chronic disease: Finland experience Erkki Vartiainen, MD, Professor, Assistant Director General 06/12/2011 Erkki Vartiainen 1 2 Start of the North Karelia project
More informationprogramme. The DE-PLAN follow up.
What are the long term results and determinants of outcomes in primary health care diabetes prevention programme. The DE-PLAN follow up. Aleksandra Gilis-Januszewska, Noël C Barengo, Jaana Lindström, Ewa
More informationObjectives. Describe results and implications of recent landmark hypertension trials
Hypertension Update Daniel Schwartz, MD Assistant Professor of Medicine Associate Medical Director of Heart Transplantation Temple University School of Medicine Disclosures I currently have no relationships
More informationNutritional Risk Factors for Peripheral Vascular Disease: Does Diet Play a Role?
Nutritional Risk Factors for Peripheral Vascular Disease: Does Diet Play a Role? John S. Lane MD, Cheryl P. Magno MPH, Karen T. Lane MD, Tyler Chan BS, Sheldon Greenfield MD University of California, Irvine
More informationIs there a mechanism of interaction between hypertension and dyslipidaemia?
Is there a mechanism of interaction between hypertension and dyslipidaemia? Neil R Poulter International Centre for Circulatory Health NHLI, Imperial College London Daegu, Korea April 2005 Observational
More informationFact Sheet Alzheimer s disease
What is Alzheimer s disease Fact Sheet Alzheimer s disease Alzheimer s disease, AD, is a progressive brain disorder that gradually destroys a person s memory and ability to learn, reason, make judgements,
More informationDEMENTIA? 45 Million. What is. WHAT IS DEMENTIA Dementia is a disturbance in a group of mental processes including: 70% Dementia is not a disease
What is PRESENTS DEMENTIA? WHAT IS DEMENTIA Dementia is a disturbance in a group of mental processes including: Memory Reasoning Planning Learning Attention Language Perception Behavior AS OF 2013 There
More informationThe incidence and prevalence of dementia are expected to increase several-fold in the
NEUROLOGICAL REVIEW Promising Strategies for the Prevention of Dementia Laura E. Middleton, PhD; Kristine Yaffe, MD The incidence and prevalence of dementia are expected to increase several-fold in the
More informationStatins and Cognition A Focus on Mechanisms
Statins and Cognition A Focus on Mechanisms Note: Deleted copyrighted graphs/tables are described In red text and source references are provided Disclosures: SPARCL Steering Committee and past consultant
More informationDyslipidemia in women: Who should be treated and how?
Dyslipidemia in women: Who should be treated and how? Lale Tokgozoglu, MD, FACC, FESC Professor of Cardiology Hacettepe University Faculty of Medicine Ankara, Turkey. Cause of Death in Women: European
More informationInterventions to Prevent Age- Related Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer s-type Dementia
Interventions to Prevent Age- Related Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer s-type Dementia Minnesota Evidence-based Practice Center for the Health and Medicine Division,
More informationSocioeconomic status and the 25x25 risk factors as determinants of premature mortality: a multicohort study of 1.7 million men and women
Socioeconomic status and the 25x25 risk factors as determinants of premature mortality: a multicohort study of 1.7 million men and women (Lancet. 2017 Mar 25;389(10075):1229-1237) 1 Silvia STRINGHINI Senior
More informationDementia risk factors for Australian baby boomers
Neurology International 2010; volume 2:e13 Dementia risk factors for Australian baby boomers Peter K. Panegyres, Victoria Gray Neurodegenerative Disorders Research, Subiaco, Western Australia Abstract
More informationSecondary prevention and systems approaches: Lessons from EUROASPIRE and EUROACTION
Secondary prevention and systems approaches: Lessons from EUROASPIRE and EUROACTION Dr Kornelia Kotseva National Heart & Lung Insitute Imperial College London, UK on behalf of all investigators participating
More informationALZHEIMER S DISEASE OVERVIEW. Jeffrey Cummings, MD, ScD Cleveland Clinic Lou Ruvo Center for Brain Health
ALZHEIMER S DISEASE OVERVIEW Jeffrey Cummings, MD, ScD Cleveland Clinic Lou Ruvo Center for Brain Health Prevalence AD: DEMOGRAPHY AND CLINICAL FEATURES Risk and protective factors Clinical features and
More informationDisclosures. Diabetes and Cardiovascular Risk Management. Learning Objectives. Atherosclerotic Cardiovascular Disease
Disclosures Diabetes and Cardiovascular Risk Management Tony Hampton, MD, MBA Medical Director Advocate Aurora Operating System Advocate Aurora Healthcare Downers Grove, IL No conflicts or disclosures
More informationEFFECT OF PLANT SOURCE DIETARY INTAKE ON BLOOD PRESSURE OF ADULTS IN BAYELSA STATE
EFFECT OF PLANT SOURCE DIETARY INTAKE ON BLOOD PRESSURE OF ADULTS IN BAYELSA STATE 1 Dr. Olusegun, A. Kuforiji & 2 John Samuel 1 Department of Agricultural Technology, Federal Polytechnic, Ekowe, Bayelsa
More informationThe current state of healthcare for Normal Aging, Mild Cognitive Impairment, & Alzheimer s Disease
The current state of healthcare for Normal Aging, g, Mild Cognitive Impairment, & Alzheimer s Disease William Rodman Shankle, MS MD FACP Director, Alzheimer s Program, Hoag Neurosciences Institute Neurologist,
