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P9: Prevention

Detailed programme, abstracts and presentations

P9: Prevention

P9.1. The Hellenic longitudinal investigation of aging and diet (HELIAD): study description and preliminary data

MARGIOTI Eleni, SAKKA Paraskevi, DARDIOTIS E, KOSMIDIS MH, YANNAKOULIA M, HADJIGEORGIOU GM, SCARMEAS N.

Background: Alzheimer's disease (AD) is a progressive, irreversible neurodegenerative disease that has been described as a rapidly growing epidemic of modern societies. In Greece, population-representative, recent data concerning AD prevalence and incidence of diseases of cognitive aging are lacking. The Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) is a population-based, collaborative, multidisciplinary study designed to investigate the prevalence and incidence of Mild Cognitive Impairment (MCI), AD, other forms of dementia and other neurodegenerative brain diseases in the Greek population over the age of 65 years. The study also aims to investigate correlations between cognitive function of the elderly and other factors, such as demographic, nutritional, social and environmental.

Methods: The study is being conducted in Larissa and in Maroussi-Athens. Community-dwelling individuals have been selected to participate in the study through random sampling from municipality registries. The study is prospective in design with planned reevaluation every 3 years.

Results: In total, 1900 participants have already completed the initial evaluation and 520 have been reassessed after an average of 3 years. According to data analyses from the first subgroup of 1050 participants, they were on average 73.4±6.0 years old, 60% of the sample were female, while most of the participants were poorly educated with an average of 5.41±3.5 years of education. Preliminary data relating to demographics, neuropsychological tests, medical history, dietary habits etc. concerning the full sample will be presented in the conference. 

Conclusions: The HELIAD study may provide important data for expanding our knowledge regarding the prevalence, incidence and risk factors of dementia and several other neuropsychiatric diseases in Greece towards designing and implementing comprehensive and effective policies and strategies.

P9.2. Experiences of users in Ireland of an online intervention (In-MINDD) to support the implementation of lifestyle changes to reduce dementia risk: A qualitative exploration using Normalization Process Theory

PIERCE Maria, REDMOND Muriel, BROWNE Susan, WOOD Karen, POWER Kevin, O’DONNELL Catherine, IRVING Kate

Dementia is a serious loss of cognitive ability beyond what might be expected from normal ageing. Whilst dementia is incurable, a number of factors have been identified which can either enhance or reduce an individual’s risk of developing dementia. However, the links between dementia and modifiable risk factors are neither well known among the general public nor well addressed in primary care. In-MINDD (Innovative Midlife intervention for Dementia Deterrence), an EU FP7 funded project, seeks to address this. Using a LIfestyle for BRAin Health (LIBRA) model based on a systematic review and Delphi consensus study (Deckers et al., 2014), the In-MINDD profiler was developed to assess the presence or absence of modifiable risk factors for dementia and generate a personalized profile of person’s lifestyle for brain heath. An accompanying online environment with information and supports was developed to assist individual’s adopt and adhere to lifestyle changes to promote their brain health and potentially reduce their risk of developing dementia in later life. A feasibility randomised controlled trial (RCT) was undertaken in Ireland, France, Scotland and the Netherlands to evaluate the impact of the In-MINDD intervention on participants’ lifestyle for brain health score. The Feasibility RCT included a qualitative process evaluation underpinned by Normalisation Process Theory (NPT) and is a crucial aspect of the In-MINDD trial. In-depth interviews were carried out with participants in each of the four participating countries. This article presents the findings from in-depth interviews with participants in Ireland exploring how they comprehend dementia risk, how this impacts on their understanding/willingness to use the In-MINDD intervention, and whether they are able and willing to make/maintain lifestyle changes suggested. This use of NPT to understand why complex interventions are embedded, or not, into daily life and work has been recognised as a crucial aspect of implementation research.

P9.3. Moderate to high intensity aerobic exercise in elderly persons with Alzheimer’s disease

WALDEMAR Gunhild, HOFFMANN Kristine, SOBOL Nana A, FREDERIKSEN Kristian S, BEYER Nina, VOGEL Asmus, VESTERGAARD Karsten, BRAENDGAARD Hans, GOTTRUP Hanne, LOLK Annette, WERMUTH Lene, JACOBSEN Soeren, LAUGESEN Lars P, GERGELYFFY Robert G, HOEGH Peter, BJERREGAARD Eva, ANDERSEN Birgitte B, SIERSMA V, JOHANNSEN Peter, COTMAN Carl W, HASSELBALCH Steen G.

Introduction: Exercise has the potential to improve cognition, functional ability and quality of life, but evidence is scarce regarding the effect of moderate-to-high intensity exercise in patients with Alzheimer´s disease (AD). This was investigated in ADEX, a single blinded multi-centre RCT in patients with mild to moderate AD.

