Alzheimer's Disease International Research Articles

Traditional healing and medicine in dementia care for Indigenous populations in North America, Australia, and New Zealand: Exploring culturally-safe dementia care policy from a global perspective.

In 2018, the World Health Organization recognized traditional healers as community stakeholders in dementia care. This scoping review aimed to summarize the existing dementia care literature regarding strategies for the integration of traditional healing in dementia care and the roles of traditional healers. A group of Indigenous Elders from Northern Ontario, Canada, guided, reviewed, and validated the research process and findings. The Joanna Briggs Institute approach was applied to a structured search strategy across the CINAHL, Embase, MEDLINE, and PsycINFO databases. A title and abstract screening were completed, followed by a full-text assessment of the identified manuscripts. A total of 143 full manuscripts were reviewed, of which two studies fully met the community-determined inclusion/exclusion criteria. The integration of traditional healing practices into dementia care offers a pathway to culturally-safe care for people with dementia. The findings identified policy advocacy as key to engage, educate, and empower traditional healers. The WHO recognized traditional healers as community stakeholders in dementia care and prevention worldwide in 2018; however, traditional healers are underrepresented and marginalized in healthcare systems due to the lack of culturally-safe dementia care (CSDC) policies at community and national levels globally.Community-based CSDC models were critically reviewed and validated by local Indigenous community stakeholder consultations.The result is a call to action to assist the WHO and Alzheimer's Disease International in developing guidelines for CSDC policy improvements with the global Indigenous community for the engagement and empowerment of traditional healers to navigate dementia care and to implement the WHO Global Action Plan on the Public Health Response to Dementia (2017-2025).Integration of Western biomedical and Indigenous traditional healing and medicine in dementia care in the healthcare system can reduce health disparities and empower traditional healers on a global scale. Indigenous-led models that include traditional healers in dementia care are critical for improving equity gaps in dementia care for Indigenous Peoples.

A Role-Needs Framework: Rethinking Support for Informal Caregivers for Alzheimer's Across the Global South and Global North.

Caregivers play an essential role in supporting people with Alzheimer's disease globally. User-informed research is vital to developing trans-cultural guidelines for dementia support organisations. While coping strategies of caregivers are well researched, the 'coping-effectiveness' framework falls short of representing all caregiver needs. Our aim was to develop a robust and inclusive, globally applicable framework of caregiver-informed support needs. In partnership with Alzheimer's Disease International and Roche, we conducted qualitative online semi-structured interviews with 34 family caregivers from the Global North (UK, US) and Global South (Brazil, South Africa) in the COVID-19 context. Participant-generated photographs helped encourage discussions of hidden contextual issues. Iterative inductive narrative analysis of interviews and photographs was carried out with input from global and national charity and industry sectors. We identified a framework of four cross-cultural caring approaches with implications for support: (1) Empathising, using emotion-focused strategies to develop strong expertise and coping skills, with time specific information, psychosocial and peer support needs. (2) Organising, using problem-focused strategies, with strong narratives of expertise and advocacy which benefited from early structured information and professional confirmation. (3) Non-identifying caregiving, where daily aspects of caring occurred without specialist knowledge and expertise, and caregivers sought assistance in managing disease-related support. (4) Reluctance, where struggling with unwanted caring responsibilities meant caregivers looked to professionals to carry out daily care. Our findings move beyond the 'coping-effectiveness' framework of support to suggest a novel 'role-needs' framework. Our approach supports inclusive ways of tailoring support to fit individual caregiver circumstances globally.

Does the Pharmacy Profession View the Full Picture of Cognitive Disorders?

The imperative for pharmacists to play a more significant role in working with patients affected by cognitive impairment has never been greater. This is a rapidly evolving issue, and data from the organization Alzheimer's Disease International presents a range of epidemiological facts that should be of concern to health practitioners, health administrators, governments and other funders, policy makers, and the wider public. Consumers have every right to expect, and indeed to demand, action from agencies that can and should act. According to Alzheimer's Disease International, the number of cases of dementia worldwide is expected to increase by 100% over the coming 20 years.

Implementation of the Macao dementia policy: a scoping review for the way forward.