More informationMild Cognitive Impairment
Mild Cognitive Impairment Victor W. Henderson, MD, MS Departments of Health Research & Policy (Epidemiology) and of Neurology & Neurological Sciences Stanford University Director, Stanford Alzheimer s
More information8/14/2018. The Evolving Concept of Alzheimer s Disease. Epochs of AD Research. Diagnostic schemes have evolved with the research
The Evolving Concept of Alzheimer s Disease David S. Geldmacher, MD, FACP Warren Family Endowed Chair in Neurology Department of Neurology UAB School of Medicine Epochs of AD Research Epoch Years Key Event
More informationUnderstanding new international guidelines to tackle CV Risk: A practical model John Deanfield, MD UCL, London United Kingdom s
Understanding new international guidelines to tackle CV Risk: A practical model John Deanfield, MD UCL, London United Kingdom s Ho Chi Minh City, Vietnam August 7, 2014 JBS 2 Risk Guidelines (2005) Based
More informationStroke secondary prevention. Gill Cluckie Stroke Nurse Consultant St. George s Hospital
Stroke secondary prevention Gill Cluckie Stroke Nurse Consultant St. George s Hospital Stroke recurrence The risk of recurrent stroke is greatest after first stroke 2 3% of survivors of a first stroke
More informationRisk Factors for NCDs
Risk Factors for NCDs Objectives: Define selected risk factors such as; tobacco use, diet, nutrition, physical activity, obesity, and overweight Present the epidemiology and significance of the risk factors
More informationOscar L. Lopez, M.D. Departments of Neurology and Psychiatry Alzheimer s Disease Research Center University of Pittsburgh School of Medicine
14th Annual Mild Cognitive Impairment Symposium The Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center Miami, Florida Markers of inflammation and immune activation, small
More informationCONSULTATION DRAFT NATIONAL PREVENTIVE HEALTH RESEARCH STRATEGY ( )
7 September 2012 Ms Louise Sylvan Chief Executive Officer Australian National Preventive Health Agency GPO Box 462 CANNBERRA ACT 2601 Dear Louise CONSULTATION DRAFT NATIONAL PREVENTIVE HEALTH RESEARCH
More informationDifferent worlds, different tasks for health promotion: comparisons of health risk profiles in Chinese and Finnish rural people
HEALTH PROMOTION INTERNATIONAL Vol. 16, No. 4 Oxford University Press 2001. All rights reserved Printed in Great Britain Different worlds, different tasks for health promotion: comparisons of health risk
More informationThe target blood pressure in patients with diabetes is <130 mm Hg
Controversies in hypertension, About Diabetes diabetes and and metabolic Cardiovascular syndrome Risk ESC annual congress August 29, 2011 The target blood pressure in patients with diabetes is
More informationHypertension in 2015: SPRINT-ing ahead of JNC-8. MAJ Charles Magee, MD MPH FACP Director, WRNMMC Hypertension Clinic
Hypertension in 2015: SPRINT-ing ahead of JNC-8 MAJ Charles Magee, MD MPH FACP Director, WRNMMC Hypertension Clinic Conflits of interest? None Disclaimer The opinions contained herein are not to be considered
More informationThesis for doctoral degree (Ph.D.) 2007 Predictors of cognitive decline in memory clinic patients. Christin Andersson. Christin Andersson
Thesis for doctoral degree (Ph.D.) 2007 Thesis for doctoral degree (Ph.D.) 2007 Predictors of cognitive decline in memory clinic patients Christin Andersson Predictors of cognitive decline in memory clinic
More informationCould physical activity delay cognitive decline in older adults with vascular risk factors? The AIBL active study
RASAD 26-29 March 2012 Melbourne, Australia Could physical activity delay cognitive decline in older adults with vascular risk factors? The AIBL active study Nicola T Lautenschlager Professor of Psychiatry
More informationT. Suithichaiyakul Cardiomed Chula
T. Suithichaiyakul Cardiomed Chula The cardiovascular (CV) continuum: role of risk factors Endothelial Dysfunction Atherosclerosis and left ventricular hypertrophy Myocardial infarction & stroke Endothelial
More informationMild Cognitive Impairment (MCI)
October 19, 2018 Mild Cognitive Impairment (MCI) Yonas E. Geda, MD, MSc Professor of Neurology and Psychiatry Consultant, Departments of Psychiatry & Psychology, and Neurology Mayo Clinic College of Medicine
More informationNo response (n 210) Declined (n 728) Lost during run-in (n 233) Lost before baseline (n 350) randomisation (n 69)
All men and women aged 55 74 years from city of Kuopio (n 16 010) Random sample invited to the study in 2002 (n 3000) No response (n 210) Respondents (n 2790) Willing to participate (n 2062) Randomised
More informationProfessor Norman Sharpe. Heart Foundation West Coast
Professor Norman Sharpe Heart Foundation West Coast Primary Care the Keystone to Heart Health Improvement Norman Sharpe June 2013 The heart health continuum and the keystone position The culprit disease
More informationUNIVERSITY OF WESTERN ONTARIO
UNIVERSITY OF WESTERN ONTARIO Vladimir Hachinski, CM, MD, FRCPC, DSc Department of Clinical Neurological Sciences University of Western Ontario London, Ontario, Canada Vladimir.hachinski@lhsc.on.ca ALZHEIMER
More information