0 holmerova moderator dementia ifa

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0 holmerova moderator dementia ifa

  1. 1. Dementia and its impact Iva Holmerová
  2. 2. Dementia history1907 – 1 case of dementiaÜber eine eigenartige Erkrankung der Hirnrinde. Allgemeine Zeitschrift für Psychiatrie 64:146-148ALOIS ALZHEIMER Amyloid. plaky Neurofib. klubka
  3. 3. •OSKAR FISCHER 1876- 1942 (Slaný - KZ Teresienstadt) Worked in the Department of Pathology, Psychiatric Department, Charles University in PragueOskar Fischer, 1876 - 1942
  4. 4. 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 ofdementia. Brain 2008.
  5. 5. Arnold Pick (1851-1925)• 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)
  6. 6. Prevalence of serious diseases and age (FR PRES 2008, P.Amouyel) 40 30 Dementia Cases / 100 20 Stroke 10 Parkinson 0 60 70 80 90 100 Age (years)
  7. 7. Disease burdenH.Brodaty (Paris Alzheimer, 2008):- 19th century – infections- 20th century – cardiovascular and oncological diseases- 21st century – neurodegeneration
  8. 8. 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…
  9. 9. 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)
  10. 10. Persons with dementia - numbers (dle ADI 2008, EuroCoDe)EU 2011 Czech Republic: 2000 – 88 0008 100 000 2005 – 95 000 2010 – 111 000CZ 2011 2015 – 124 000110 000 - 140 000 2020 – 138 000 2025 – 157 000Globally 2030 – 180 000 2035 – 202 00039 000 000 2040 – 213 000 2045 – 218 000 2050 – 227 000
  11. 11. 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…)
  12. 12. Syndrom of dementia (ABC)• ADLs – impaired self-sufficiency• Behavioral and psychological symptoms• Cognitive impairment
  13. 13. 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) 14
  14. 14. 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)•
  15. 15. Five-Country Alzheimer’s Disease Survey • Designed and analyzed by the Harvard School of Public Health and 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 Dianne Gove) • 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 Interview Total Dates Interviews Margin of Error France February 7-14, 2011 529 +/-4.3% Germany February 7-19, 2011 499 +/-4.4% Poland February 7-10, 2011 509 +/-4.3% Spain February 8-13, 2011 502 +/-4.4% U.S. February 7-27, 2011 639 +/-3.9% • .
  16. 16. Public Attitudes about What Disease They AreMost Afraid of Getting, Top Three Choices France Cancer 41% Alzheimer’s 27% Stroke 18% Germany Cancer 44% Alzheimer’s 23% Stroke 14% Poland Cancer 43% Heart disease 13% Alzheimer’s 12% Spain Cancer 49% Alzheimer’s 24% Stroke 17% U.S. Cancer 40% Alzheimer’s 22% Heart disease 10%
  17. 17. Public’s Experience with Knowing Someone withAlzheimer’s Disease Know or have known someone with Alzheimer’s France 72% Germany 73% Poland 54% Spain 77% U.S. 73% And that person is/was a family member France 30% Germany 34% Poland 19% Spain 33% U.S 42%
  18. 18. Public’s Perception of Whether Alzheimer’s Is a Fatal Disease Yes, is a fatal disease France 44% Germany 33% Poland 34% Spain 42% U.S. 61% No, is not 50% France 62% Germany 55% Poland 53% Spain 35% U.S
  19. 19. Public Attitudes about Wanting to See a Doctor If They WereExhibiting Signs of Confusion and Memory Loss Yes, would want to see doctor to determine if Alzheimer’s France 88% Germany 90% Poland 85% Spain 95% U.S. 89% No, would not want to see doctor France 11% Germany 7% Poland 9% Spain 4% U.S 10%
  20. 20. Public Attitudes about Wanting a Family Member Who WasExhibiting Signs of Confusion and Memory Loss to See a Doctor Yes, would want family member to see doctor to determine if France Alzheimer’s 94% Germany 98% Poland 97% Spain 99% U.S. 98% No, would not want family member to see doctor France 6% Germany 1% Poland 2% Spain 1% 2% U.S
  21. 21. Public Attitudes about Wanting to Be ToldIf A Doctor Believed They Had Alzheimer’s Disease Yes, would want to be told France 97% Germany 98% Poland 96% Spain 94% No, would not want to be told 3% France Germany 2% Poland 2% Spain 5% This question not asked in U.S.
  22. 22. Public Attitudes about Wanting a Family Member to Be ToldIf 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 84% Germany 87% Poland 80% Spain 81% No, would not want family member to be told France 10% Germany 9% Poland 11% Spain 13% This question not asked in U
  23. 23. Public’s Interest in Getting a Test Before Exhibiting Symptoms to Determine IfThey Were Likely to Get Alzheimer’s in the Future, Should Such a Test BecomeAvailable Very likely to get such a test France 26% Germany 23% Poland 30% Spain 39% U.S. 30% Somewhat likely France 39% Germany 28% Poland 48% Spain 32% U.S 35% Not too/not at all likely France 33% Germany 48% Poland 20% Spain 27% U.S 35%
  24. 24. Public’s Perception of Whether There Is Or Will Be an Effective Medical orPharmaceutical Treatment to Slow the Progression of Alzheimer’s Disease inthe Next Five Years There is an effective treatment now France 40% Germany 42% Poland 63% Spain 27% U.S. 47% There will be an effective treatment in next five years France 31% Germany 14% Poland 7% Spain 26% U.S 24% Is not an effective treatment now/will not be one in five years France 18% Germany 19% Poland 8% Spain 18% U.S 18%
  25. 25. Children book – The Magic Tape Recorder Supported by Krka

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