The implementation of dementia policy is a complex process of translating policy goals to actions to address the changing needs of people living with dementia. Leveraging on others' experiences would help policy decision-makers and actors better prepare for the challenges. This study explored the development, the implementation and the impact of the dementia policy in Macao, a "role model" recognized by the Alzheimer's Disease International. A scoping review of policies, strategies, and news articles, as well as scholarly work from 6 scientific databases dated till March 2023 was conducted under the guidance of the Health Policy Triangle Framework. According to 284 documents, the dementia policy in Macao, driven by government leadership and supported with public-private partnership, aimed to integrate health and social services to achieve the goals of "Early prevention, Early detection, Early diagnosis, Early treatment and Early support." Promoting the preparedness according to the dementia burden trajectory, empowering the public and the service providers with training and education, and encouraging services-related research were among the key actions. With major changes in dementia care configuration, a dementia service network, a dementia-friendly community and a one-stop service model for disease screening, diagnosis, treatment and support have been developed. Reconfiguring existing resources in the health and social services to form an integrated service network at the community level could be considered a priority of action. Continuous engagement, collaboration and empowerment at different levels across these sectors is crucial for the sustainability of a dementia policy.

Therapeutic Effects of Plant Anthocyanin against Alzheimer's Disease and Modulate Gut Health, Short-Chain Fatty Acids.

Alzheimer's disease (AD) is the most common form of dementia and neurogenerative disease (NDD), and it is also one of the leading causes of death worldwide. The number of AD patients is over 55 million according to 2020 Alzheimer's Disease International (ADI), and the number is increasing drastically without any effective cure. In this review, we discuss and analyze the potential role of anthocyanins (ACNs) against AD while understanding the molecular mechanisms. ACNs have been reported as having neuroprotective effects by mitigating cognitive impairments, apoptotic markers, neuroinflammation, aberrant amyloidogenesis, and tauopathy. Taken together, ACNs could be an important therapeutic agent for combating or delaying the onset of AD.

Neurocognitive effects of proanthocyanidin in Alzheimer's disease: a systematic review of preclinical evidence.

Cognitive disorders and dementia largely influence individual independence and orientation. Based on the Alzheimer's Disease International (ADI) estimation, approximately 75% of individuals with dementia are undiagnosed. In fact, in some low- and middle-income countries, the percentage is as high as 90%. In this systematic review, which is based on PRISMA guidelines, we aim to identify the mechanism of action of proanthocyanidin. Finding a natural product alternative as a potential nootropic can help increase the number of armamentariums against dementia and other cognitive impairments. In this preclinical research, we determined the effect of proanthocyanidins on Alzheimer's disease (AD) by searching electronic bibliographic databases like Scopus, Proquest, ScienceDirect, PubMed, and Google. There was no imposed time limit. However, the search was limited to only English articles. The review protocol is registered on PROSPERO as CRD42022356301. A population, intervention, control, and outcomes (PICO) technique was utilized for report inclusion, and all reports were assessed for risk of bias by using the SYRCLE's RoB tool. The article's bibliographic information, induction model, type of proanthocyanidins, animal strain/weight/age, and outcome measurements were acquired from ten papers and are reported here. Further analysis was validated and determined for the review. The included studies met the review's inclusion criteria and suggested that proanthocyanidins have a neurocognitive effect against AD. Additionally, the effectiveness of proanthocyanidins in reducing oxidative stress, acetylcholinesterase activity, amyloid beta, its efficacy in alleviating superoxide dismutase, cognitive properties, and in facilitating cholinergic transmission in various models of AD has been collectively observed in ten studies.

