28th International Conference of Alzheimer’s Disease International 18 - 20 April 2013 Taipei Abstract Booklet www.adi2013.org 28th International Conference of Alzheimer’s Disease International 18 - 20 April 2013 Taipei ABSTRACT BOOKLET To search this Abstract document: Click the search button below. Enter your term in the search box. You can enter full or partial text for a speaker’s name, abstract number, category or topic. Clicking the search button will then list all successful matches for the search term, and clicking on any of the results in the list will take you immediately to the appropriate page. The search window can be shown at any time by selecting “Edit > Search” from the top fi le menu, or using the following shortcut keys: “Shift - Control - F” on a Windows operating system “Shift - Command - F” on an Apple operating system 2 www.adi2013.org PL02 Date: Thursday 18 April 2013 Sessions: Challenges for the Global Health System WORLD HEALTH ORGANIZATION MAKES DEMENTIA A PUBLIC HEALTH PRIORITY M.Wortmann1 1Executive Director of Alzheimer’s Disease International Abstract: The World Health Organization (WHO) and Alzheimer’s Disease International (ADI) have launched a report Dementia: A Public Health Priority on April 2012. The report has been made with a group of more than 30 experts from around the world and touches on aetiology, prevalence and incidence data, risk factors, dementia policies, health and social systems, care and caregivers, awareness raising and ethical issues. It concludes with a number of recommendations: with a new case of dementia every four seconds somewhere in the world, governments need to prepare and create national Alzheimer and dementia plans, stimulate dementia friendly communities, improve public and professional attitudes, improve health and social care systems, support caregivers and raise awareness about the disease and increase the priority given to dementia in the public research agenda. Dr. Margaret Chan, Director-General of the WHO says in the Foreword of the report: “The overwhelming number of people whose lives are altered by dementia, combined with the staggering economic burden on families and nations, makes dementia a public health priority. The cost of caring for people with dementia is likely to rise even faster than its prevalence, and thus it is important that societies are prepared to address the social and economic burden caused by dementia.” ADI believes that when the World Health Organization declares dementia a public health priority many countries, especially lower and middle-income countries, will be mobilised to take more action than they used to do. www.adi2013.org 3 28th International Conference of Alzheimer’s Disease International 18 - 20 April 2013 Taipei ABSTRACT BOOKLET PL04 Date: Thursday 18 April 2013 Sessions: Challenges for the Global Health System POSITIONING NON-COMMUNICABLE DISEASES (NCDS) IN THE GLOBAL HEALTH AND DEVELOPMENT AGENDA C. Adams1 Chief Executive Officer of the Union for International Cancer Control (UICC) and the Chair of the NCD Alliance Abstract: Objectives To outline the activities of the NCD Alliance has and continues to take to position NCDs in the global health and development agendas. Highlight the learning to date and the plans which are in place to include NCDs in the post 2015 discussions. I will specifically cover: - What is the NCD Alliance? - UN Summit, where did it come from, advocacy process and the results - Where we are now with follow up / WHO - Alzheimer's disease shares most risk factors with cancers, diabetes and cardiovascular disease; how can we work together to the benefit of all those affected by these diseases? - What could people take away for their own advocacy Conclusions Advocacy at the highest level demands good intel, great planning, communication and execution. References NCD Alliance materials available on www.NCDAllinace.org Disclosure of Interest: None Declared 4 www.adi2013.org PL05 Date: Thursday 18 April 2013 Sessions: Prevention and Risk Factors in Dementia THE PROJECTED EFFECT OF RISK FACTOR PREVALENCE ON ALZHEIMER’S DISEASE PREVALENCE D. E Barnes1 University of California, San Francisco, and San Francisco Veterans Affairs Medical Center, San Francisco, California, United States Abstract: Objectives The number of people living with Alzheimer’s disease (AD) and other forms of dementia is expected to more than triple over the next 40 years, and there are currently no disease modifying treatments or cures. However, many AD risk factors are modifiable, raising the hope that if we could lower the prevalence of AD risk factors, we could potentially lower the prevalence of AD over time. The goal of our study was to project the impact of changes in risk factor