Dr. Miia KivipeltoProfessor of Clinical Geriatric Epidemiology at the Department of Neurobiology,
Care Sciences and Societ...
Is it possible to
prevent
Alzheimer’s disease?
Karolinska Institutet
Alzheimer Disease Research Center and
Aging Research ...
What is dementia?
Dementia is not a specific disease.
It is an “umbrella term” used to describe the symptoms of a group of ...
What is dementia?
Dementia is not a specific disease.
It is an “umbrella term” used to describe the symptoms of a group of ...
What is dementia?
Dementia is not a specific disease.
It is an “umbrella term” used to describe the symptoms of a group of ...
Alzheimer’s Disease
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13
Alzheimer’s Disease
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13
What are the symptoms of Alzheimer’s ?
Memory loss:
Short-term memory
Dementia is progressive: as time advances, symptoms ...
Dementia is progressive: as time advances, symptoms worsen.
Ability to focus &
concentrate:
E.g. following a
conversation
...
Memory loss is a
normal part of aging
Common incorrect belief
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13
Now we know that dementia is NOT a normal part of aging
Memory loss is a
normal part of aging
Common incorrect belief
Miia...
Now we know that dementia is NOT a normal part of aging
Memory loss is a
normal part of aging
Common incorrect belief
If w...
Expected lifetime
(Christensen et al. Lancet 2009)
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13
CIA World Factbook 2012, Estimated Life Expectancy at Birth.
+80 +77 +75 +72 +70 +67
Expected lifetime
Miia Kivipelto, MD,...
The proportion of older adults (65+) will reach 28% in 2050
The aging population in the UAE
Miia Kivipelto, MD, PhD, Profe...
0
7.5
15
22.5
30
3.4 3.4 3.5
1.8 1.5 2.1 1.3 1.4 1.1 1 1 0.8 0.4 0.8 1.7
3.6
6.3
10.2
15.6
22.1
28
1950 1955 1960 1965 197...
0
7.5
15
22.5
30
3.4 3.4 3.5
1.8 1.5 2.1 1.3 1.4 1.1 1 1 0.8 0.4 0.8 1.7
3.6
6.3
10.2
15.6
22.1
28
1950 1955 1960 1965 197...
0
7.5
15
22.5
30
3.4 3.4 3.5
1.8 1.5 2.1 1.3 1.4 1.1 1 1 0.8 0.4 0.8 1.7
3.6
6.3
10.2
15.6
22.1
28
1950 1955 1960 1965 197...
(Fratiglioni, Qiu, Oxford Textbook Old Age Psychiatry, 2013)
Advanced age: A major risk factor for dementia
Age-specific pr...
Effects of Delay of Onset of Disease on Prevalence of Dementia
5 year delay in the onset of Alzheimer’s would decrease the...
Dementia: importance of life-long exposure to multiple factors
Mangialasche, Kivipelto et al., 2012
Birth
Childhood
2nd De...
Modifiable risk factors for Alzheimer’s
Risk Factors Protective Factors
Miia Kivipelto, MD, PhD, Professor
Monday, Septemb...
Modifiable risk factors for Alzheimer’s
Risk Factors Protective Factors
• Stroke
• High Blood Pressure
• High Blood Choles...
Modifiable risk factors for Alzheimer’s
Risk Factors Protective Factors
• Stroke
• High Blood Pressure
• High Blood Choles...
Combined effect of vascular risk factors at midlife
Risk
BMI
>30 kg/m
2.1
Systolic
blood
pressure
>140mmHg
2.0
Cholesterol...
Healthy, balanced diet can reduce the risk for memory problems
Luchinger et al., Curr Neurol Neurosci Rep 2007 - Scarmeas ...
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13
Rovio, Kivipelto et al., Lancet Neurology 2005 Rovio, Kivipelto, et al. Neurobiol Aging 2009
Physical activity at midlife
...
Rovio, Kivipelto et al., Lancet Neurology 2005 Rovio, Kivipelto, et al. Neurobiol Aging 2009
Physical activity at midlife
...
Rovio, Kivipelto et al., Lancet Neurology 2005 Rovio, Kivipelto, et al. Neurobiol Aging 2009
Physical activity at midlife
...