TRIAD multi‐dimensional biobank for biomarker discovery

AbstractBackgroundThe Translational Biomarkers in Aging and Dementia (TRIAD) is a longitudinal, biomarker‐based cohort designed to study interactions between the pathophysiological processes driving to dementia. Currently, 50 million people worldwide have dementia [1]. PET and MRI imaging have been widely used to assess disease stage, though expensive and not readily accessible [2]. More recently though, breakthroughs in blood‐based biomarkers have proven a useful, available, and more cost‐effective way of evaluating amyloid and tau positivity. The TRIAD Biobank provides a unique framework to study disease stage using blood‐based biomarkers in conjunction with PET and CSF studies. Our cohort allows for validation of novel biomarkers as we simultaneously acquire gold standard second generation imaging acquisitions with full spectrum fluid biomarkers (CSF, saliva, plasma, urine). Importantly, the data acquired is integrated in a database compliant to multi‐dimensional biomarker analysis.MethodFigure 1 depicts the cohort's banked fluids by diagnostic group. Figure 2 depicts the cohort's banked fluids by sex grouping.ResultThe TRIAD Biobank stores 1,034 blood samples from 655 participants, 658 of these being follow‐up collections. Additionally, cerebrospinal fluid has been collected from 381 individuals accounting for 520 collections in the bank, 812 urine collections from 662 individuals and 591 saliva samples from 432 individuals.Additionally, the cohort has collected 761 tau PET scans using [18F]MK6240, 644 amyloid PET scans using [18F]AZD4694 and 804 MRI using 3 Tesla.ConclusionWith dementia being one of the leading, most costly causes of death, the need for early detection, more affordable, less invasive, and more readily available ways to determine disease stage is apparent [2]. The TRIAD multi‐dimensional biobank provides a wealth of resources to discover affordable biomarkers needed for early diagnosis and Alzheimer’s disease prevention.[1] Patterson, C. 2018. World Alzheimer Report 2018: The state of the art of dementia research, new frontiers. London, England: Alzheimer's Disease International.[2] Gauthier S, Rosa‐Neto P, Morais JA, & Webster C. 2021. World Alzheimer Report 2021: Journey through the diagnosis of dementia. London, England: Alzheimer’s Disease International.

TRIAD multi‐dimensional biobank for biomarker discovery

AbstractBackgroundThe Translational Biomarkers in Aging and Dementia (TRIAD) is a longitudinal, biomarker‐based cohort designed to study interactions between the pathophysiological processes driving to dementia. Currently, 50 million people worldwide have dementia [1]. PET and MRI imaging have been widely used to assess disease stage, though expensive and not readily accessible [2]. More recently though, breakthroughs in blood‐based biomarkers have proven a useful, available, and more cost‐effective way of evaluating amyloid and tau positivity. The TRIAD Biobank provides a unique framework to study disease stage using blood‐based biomarkers in conjunction with PET and CSF studies. Our cohort allows for validation of novel biomarkers as we simultaneously acquire gold standard second generation imaging acquisitions with full spectrum fluid biomarkers (CSF, saliva, plasma, urine). Importantly, the data acquired is integrated in a database compliant to multi‐dimensional biomarker analysis.MethodFigure 1 depicts the cohort's banked fluids by diagnostic group. Figure 2 depicts the cohort's banked fluids by sex grouping.ResultThe TRIAD Biobank stores 1,034 blood samples from 655 participants, 658 of these being follow‐up collections. Additionally, cerebrospinal fluid has been collected from 381 individuals accounting for 520 collections in the bank, 812 urine collections from 662 individuals and 591 saliva samples from 432 individuals.Additionally, the cohort has collected 761 tau PET scans using [18F]MK6240, 644 amyloid PET scans using [18F]AZD4694 and 804 MRI using 3 Tesla.ConclusionWith dementia being one of the leading, most costly causes of death, the need for early detection, more affordable, less invasive, and more readily available ways to determine disease stage is apparent [2]. The TRIAD multi‐dimensional biobank provides a wealth of resources to discover affordable biomarkers needed for early diagnosis and Alzheimer’s disease prevention.[1] Patterson, C. 2018. World Alzheimer Report 2018: The state of the art of dementia research, new frontiers. London, England: Alzheimer's Disease International[2] Gauthier S, Rosa‐Neto P, Morais JA, & Webster C. 2021. World Alzheimer Report 2021: Journey through the diagnosis of dementia. London, England: Alzheimer’s Disease International.

Funding dementia research: new initiatives

Decades ago, dementia was generally regarded as a natural consequence of the ageing process, but pivotal scientific discoveries made in the past 20 years are altering this perspective. With much still to understand about the complex changes in brain mechanisms that occur in people with dementia, and the recent discovery of biomarkers for diagnosis and prognosis, the need for more research funding is urgent. Udani Samarasekera investigates new initiatives in the field. Dementia care: beyond a diagnosisEnormous progress has been made over the past two decades in dementia research. In particular, the identification of biomarkers is a landmark development in the diagnosis of Alzheimer's disease. However, this progress so far has not translated into improvements in patient care, with a staggering 85% of the over 55 million people living with dementia not receiving any post-diagnosis care, according to Alzheimer's Disease International's 2022 World Alzheimer Report . Full-Text PDF

