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Is it possible to prevent Alzheimer’s disease? | Dr. Miia Kivipelto
Dr. Miia Kivipelto discusses Alzheimer's disease, defining dementia as an umbrella term for symptoms affecting memory, behavior, and thinking. Key factors influencing the risk of Alzheimer's include advanced age, vascular risk factors, and lifestyle choices, with recommendations for prevention emphasizing active living, a balanced diet, and management of health conditions. Clinical trials such as the FINGER study suggest potential for intervention in reducing cognitive decline and dementia risk through multi-domain approaches.
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Is it possible to prevent Alzheimer’s disease? | Dr. Miia Kivipelto
- 1. Dr. Miia KivipeltoProfessorof Clinical Geriatric Epidemiology at the Department of Neurobiology, Care Sciences and Society Karolinska Institutet Sweden Monday, September 16, 13
- 2. Is it possibleto 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. What is dementia? Dementiais 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. What is dementia? Dementiais 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. What is dementia? Dementiais 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. Alzheimer’s Disease Miia Kivipelto,MD, PhD, Professor Monday, September 16, 13
- 7. Alzheimer’s Disease Miia Kivipelto,MD, PhD, Professor Monday, September 16, 13
- 8. What are thesymptoms 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. 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. Memory loss isa normal part of aging Common incorrect belief Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
- 11. Now we knowthat 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. Now we knowthat 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. Expected lifetime (Christensen etal. Lancet 2009) Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
- 14. CIA World Factbook2012, Estimated Life Expectancy at Birth. +80 +77 +75 +72 +70 +67 Expected lifetime Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
- 15. The proportion ofolder adults (65+) will reach 28% in 2050 The aging population in the UAE Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
- 16. 0 7.5 15 22.5 30 3.4 3.4 3.5 1.81.5 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. 0 7.5 15 22.5 30 3.4 3.4 3.5 1.81.5 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. 0 7.5 15 22.5 30 3.4 3.4 3.5 1.81.5 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. (Fratiglioni, Qiu, OxfordTextbook 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. Effects of Delayof 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. Dementia: importance oflife-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. Modifiable risk factorsfor Alzheimer’s Risk Factors Protective Factors Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
- 23. Modifiable risk factorsfor 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. Modifiable risk factorsfor 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. Combined effect ofvascular 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. Healthy, balanced dietcan 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. Miia Kivipelto, MD,PhD, Professor Monday, September 16, 13
- 28. Miia Kivipelto, MD,PhD, Professor Monday, September 16, 13
- 29. Rovio, Kivipelto etal., 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. Rovio, Kivipelto etal., 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. Rovio, Kivipelto etal., 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. (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. Håkansson, Kivipelto etal., 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. Håkansson, Kivipelto etal., 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. Håkansson, Kivipelto etal., 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. Loneliness Loneliness FUTURE Miia Kivipelto, MD,PhD, Professor Monday, September 16, 13
- 37. Loneliness Loneliness FUTURE Miia Kivipelto, MD,PhD, Professor Monday, September 16, 13
- 38. Clinical Trials Finnish GeriatricIntervention Study to Prevent Cognitive Impairment and Disability (FINGER) Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
- 39. Intervention Schedule NUTRITION EXERCISE COGNITIVE TRAINING MONITORINGAND 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. FINGER intervention Miia Kivipelto,MD, PhD, Professor Monday, September 16, 13
- 41. European Dementia PreventionInitiative 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. Healthy Aging ThroughInternet 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. (Mangialasche, Winblad, Kivipelto,et al., Lancet Neurol 2010) Drug development in Alzheimer’s Disease Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13
- 44. Is it possibleto 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. Miia Kivipelto, MD,PhD, Professor Monday, September 16, 13
- 46. LIFE MATTERS ! MiiaKivipelto, MD, PhD, Professor Monday, September 16, 13
- 47. THANK YOU Karolinska Institutet AlzheimerDisease Research Center and Aging Research Center, Sweden Miia Kivipelto, MD, PhD, Professor Monday, September 16, 13