prevalence on AD prevalence worldwide. Methods We used population attributable risks (PARs) to estimate the proportion of AD cases that are potentially attributable to 7 modifiable risk factors including physical inactivity, low education, smoking, diabetes, midlife hypertension, midlife obesity, and depression. Risk factor prevalence was determined through internet searches and public databases. Relative risks were determined from the most recent and comprehensive published meta-analyses. Results Worldwide, low education contributed to the largest proportion of AD cases (nearly 1 in 5). Smoking contributed to 1 in 7 cases, while physical inactivity contributed to 1 in 8 cases and depression contributed to 1 in 10 cases. Medical conditions including diabetes, midlife hypertension and midlife obesity contributed to a smaller proportion of cases due to lower population prevalence levels. Together, the 7 modifiable risk factors examined contributed to approximately half of AD cases worldwide. If the prevalence of all 7 risk factors were 10% lower than current levels, we estimate that there would be 1.1 million fewer cases of AD. In cities such as Taipei, where smoking levels are relatively low (15%) and education levels are relatively high, it is possible that AD prevalence levels will not rise as high as current projections. Conclusions Up to half of AD cases worldwide may be attributable to modifiable risk factors. Large-scale public health interventions to encourage healthier lifestyles and public education could potentially mitigate some of the projected rise in AD prevalence over the next 40 years. References Barnes DE, Yaffe K. The projected effect of risk factor reduction on Alzheimer’s disease prevalence. Lancet Neurol 2011; 10(9): 819-828. Disclosure of Interest: None Declared www.adi2013.org 5 28th International Conference of Alzheimer’s Disease International 18 - 20 April 2013 Taipei ABSTRACT BOOKLET PL06 Date: Thursday 18 April 2013 Sessions: Prevention and Risk Factors in Dementia RISK FACTORS AND PREVENTION IN DEMENTIA H Brodaty1,2,3 1 Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia. 2 Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia. 3 Aged Care Psychiatry, Prince of Wales Hospital, Randwick, New South Wales, Australia. Abstract: Objectives To review risk factors and preventative strategies for dementia, focusing on Alzheimer’s disease Methods Selective review of literature Results Possibly 50% of the population risk of Alzheimer’s disease can be attributed to potentially modifiable environmental and lifestyle factors including high blood pressure, obesity and high cholesterol in mid-life, diabetes (type II), high fat diets, head injury, lack of education, lack of exercise, depression, low birth weight for gestational age, social isolation and smaller head circumference. Epidemiological studies report protective effects for physical exercise, education, complex mental activity in mid-life, mental activities, fluids rich in anti-oxidants and polyphenols such as vegetables and fruit juice and wine, (green) tea, fish, anti-cholesterol drugs and hormone replacement therapy. Evidence for prevention effectiveness has been mixed. Randomised controlled trials with hormone replacement therapy, anti-inflammatory drugs, vitamin E and Ginkgo biloba have proven ineffective. Beneficial effects have been demonstrated for physical exercise, computer cognitive training, and adherence to Mediterranean diet, though not all trials are positive. There is stronger evidence that attention to vascular risk factors may prevent vascular dementia. There is no evidence for any preventative strategy for other neurodegenerative dementias such as Lewy body disease or frontotemporal dementia. Avoidance of heavy alcohol use and use of protective head gear and seat belts will reduce risk of dementia secondary to head injury. Conclusions There is no absolute prevention against Alzheimer’s disease specifically or dementia in general. Secondly, prevention often means postponement rather than elimination. Thirdly, preventative strategies may be more effective against vascular dementia. Independent replication is required before accepting reports. In any case, recommended lifestyle changes are physically beneficial and not harmful. Public campaigns to about the potential to delay onset of cognitive decline could focus on regular physical exercise, mental activity, blood pressure control, attention to diet and avoidance of obesity and type 2 diabetes. Disclosure of Interest: Consultant, advisory board member, sponsored speaker and/or investigator for Baxter, Janssen, Lilly, Lundbeck, Merck, Novartis, Pfizer, Sanofi, Servier 6 www.adi2013.org PL07 Date: Thursday 18 April 2013 Sessions: Prevention and