12^th World Congress on Advances and Innovations in Dementia September 17-18, 2018 Singapore

Biography:

Dr Alessandra Doolan is an independent healthcare consultant specialising in health economics, advocacy and policy. Alessandra obtained her PhD in clinical research and Master of Public Health at the University of Sydney, majoring in Health Economics and Policy Research. Alessandra has over 20 years of experience in healthcare in the public and private sectors including the areas of community care, allied health, and hospital quality management systems (QMS). 

Abstract:

Statement of the Problem: In Australia, there are more than 400,000 individuals living with dementia. The number of people with dementia is estimated to increase to more than 500,000 by 2025, and over 1,000,000 by 2050. Dementia is a major cause of disability in older Australians – nearly 95% of individuals living with dementia are aged 65 years or older. The estimated economic burden of dementia in Australia costs around $14 billion (2016) and is expected to increase more than double by 2050.  Currently, around 75% of Australians with dementia live in the community. Projections suggest future demand for carers will not be met.

Innovative technologies are increasing the possibility for people with dementia to remain living independently at home. Evidence shows that being able to stay at home and performing similar routines prior to diagnosis can slow the progression of dementia. However, as the disorder progresses, it is important that the dementia sufferer has access to in-home services and support from doctors, allied health services, carers, and family. Home modifications to improve mobility and accessibility may become necessary. Despite the high costs associated to living at home for people with dementia, the cost is 85% less on average compared to the costs for those living in residential aged care setting.

Conclusion and significance: With the growing burden of dementia in Australia, there is a crucial need to develop a comprehensive holistic national approach to improving the quality of care and support for people with dementia living in the community. Health policies to be implemented to increase accessibility to safe and cost-effective technologies that improves the quality of life of people with dementia to continue living independently in the community.

 

Biography:

Tom Duncan is a postdoctoral researcher at the University of Sydney. His background is in histology, cell biology, and regenerative medicine. At the University of Sydney he manages Australia’s first Canine Brain Bank, and leads research into the neuropathology of canine dementia and the development of an autologous cell therapy for human Alzheimer’s disease. Utilizing canine dementia as a translational model, Tom is involved in a world-first phase I veterinary clinical trial of a cell therapy treating community dogs with dementia. Tom supervises a team of postgraduate students in research projects using advanced microscopy and microanalysis technique to characterize neuropathology and neurogenesis in animal models. He also lecturers at the University of Sydney on neuroscience, regenerative medicine, and human anatomy and histology. 

Abstract:

Dementia currently affects 50 million individuals worldwide, with projections of 130 million by the year 2050. Due to limited progress in medical management dementia remains an incurable and fatal disorder. The underlying clinicopathologic issue in early Alzheimer’s dementia is mass neuronal loss in the hippocampus. Repopulation by exogenous neural precursors is a promising therapeutic strategy but has yet to reach clinical trial. One of the major challenges has been poor translational fidelity between rodents and humans. We have therefore focused on Canine Cognitive Dysfunction (CCD), a neurodegenerative disorder in older pet dogs with many parallels to human Alzheimer’s dementia. Dogs with CCD display amnesia, spatial disorientation and agitation, and express neurodegeneration alongside Alzheimer pathology. To date, we have produced >50 genetically non-modified neural precursor cell lines from adult canine skin, termed SKNs. These are highly homogenous in culture, rate-limited by virtue of low number of maximal cell doublings, and differentiate almost exclusively into neurons, endogenously upregulating neuronal specification genes. We show that canine SKN transplantation into the aged rodent hippocampus is safe and leads to widespread neuronal engraftment. Donor cells become electrophysiologically active, and integrate synaptically into host neuronal circuitry. Moreover, we observe rescue of hippocampal-dependent place recognition memory deficits, with exploration ratio restored to levels equivalent with young rats. Accordingly, we are now assessing the safety and efficacy of our SKN therapy in a world-first therapeutic trial to treat dementia in a higher-order animal model. We can report that 18-months following MRI-guided intra-hippocampal injection of autogenic SKNs, two consecutive patients demonstrate stable and clinically meaningful improvement in CCD signs, such that they are functionally cured. These results are paralleled by dramatic improvements on objective spatial memory testing. These exciting early trial results indicate that SKN therapy can in-principle reverse a naturalistic dementia-like syndrome.