(Karp et al, Dement Geriatr Cogn Disord 2005)
Leisure time activities in late life
0
0.25
0.5
0.75
1
High Mental Score Hig...
Håkansson, Kivipelto et al., BMJ 2009 Håkansson et al., manuscript
Social and psychological factors
Social Factors Psychol...
Håkansson, Kivipelto et al., BMJ 2009 Håkansson et al., manuscript
Social and psychological factors
Social Factors Psychol...
Håkansson, Kivipelto et al., BMJ 2009 Håkansson et al., manuscript
Social and psychological factors
Social Factors Psychol...
Loneliness
Loneliness
FUTURE
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13
Loneliness
Loneliness
FUTURE
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13
Clinical Trials
Finnish Geriatric Intervention Study to Prevent Cognitive
Impairment and Disability (FINGER)
Miia Kivipelt...
Intervention Schedule
NUTRITION
EXERCISE
COGNITIVE TRAINING
MONITORING AND MANAGEMENT OF
METABOLIC AND VASCULAR RISK FACTO...
FINGER intervention
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13
European Dementia Prevention Initiative
EDPI%
http://www.edpi.org/
Finnish Geriatric Intervention Study to Prevent Cogniti...
Healthy Aging Through Internet Counseling in the Elderly
www.HATICE.eu
Miia Kivipelto, MD, PhD, Professor
New use of techn...
(Mangialasche, Winblad, Kivipelto, et al., Lancet Neurol 2010)
Drug development in Alzheimer’s Disease
Miia Kivipelto, MD,...
Is it possible to prevent dementia?
•Control blood pressure and other vascular risk factors
•Be active and maintain an act...
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13
LIFE MATTERS !
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13
THANK YOU
Karolinska Institutet
Alzheimer Disease Research Center and
Aging Research Center, Sweden
Miia Kivipelto, MD, Ph...
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Is it possible to prevent 
Alzheimer’s disease? | Dr. Miia Kivipelto

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Dr. Miia Kivipelto, the Deputy Head at the Aging Research Center and Alzheimer Disease Research Center at Karolinska Institute. Dr. Miia has conducted extensive research and is a recipient of numerous awards such as the Academy of Finland Award for Social Impact and the Junior Chamber International Award as Outstanding Young Person.

Muntada is an innovative platform for sharing new ideas that stimulate creative thinking, learning and active discussions. It is through presenting enriching and locally relevant topics that Muntada aims to inform, update and empower the local community.
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Is it possible to prevent 
Alzheimer’s disease? | Dr. Miia Kivipelto

  1. 1. Dr. Miia KivipeltoProfessor of Clinical Geriatric Epidemiology at the Department of Neurobiology, Care Sciences and Society Karolinska Institutet Sweden Monday, September 16, 13
  2. 2. Is it possible to prevent Alzheimer’s disease? Karolinska Institutet Alzheimer Disease Research Center and Aging Research Center, Sweden Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  3. 3. What is dementia? Dementia is not a specific disease. It is an “umbrella term” used to describe the symptoms of a group of conditions that impair memory, behaviors and thinking. DEMENTIA Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  4. 4. What is dementia? Dementia is not a specific disease. It is an “umbrella term” used to describe the symptoms of a group of conditions that impair memory, behaviors and thinking. 60-80% DEMENTIA ALZHEIMER’S Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  5. 5. What is dementia? Dementia is not a specific disease. It is an “umbrella term” used to describe the symptoms of a group of conditions that impair memory, behaviors and thinking. 60-80% Vascular Dementia Dementia with Lewy Bodies Fronto-temporal Dementia Parkinson’s Disease DEMENTIA ALZHEIMER’S Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  6. 6. Alzheimer’s Disease Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  7. 7. Alzheimer’s Disease Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  8. 8. What are the symptoms of Alzheimer’s ? Memory loss: Short-term memory Dementia is progressive: as time advances, symptoms worsen. Communication difficulties: finding the right words, understanding what is said Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  9. 9. Dementia is progressive: as time advances, symptoms worsen. Ability to focus & concentrate: E.g. following a conversation Mood changes: Sadness, anger, fear, irritability… Miia Kivipelto, MD, PhD, Professor What are the symptoms of Alzheimer’s ? Monday, September 16, 13