Methods: Two-hundred community-dwelling elderly persons with mild to moderate AD (MMSE score >19) were randomised to a control group receiving usual care and an intervention group receiving 16 weeks of supervised exercise (one hour three times/week, moderate-to-high intensity aerobic exercise, intended intensity of 70-80% of heart rate reserve). An extensive battery of cognitive tests, scales for neuropsychiatric symptoms, and quality of life were administered. Primary outcome was change from baseline in cognitive performance estimated by Symbol-Digit Modalities test (SDMT) in the intention-to-treat (ITT) group.

Results: One-hundred and ninety patients completed the study (mean age 71, range 50-89 years, mean MMSE-score 24, range 22-27). The ITT analysis showed a significant difference in the Neuropsychiatric Inventory in favor of the intervention group. No significant difference between intervention and control group was found in SDMT, but in subjects who adhered to the exercise protocol, we found a significant effect on SDMT in favor of the intervention group

Conclusion: This is the first completed large RCT on moderate to high intensity aerobic exercise in mild AD. Exercise appears to reduce neuropsychiatric symptoms in persons with mild AD, with additional benefits of preserved cognition in a subgroup of persons with high attendance and intensity.

P9.4. Participation in leisure activity to prevent later life cognitive decline: a systematic review of literature

FALLAHPOUR Mandana, BORELL Lena, LUBORSKY Mark, NYGÅRD Louise

Later life cognitive decline imposes restrictions in participation and dependence in everyday life on those afflicted, as well as burden of care on family and caregivers, healthcare professionals and requires considerable resources from society. Given the priority to the preventive strategies against later life cognitive decline, a large number of empirical studies have examined the link between participation in leisure activities and later life cognitive decline. This study aimed to describe the state of knowledge of the definition, categorization and operationalization of leisure activity in the empirical research that focused on preventing dementia. The analysis focused specifically on how leisure activity, dose effects and subjective aspects of leisure activity were operationalized as well as on the findings of the empirical research that focused on preventing dementia, and on discussing implications for occupational therapy. A systematic search was performed in different online databases for years 2000 to 2011, identified 52 publications for inclusion. Findings were discussed using the Model of Human Occupation and factors that might contribute to associations between participation in leisure activities and prevention of cognitive decline. The findings show that participation in leisure activities might significantly contribute to prevention of later life cognitive decline. However, important limitations were detected in terms of a lack of theoretical underpinnings, and little consensus and standardization in measuring key variables. The study reinforces the critical need to overcome these limitations to enable health care professionals to make evidence-based recommendations for increased participation in activities as a means of promoting health and preventing cognitive decline

P9.5. The voluntary action of universal prevention of dementia

HEBAR Karmen

The extract introduces intention, preparation, realisation and evaluation of the research with the topic of universal prevention of dementia, entitled: “With activities towards the quality of growing old”, carried out by a Students' voluntary club at the Institute of AMS on The day for Changes.

The action was carried out in a form of intergenerational socializing, with a participation of high school students, elderly people from the surrounding Homes for the elderly (Retirement homes), their companions and mentors of voluntary work at the Grammar school. With this action we wanted to raise participants' awareness on dementia, as well as on its risky and protective factors. We wanted to encourage them to lead a healthy lifestyle (in a social, mental and physical way), since the latter can be a protective factor for dementia. The intention of the initiative was also a stimulation of the youngsters to a prosocial behaviour towards tolerance and empathy, and to minimise the presence of possible stereotypes or prejudices and at the same time, create an individual (with dementia) friendly society.

Besides educational benefits and providing information about dementia and its risky and protective factors, this action was conducted in specific activities within workshops which, in a continuous implementation over a long period of time, can affect protectively or curatively in a milder form of dementia. In these workshops, the participants applied social and didactic games to train motor and orientation skills, social, visual, acoustic and physical abilities. We finished the action with tea and pastry and the evaluation of a meeting, in a style of “Alzheimer Café”.

After the evaluation of the action, the students showed larger awareness on dementia along with better knowledge of its protective and risky factors, as well as a high level of satisfaction with the directly gained experiences. Positive responses of all participants and their desire to organise such initiatives more frequently, have encouraged us to think about the repetition of the workshops. The action could be an example of a good practice for schools, particularly for those which include voluntary activities in their programmes.

 

 
 

Last Updated: Monday 28 September 2015

 

 
  • Acknowledgements

    The 25th AE Conference in Ljubljana received funding under an operating grant from the European Union’s Health Programme (2014-2020). Alzheimer Europe and Spominčica gratefully acknowledge the support of all conference sponsors.
  • European Union
  • Roche
  • SCA Global Hygiene
 
 

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