Advances in Alzheimer's disease research over the past two decades

Over the past two decades, the landscape of dementia research has changed drastically due to advances in knowledge at the molecular, cellular, animal, and human levels. Advances have not been limited to the Alzheimer's disease spectrum but include improved understanding of other disorders that can also lead to dementia. In this Anniversary Round-up, I discuss what I consider to be the most important advances in Alzheimer's disease research that have occurred since the first publication of The Lancet Neurology 20 years ago. Dementia care: beyond a diagnosisEnormous progress has been made over the past two decades in dementia research. In particular, the identification of biomarkers is a landmark development in the diagnosis of Alzheimer's disease. However, this progress so far has not translated into improvements in patient care, with a staggering 85% of the over 55 million people living with dementia not receiving any post-diagnosis care, according to Alzheimer's Disease International's 2022 World Alzheimer Report . Full-Text PDF

Functional near-infrared spectroscopy of prefrontal cortex during memory encoding and recall in elderly with type 2 diabetes mellitus.

Low-frequency Fahræus-Lindqvist-driven oscillations in the small vessels are crucial because oscillations in small vessels support nutrient supply. Understanding of this is critical in type 2 diabetes mellitus (T2DM) to develop therapeutic measures in order to prevent Alzheimer's Disease Related Dementias. Indeed, vascular factors are known to contribute to cerebrovascular disease as well as mild cognitive impairment and dementia, which are predicted to affect 152 million people by 2050 (Alzheimer's Disease International London, UK, 2019). In this clinical study, we performed functional near-infrared spectroscopy (fNIRS) of the forehead to investigate the effect of the Mini-Cog with three-item recall test on the prefrontal cortex (PFC) activation and the relative oscillatory power in the 0.01-0.02-Hz (FahræΣus-Lindqvist effect) and 0.021-0.052 Hz (smooth muscle autonomic innervation) frequency bands in elderly (60 years and older) T2DM and age-matched controls. We found a significant (p<0.01) difference in the PFC activation between elderly subjects with T2DM and age-matched elderly controls. Moreover, power spectral density (PSD) analysis revealed a significantly lower relative power in 0.021-0.052 Hz (smooth muscle autonomic innervation) frequency band in elderly subjects with T2DM during the Mini-Cog three-item recall test. Furthermore, a drop in the oscillatory power in the 0.01-0.02 Hz frequency band during Mini-Cog three-item recall test was found more pronounced in the elderly subjects with T2DM. Therefore, our study highlighted portable brain imaging to capture cerebrovascular reactivity to cognitive load that may provide a biomarker of cerebrovascular dysfunction in T2DM. Clinical Relevance-Our study establishes forehead portable brain imaging under cognitive load for monitoring cerebrovascular function in T2DM.

A systematic review and meta-analysis of studies on screening for mild cognitive impairment in primary healthcare

BackgroundCognitive disorders and dementia have an important effect on individual independence and orientation. According to the Alzheimer's Disease International (ADI) 75% of people with dementia are not diagnosed; this may be as high as 90% in some low- and middle-income countries. This systematic review and meta-analysis aimed to identify the test performance of screening tools and compare them pairwise. The findings of our study can support countries in planning to establish and care for mild cognitive impairment in primary health centers.MethodsMedline (PubMed), Scopus, Cochrane, Dare, All EBM Reviews, CRD (OVID), and Proquest were searched from 2012 to November 2021. The risk of bias was assessed through the QUADAS-2 instrument. Given the high heterogeneity between studies, a random-effects model was used to calculate the pooled effect sizes for diagnostic accuracy measures (sensitivity, specificity, and area under curve indices). I2 test was used for assessing heterogeneity and predefined subgroup analyses were performed using participants’ age, country’s income, and sample size of studies.ResultsA systematic search identified 18,132 records, of which, 20 studies were included in the quality assessment, and six were included in quantitative analysis. None of the studies had examined the feasibility or efficiency of mass screening. According to a pairwise comparison, IQCODE, AD8 and GPCOG showed equal or better diagnostic performance relative to the MMSE in terms of sensitivity and specificity. The random-effect model for the MMSE showed the pooled sensitivity equal to 0.73 (95% CI 0.57–0.90), the pooled specificity equal to 0.83 (95% CI 0.75—0.90), and the pooled AUC equal to 0.88 (95% CI 0.83–0.93).ConclusionSeveral benefits have been attached to short tests making them a suitable choice for use in primary healthcare settings. Considering factors such as accuracy, time of application, ease of scoring, and utilization charges, tests such as IQCODE, AD8, and GPCOG or appropriate combination with counterpart tools seem to be good alternatives to the use of the MMSE in primary care.