Biography:

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Abstract:

Background: Caregivers (CGs) of people with dementia (PWD) often experience role overload and a high level of perceived burden during caregiving. The American Psychiatric Association has recommended using a psychosocial intervention as a quality practice to enhance the self-efficacy (SE) of CGs in dementia caregiving. Methodology: Critically compare the program design through a literature review and adopting Bandura’s (1997) theoretical framework of self-efficacy, an evidence-based psychosocial intervention for dementia caregiver (PSI-CG) was worked out which aimed at enhancing the caregiving SE and reduce the perceived burden of the CG. The intervention focused on providing four types of information to bolster the caregivers’ self-efficacy. They include mastery experience, vicarious learning, verbal persuasion, and physiological and psychological feedback. The intervention consisted of three face-to-face group sessions that included knowledge and skills training, group sharing, and relaxation exercises. After each group session, a telephone call was provided to each CG by the program assistant for knowledge checking and consolidating strengths and gains in the previous sessions. After validation on the intervention, an RCT study was conducted to examine the effectiveness. A total of 115 CG of PWD were recruited while follow-up visit in the Mental Health Centre in Hong Kong. Upon three intervention groups, block randomization and a block size of eight was used to randomize the CGs to receive either the PSI-CG (n=56) or the control intervention (n=59) by using a ratio of 1:1.Results: The GEE results indicated the intervention effectiveness that compared with the control group who received the information booklet, those who received the PSI-CG had significantly greater improvements in overall caregiving SE (p=0.045), particularly on the SE in handling disruptive behaviors (p=0.005). The particular favorable effect on handling disturbing symptoms may be related to the education on the communication skills by modifying the CG mindset towards PWD behaviors, and peer-led discussions over symptom management. For further improvements, future study may consider adding components, for example, a social break and additional booster sessions, to facilitate peer support among the CG.

Biography:

Abstract:

It is evident and obligatory that care runs in every aspect across life span, also significant in old ageing population with chronic diseases. Family is central to care. Home based palliative care with effect partnership with formal and informal carers are needed. Dementia is neuropsychiatric and public health problem which causes multiplicity of psychosocial vulnerabilities. The cluster of vulnerabilities will lead them to be a susceptible second patient. The aim of the study is to find the level of psychosocial wellbeing of family carers with persons with dementia in home based palliative care environment. Well-being is the appraisal of quality of life. Palliative care is designed to enhance quality of life. According to WHO, “Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”. Wellbeing of carers has to be fostered, to dismantle the illbeing through health promotion. The objective of the study is to know the socio demographic details of family carers, burden, resilience, social support and family dynamics of the carers in the family utilizing home palliative care facilities. Hypothesis was constructed and tested between the variables. The researcher has used Descriptive research design. The research setting was Harippad Block, kumarapuram panchayat was selected with 15 wards and sample survey was done with the carers attached with palliative services. The Standardized measuring instruments used were Zarit carers burden scale, Resilience scale by Gail. M. Wagnild and Multidimensional social support scale and Macmaster Family Assessment Device. The collected data was analyzed through Statistical Package for Social Science SPSS23. The results will be presented in the full paper. To conclude Home based palliative care services must fill the service gap in India for long term care. Psychosocial component has to be strengthened through professional mediation

Biography:

Naomi Lilly is a member of the class of Duke University 2020. Naomi is studying African American Studies and Gender Studies, and pursuing a certificate in Documentary Studies. At Duke, she is a member of the Penny Pilgram Cohort, the political chair co-president for Duke’s NAACP chapter, a member of the Duke Deja Blue acapella group, and a content creator for The Bridge (an online publication). Her academic interests include gender and racial injustice, the role of activism in today’s society, and the media’s growing impact with issues related to social injustice(s). After college, Naomi seeks to focus on accurate minority representation in entertainment.

Abstract:

My grandmother is an 88-year-old African American woman with dementia. My project seeks to explore the role dementia has played within my family, specifically, how the cycle of role reversal has shaped the matriarch position my grandmother once held within my family. Discussion of the topic will be facilitated by my grandmother, her children, and grandchildren. Literary works include publications that focus on dementia as a symptom and dementia as it pertains to the role of caretakers. These works were used to demonstrate differences between written text and what it means to face dementia outside of text. The final project will take the form of a documentary that seeks to capture the emotions and realities my family has had to face as a result of my grandmother’s condition. The documentary is different from a paper because in many ways, it serves as a case study that helps to build personality and impact. This personality and impact will ultimately help viewers paint an image of what life looks like for a person with dementia and how the conditions that are attributed to dementia, impact surrounding individuals (i.e. family). The documentary will be guided by the recognition of a role reversal and reflections on memories before and after my grandma’s condition began and continued to worsen. These memories help to allow individuals to recognize the changes dementia can have on what may be considered a person’s everyday routine. These memories will also help viewers connect to the content due to the raw nature of the responses given by interviewees and the unfortunate realities dementia presents. These answers help to paint the image of a matriarch and a change in the hierarchal roles within the family at large