  10. 10. Memory loss is a normal part of aging Common incorrect belief Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  11. 11. Now we know that dementia is NOT a normal part of aging Memory loss is a normal part of aging Common incorrect belief Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  12. 12. Now we know that dementia is NOT a normal part of aging Memory loss is a normal part of aging Common incorrect belief If we have a family member who is showing signs of dementia, it is important to see a doctor to determine the cause & follow the patient. Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  13. 13. Expected lifetime (Christensen et al. Lancet 2009) Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  14. 14. CIA World Factbook 2012, Estimated Life Expectancy at Birth. +80 +77 +75 +72 +70 +67 Expected lifetime Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  15. 15. The proportion of older adults (65+) will reach 28% in 2050 The aging population in the UAE Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  16. 16. 0 7.5 15 22.5 30 3.4 3.4 3.5 1.8 1.5 2.1 1.3 1.4 1.1 1 1 0.8 0.4 0.8 1.7 3.6 6.3 10.2 15.6 22.1 28 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050 The proportion of older adults (65+) will reach 28% in 2050 The aging population in the UAE Trends of UAE’s Elderly Population, 1950 - 2050 Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  17. 17. 0 7.5 15 22.5 30 3.4 3.4 3.5 1.8 1.5 2.1 1.3 1.4 1.1 1 1 0.8 0.4 0.8 1.7 3.6 6.3 10.2 15.6 22.1 28 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050 The proportion of older adults (65+) will reach 28% in 2050 The aging population in the UAE Trends of UAE’s Elderly Population, 1950 - 2050 Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  18. 18. 0 7.5 15 22.5 30 3.4 3.4 3.5 1.8 1.5 2.1 1.3 1.4 1.1 1 1 0.8 0.4 0.8 1.7 3.6 6.3 10.2 15.6 22.1 28 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050 The proportion of older adults (65+) will reach 28% in 2050 The aging population in the UAE Trends of UAE’s Elderly Population, 1950 - 2050 Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  19. 19. (Fratiglioni, Qiu, Oxford Textbook Old Age Psychiatry, 2013) Advanced age: A major risk factor for dementia Age-specific prevalence rates of dementia across the world Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  20. 20. Effects of Delay of Onset of Disease on Prevalence of Dementia 5 year delay in the onset of Alzheimer’s would decrease the disease prevalence by 50% USprevalenceofAD(millions) Delay (years) 0 .5 1 2 5 1997 2007 2017 2027 2037 2047 Year 8 6 4 2 0 Brookmeyer et al., 1998, Jorm et al., 2005 Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  21. 21. Dementia: importance of life-long exposure to multiple factors Mangialasche, Kivipelto et al., 2012 Birth Childhood 2nd Decade Adult Life - Middle Age Transition Old Age 0 20 60 75 Genetic EnvironmentHealthy Brain Alzheimer’s Brain Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  22. 22. Modifiable risk factors for Alzheimer’s Risk Factors Protective Factors Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  23. 23. Modifiable risk factors for Alzheimer’s Risk Factors Protective Factors • Stroke • High Blood Pressure • High Blood Cholesterol • Obesity • Diabetes mellitus • Smoking • Depression/stress • Head trauma • ? Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  24. 24. Modifiable risk factors for Alzheimer’s Risk Factors Protective Factors • Stroke • High Blood Pressure • High Blood Cholesterol • Obesity • Diabetes mellitus • Smoking • Depression/stress • Head trauma • ? • High education • Physical activity • Active lifestyle • Antioxidants • Fish oils • Coffee • Antihypertensives • Statins Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  25. 25. Combined effect of vascular risk factors at midlife Risk BMI >30 kg/m 2.1 Systolic blood pressure >140mmHg 2.0 Cholesterol >6.5 mmol/l 1.9 Kivipelto et al., Arch Neurol 2005 0 1.75 3.50 5.25 7.00 0 1 2 3 6 3 11 Number of risk factors present 2 Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  26. 