From Plan to Impact IV, progress towards the WHO global action plan on dementia

AbstractBackgroundAt the World Health Assembly 2017, the World Health Organization launched the Global action plan on the public health response to dementia 2017‐2025. Alzheimer's Disease International (ADI) monitors progress towards the action areas and targets of the Global plan and in May 20201 will publish "From plan to impact IV", which is especially poignant in the context of Covid‐19.MethodADI continuously gathers information and updates relating to the 7 action areas of the Global action plan through our network of over 100 member associations and federations globally, as well as our contacts and partners in research, science, health and care, people living with dementia and carers. A specific analysis of progress towards the key goal of developing national dementia plans or strategies is a focal point of the research. In addition there will be a focus on the impact and implications of Covid‐19, including disruption to services, diagnosis and research.ResultThere was some encouraging policy developments in 2020 despite the challenges of Covid‐19, with the governments of China, Dominican Republic, Germany and Iceland developing national dementia plans. However, there are still only 35 national plans in existence, increasing urgency, and a need for a new focus and mobilisation to reach the central goal of the Global action plan, of 146 Member States developing a plan by 2025. This equates to the need for over 25 new plans every year.ConclusionProgress is being made across all 7 action areas of the Global action plan on dementia, with hope in the form of potential breakthroughs in disease modifying treatments and diagnostics, but this too is reflected in the need for much better healthcare preparedness. ADI, working with WHO and our partners, will continue to focus attention on governments across the world to take action, to develop robust and well‐funded national plans and to monitor their progress and to fulfil their commitments in adopting the Global action plan on dementia.

Effect of multimodal non‐pharmacologic interventions on cognitive function for people with dementia: Systematic review

AbstractIntroductionDementia is a progressive brain degeneration characterized by a progressive deterioration in cognition and independent living capacity (Sobral, Pestana, &amp; Paúl, 2015). Fifty million people are living with dementia globally. This number will be projected to grow to 82 million by 2030 and 152 million by 2050 (Alzheimer's Disease International, 2020. Since dementia is complex syndrome, multimodal non‐pharmacologic interventions (MNPIs) are highly recommended (Dannhauser et al., 2014; Graessel et al., 2011; Han et al., 2017; Yang et al., 2019). Currently, there is little available evidence to determine which multimodal interventions are effective for cognitive function improvement.MethodA comprehensive search was done in PubMed, EMBASE, CINHAL, Web of Science and Medline international databases. The inclusion criteria of this review were; concerned adults with primary diagnosis of dementia, measured cognitive function outcome, used two or more type of interventions, published in English language and employed controlled trial study design. The quality appraisal of the studies was done by Cochrane risk of bias assessment tools for randomized controlled trail and non‐randomized controlled trial studies (Sterne et al., 2016; Sterne et al., 2016).ResultsFourteen RCTs and five non‐RCT studies were included in the systematic review. Nearly ninety percent of studies resulted in an improvement or maintenance of cognitive function among people with dementia. Integrated, multicomponent and dyadic based interventions implemented for longer duration resulted in improve cognitive function of people with dementia. The combination of three modes of non‐pharmacologic intervention that includes exercise, music, and cognitive training with intervention design of more than three sessions per week for at least 12 ‐ 48 weeks is recommended.ConclusionThis study showed that multimodal non‐pharmacologic interventions might improve cognitive functions among people with dementia. Future high quality randomized controlled trail studies with repeated‐measured design on the combined effect of physical exercise, music and cognitive training on cognitive function for people with dementia is recommended.