Biography:

Dr. Goldsmith has been a professor of surgery for more than forty years and a student of medical history throughout his life.  He wrote the book A Conspiracy of Silence: Franklin D. Roosevelt—Impact on History.   He also invented several surgical procedures including an operation to control Alzheimer’s disease, a procedure to treat acute and chronic spinal cord injuries, as well as an operation to eliminate the need for a permanent colostomy.  He is an author of 265 papers or book chapters, has edited four surgical texts, and has received honorary degrees from two Chinese universities.  He is a surgeon, worldwide lecturer, and adviser on the application of his surgical procedure

Abstract:

It has been commonly believed that a decrease in cerebral blood flow (CBF) which routinely occurs in Alzheimer disease (AD) results from the death of critical intra-cerebral neurons that no longer require the maintenance of an adequate blood supply.  This belief is presently being challenged by the idea that it is not neuronal death that causes a decrease in CBF, but it is actually a decrease in the CBF which leads to the death of neurons seen in AD.  In association with dead neurons located within the AD brain are varying numbers of deteriorating neurons.  Increasing the CBF to still viable but deteriorating neurons in AD is believed to delay and even improve the clinical manifestations of AD. This increase in CBF has proven effective in treating a group of patients with AD.  The increase in CBF was accomplished surgically by placing an intact, vascularized pedicled omentum directly on the AD brain. This surgical procedure should be evaluated by a carefully controlled study since finding a treatment for Alzheimer’s disease is presently of extreme importance

Biography:

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Abstract:

Objective: Dementia is a source of immense caregiver stress, and exhausts social, financial, physical and emotional resources over time. Person centered care is a holistic approach which includes a broad range of individual and group activities and  counseling of caregivers in a friendly , empathetic  environment  is considered to be a useful method of managing patients and families with dementia. In this study we aimed to study the efficacy of person-centered dementia care on behavioral problems and Quality of Life of the patients. We also aimed to study the effect of person-centered dementia care on burden, stress, depression and anxiety of the primary caregivers.

Methods: 10 persons with dementia and their respective family caregivers who received person centered care in ARDSI Hyderabad Deccan activity centre were compared with a control group of dementia patients. Behavioral problems in patients were studied using Neuropsychiatric Inventory (NPI) and Quality of Life was measured using Quality of Life for Alzheimer-Dementia Scale (QOL-AD). Carer burden was evaluated using the short Zarit Burden Inventory (ZBI); and carer depression, anxiety and stress were measured with the Depression, Anxiety and Stress Scale (DASS-21). Two groups of patients were matched on disease severity and efficacy of person centered care was compared between the two groups.

Results: Patients who were given person-centered dementia care in the activity center found to have more score on Quality Of Life- Alzheimer’s Dementia Scale and less symptoms on NPI compared to those who did not attend. Caregivers of patients who attend activity center showed significantly lower levels of burden, depression, anxiety and stress.

Conclusions: Person-centered dementia care in activity center has a positive effect on quality of life of patients with dementia and successful carer interventions helps in reducing the burden, depression, anxiety and stress levels of the caregiver.

Biography:

MS. SUCHI is an experienced International Pre School Principal/Manager who learnt Laughter exercises from many coaches around the world. She then designed Laughter Therapy which is being used in many places such as hospitals and Senior Activity Centres. She provides individual and group therapy in educational and home settings. A former Manager / Trainer is now engages in building social awareness about ‘Depression & Anxiety ‘ caused by Dementia and the harm it brings to people, families and communities. Her aim is to encourage people to seek help early and get on the path to recovery. Her works has been featured in local press, TV and Radio and has been an invited speaker at various community clubs and educational Institutions. She has also been awarded by MINDS and various community clubs in recognition of her social work.

Abstract:

There is a lack of awareness about what happy harmones are and what can be done to get them. People tend to feel unhappy for multiple reasons and a family member having Dementia  adds on Stress levels of not only the patient but the caregivers as well. Having Dementia leads to a person  feeling depressed and anxious  in some cases.