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P11. INTERDEM: Interdisciplinary research in dementia: interaction between biological and psychosocial factors in the onset and the course of dementia

Detailed programme, abstracts and presentations

Dementia is a disorder including a preclinical and a post-diagnostic phase. There is growing evidence on the interplay between biological and psychosocial aspects influencing the onset and the progression. Many efforts have been undertaken to reduce the risk of developing dementia and concepts such as brain reserve, cognitive reserve, brain plasticity as well as physical activity, cognitive and social engagement are seen as interactive and reciprocal influencing factors. There is growing evidence of the effectiveness of psychosocial interventions on quality of life and wellbeing of people with dementia and their caregivers.

There is also new evidence outlining the role of psychosocial and environmental factors in influencing the onset and progression of dementia by impacting on structural and functional aspects of physical health and brain plasticity as well as on symptoms of people with dementia and their caregivers. Moreover, the health condition, particularly cardiovascular factors, is involved in moderating the course of disease.

Joining effort and promoting interdisciplinary research which considers the reciprocal interactions between biological and psychosocial factors can enhance our understanding of the dementia syndrome and open new avenues to combined interventions. The aim of this session is to highlight the interaction between physical health, social health and psychological health in the prevention and in the progression of dementia.

P11.1. Social health: an opportunity to improve our cognitive reserve?

VERNOOIJ-DASSEN Myrra

Radboud University medical center, Nijmegen, Nederlands

Within the complex multifactorial etiological framework of dementia, several risk factors have been identified during the past years, ranging from specific genetic variants to lifestyle and vascular risk factors. Social health, conceptualized as the influence of social and environmental resources in finding a balance between capacities and limitations offers a new avenue in dementia research. Increasing evidence is accumulating that environmental factors that indicate poor social health such as lack of social support and loneliness are presumed to increase the risk of dementia, while a combination of physical, mental and social activities seems to contribute to brain reserve. The working mechanisms have also been subject of investigation. It has been found that social networks modify the relation of neuropathology to cognition. In addition, cognitive interventions caused changes in brain activation patterns. Social health aspects may contribute to brain reserve and might also be crucial in optimally using the plasticity of the brain. Early interventions based on these factors (e.g. increased social interaction) might contribute to the delay of the onset of dementia. In the SHIMMY study we aim to identify how social factors contribute to the pathophysiology of cognitive decline and develop an intervention protocol directed at social health improvement in persons at risk for dementia. Social health might be a major resource for a breakthrough in the current paucity in dementia research when integrated in eco-bio-psychosocial models.

P11.2. Social Health of People with Dementia in the Community – Results of the DemNet-D-Study in Germany

WOLF-OSTERMANN Karin1, SCHMIDT Annika1, GRÄSKE Johannes2, THYRIAN Jochen René3, HOLLE Bernhard4, SCHÄFER-WALKMANN Susanne5

1University of Bremen, Bremen, Germany, 2University of Applied Sciences in Saarbrücken, Saarbrücken, Germany, 3German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany, 4German Center for Neurodegenerative Diseases (DZNE), Witten, Germany, 5Baden-Wuerttemberg Cooperative State University, Stuttgart, Germany

Background: Worldwide great efforts are directed at supporting people with dementia (PwD) and their relatives in their own living arrangements since the number of PwD is growing rapidly. During the last year’s local dementia care networks (DCN) evolved in Germany, offering multiprofessional care and support by medical doctors, health care services, therapists, local authorities, volunteers etc. for PwD.

Objectives: The objective is to raise knowledge about health related outcomes of PwD being supported by DCN in Germany and their development over time to prove effectiveness in terms of organizing better support for PwD and their relatives

Methods: In the multi-centred, multi-professional, DemNet-D study (2012-2015) health-related outcomes of PwD supported by 13 DCN all over Germany were evaluated in a one-year follow-up. Data on quality of life (QoL-AD), social inclusion (SACA) and remaining in own apartment. as well as severity of dementia (FAST), challenging behavior (CMAI), functional abilities (IADL), and depression (GDS) were collected in face to face interviews with PwD and/or their informal caregivers.

Results: 13 DCN with altogether 560 PwD and 452 relatives took part in the study, including urban as well as rural areas. PwD mostly have a severe dementia but still report a moderate quality of life and sufficient social participation which remains almost stable over one-year follow-up. Satisfaction with care and support by DCN is reported to be high. Only a small number of PwD being cared for by DCN moved into a nursing home during follow-up.

Conclusion: DCN are a community-based approach to improve care and social health of PwD. Tailoring care to preserve persons ‘normal routines and living environments as much and as long as possible as well as partnering with PwD and their families and empowering them may be a promising way to deliver person-centered care in the community.

P11.3. Factors moderating cognitive decline during the course of dementia: a review of literature.

CHATTAT Rabih, OTTOBONI Giovanni, MARIANI Elena

University of Bologna, Bologna, Italy

The progression of dementia is variable and between 30% and 58% are considered as slower decliners. Little is known about factors influencing the progression of cognitive and functional decline.  Research on psychosocial interventions in dementia support the impact on quality of life and well-being of both people with dementia and their caregivers. The aim of the review is to highlight modifiable factors which can slow the progression of the disease in the post-diagnostic phase.

A literature search regarding the last 10 years had been developed focusing on post-diagnostic phase and factors related to the rate of disease progression.

Results:the rate of cognitive decline is influenced by a number of both health related as well as psychosocial factors. Within the most important health related factors cardiovascular disease during the course of dementia and the use of cholinesterase inhibitors are associated with a slower rate of decline;  within the psychosocial domain the care environment, the engagement in cognitive stimulating activities combined with social participation, the quality and the closeness of the caregiver care-recipient relationship , the personality of the caregivers and a problem solving oriented coping strategies are also correlated with a slow rate of decline. The mechanism underlying the potential impact of these factors are not clear but some evidences outline the role of brain plasticity and brain compensatory mechanism at least in the early stage of Alzheimer disease sensitive to psychosocial interventions.

Conclusion:Psychosocial interventions combined with medical treatments can modulate the progression of the disease. More research are needed to explain the potential underlying mechanism. The social interaction and dyads relationship play an important role.

 

 

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Last Updated: Tuesday 13 November 2018

 

 
  • Acknowledgements

    The 28th AE Conference in Barcelona received funding under an operating grant from the European Union’s Health Programme (2014-2020). Alzheimer Europe, CEAFA and Fundación Alzheimer España gratefully acknowledge the support of all conference sponsors.
  • European Union
  • Roche
 
 

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