26. Healthy, balanced diet can reduce the risk for memory problems Luchinger et al., Curr Neurol Neurosci Rep 2007 - Scarmeas et al., Annals of Neurology 2006, JAMA 2009 - Mangialasche, Kivipelto et al., JAD 2010 • Fish • Vegetables and fruits • Vitamins B, C and E Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  27. 27. Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  28. 28. Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  29. 29. Rovio, Kivipelto et al., Lancet Neurology 2005 Rovio, Kivipelto, et al. Neurobiol Aging 2009 Physical activity at midlife Couch Potatoes Dementia Alzheimer’s Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  30. 30. Rovio, Kivipelto et al., Lancet Neurology 2005 Rovio, Kivipelto, et al. Neurobiol Aging 2009 Physical activity at midlife 0.25 0.5 0.75 1 Couch Potatoes Dementia Alzheimer’s Reduced Risk Miia Kivipelto, MD, PhD, Professor 100% 60% 70% Monday, September 16, 13
  31. 31. Rovio, Kivipelto et al., Lancet Neurology 2005 Rovio, Kivipelto, et al. Neurobiol Aging 2009 Physical activity at midlife Physical activity – larger brain volume Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  32. 32. (Karp et al, Dement Geriatr Cogn Disord 2005) Leisure time activities in late life 0 0.25 0.5 0.75 1 High Mental Score High Physical Score High Social Score Low Score Miia Kivipelto, MD, PhD, Professor 30% 40% 35% 100% Reduced Risk Monday, September 16, 13
  33. 33. Håkansson, Kivipelto et al., BMJ 2009 Håkansson et al., manuscript Social and psychological factors Social Factors Psychological factors Social+psychological Loneliness 0 1.5 3 4.5 6 Risk Risk Living Alone Being Widowed Hopelessness Alone+Lonely Widowed+ Hopelessness Loneliness Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  34. 34. Håkansson, Kivipelto et al., BMJ 2009 Håkansson et al., manuscript Social and psychological factors Social Factors Psychological factors Social+psychological Loneliness 0 1.5 3 4.5 6 Risk Risk Living Alone Being Widowed Hopelessness Alone+Lonely Widowed+ Hopelessness Loneliness Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  35. 35. Håkansson, Kivipelto et al., BMJ 2009 Håkansson et al., manuscript Social and psychological factors Social Factors Psychological factors Social+psychological Loneliness 0 1.5 3 4.5 6 Risk Risk Living Alone Being Widowed Hopelessness Alone+Lonely Widowed+ Hopelessness Loneliness Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  36. 36. Loneliness Loneliness FUTURE Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  37. 37. Loneliness Loneliness FUTURE Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  38. 38. Clinical Trials Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  39. 39. Intervention Schedule NUTRITION EXERCISE COGNITIVE TRAINING MONITORING AND MANAGEMENT OF METABOLIC AND VASCULAR RISK FACTORS INTENSIVE INTERVENTION InterventionKick-Off Screening 1stBaselinevisit 2ndBaselinevisit RANDOMIZATION Months 3 6 9 12 15 18 21 24 Mini Intervention Miia Kivipelto, MD, PhD, Professor REGULAR HEALTH ADVICE Monday, September 16, 13
  40. 40. FINGER intervention Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  41. 41. European Dementia Prevention Initiative EDPI% http://www.edpi.org/ Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability Prevention of Dementia by Intensive Vascular Care MAPT Multidomain Alzheimer Preventive Trial FINGER preDIVA MAPT Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  42. 42. Healthy Aging Through Internet Counseling in the Elderly www.HATICE.eu Miia Kivipelto, MD, PhD, Professor New use of technology to improve dementia prevention Monday, September 16, 13
  43. 43. (Mangialasche, Winblad, Kivipelto, et al., Lancet Neurol 2010) Drug development in Alzheimer’s Disease Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  44. 44. Is it possible to prevent dementia? •Control blood pressure and other vascular risk factors •Be active and maintain an active life •Healthy, balanced diet •Avoid negative stress Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  45. 45. Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  46. 46. LIFE MATTERS ! Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
  47. 47. THANK YOU Karolinska Institutet Alzheimer Disease Research Center and Aging Research Center, Sweden Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13

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