COVID-19 and Long-Term Care Healthcare Worker Mental Health in Rhode Island

IntroductionHealthcare workers in long-term care settings and group homes for the disabled are at signi?cant risk of contracting COVID-19 and subsequently infecting the residents, fellow co-workers, and their family. In addition, lower paying long-term care healthcare workers maybe working multiple jobs which increases the risk of exposure. In April 2020, 27% of all deaths in the population was among residents in long-term care. The elderly population has the greatest risk for mortality from COVID-19 (Liu et al. 2020) and are disproportionality a?ected by social distance and self-isolation. Most long-term care settings have implemented lockdowns preventing families from visiting and limiting interactions among residents. Social isolation of the elderly is considered a serious public health concern. Social disconnection is a risk factor for increased depression and anxiety among the elderly. It is hypothesized that elderly persons are at high risk for poor mental health outcomes from the COVID-19 pandemic. The Alzheimer's Disease International suggest that those with dementia “may become more anxious, angry, stressed, agitated, and withdrawn during the outbreak”. These factors potentially may increase stress on healthcare workers in long-term care settings beyond the fears of exposure and transmitting COVID-19 to their families. There are few studies to date that examine the mental health impact of COVID-19 on healthcare workers in long-term care. The United Nations has highlighted the mental health risk to workers in long-term care. “First responders and front line workers, particularly workers in health and long-term care play a crucial role in ?ghting the outbreak and saving lives. However, they are under exceptional stress, being faced with extreme workloads, di?cult decisions, risks of becoming infected and spreading infection to families and communities, and witnessing deaths of patients.”MethodsHealthcare workers in long-term care facilities, and assisted living facilities in Rhode Island were given questionnaires to complete that examined mental health and risk factors associated with COVID-19. The questionnaire includes items on the healthcare worker's experience with COVID-19. Resilience is measured using The Brief Resilience Scale assessing the individual's ability to bounce back or recover from stress. Subjective incompetence is de?ned as the perceived incapacity to perform tasks and express feelings deemed appropriate in a stressful situation. Increasing distress and subjective incompetence may convert a normal reaction to stress into mental disorder requiring intervention. Demoralization is measured using the Demoralization Scale-II. Depression and anxiety is measured using two of the most commonly used screens in clinical care, the PHQ-9 for depression and the GAD-7 for generalized anxiety. Family functioning during and before the COVID-19 pandemic is measured using the three-item Brief Assessment of Family Functioning. Social support is measured during and before the COVID-19 pandemic using the emotional-informational support subscale of the Brief Social Support Scale derived from the Medical Outcomes Study Social Support Survey. Coronavirus Anxiety Scale is a mental health screener designed to aid in the identi?cation of probable cases of dysfunctional anxiety associated with the COVID-19 pandemic. The fear of Coronavirus-19 Scale was used to measure this construct. The ?ve-item Primary Care PTSD Screen was adapted to COVID-19 as a traumatic event. Items measuring healthcare worker workplace stress was developed based on a items from a number of existing scales. A 15-item health care workers attitudes toward the management of COVID-19 in the long-term care facility was developed by the research team that focuses on training of sta?, safety, and resident care.ResultsPreliminary data will be presented. Data collection is currently underway. There are 65 assisted living facilities and 85 nursing homes in Rhode Island. Approximately 10% of the facilities are currently participating with the aim to recruit nearly all facilities in the state.ConclusionsThe hypotheses to be tested is that healthcare workers in long-term care settings have mental health issues including demoralization, depression and anxiety due to the COVID-19 pandemic disaster. That those who are in facilities with COVID-19 residents have increased stress. Those facilities that have placed increased demands on healthcare workers will have employees that are having more difficulty in dealing with the COVID-19 pandemic. This study examines how healthcare workers in long-term care facilities have coped during the COVID-19 pandemic and the impact on their mental health; factors that protect or place the healthcare worker at risk for poorer mental health outcomes (depression, anxiety, demoralization, post-traumatic stress); and factors during COVID-19 that place the healthcare worker for poorer mental health outcomes during COVID-19 pandemic.FundingDepartment of Psychiatry of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Lifespan

Facilitating recruitment for dementia research: Insights from an international panel.

Dementia research is critical to improve dementia care; however, participation in this research remains limited, and recruitment is challenging. During an international panel at the 2018 Alzheimer Disease International Conference in Chicago, presentations were given to raise the profile of dementia research and share the patient experience of research participation. We observed notable shifts in perspectives on research participation from 39 participants who completed a survey before and after the presentations. These findings set the stage for future studies exploring the strength of independent motivations for research participation as well as improving recruitment efforts through education and peer support.

Pulmonary Function and Risk of Alzheimer Dementia: Two-Sample Mendelian Randomization Study

Pulmonary Function and Risk of Alzheimer Dementia: Two-Sample Mendelian Randomization Study

Global response to the provision of dementia information and support during the COVID‐19 crisis

BackgroundDementia and COVID‐19 share the same key risk factor ‐ age. As the world reacted to the pandemic it became evident that people living with dementia were an exceptionally high‐risk group; disruption to the diagnosis pathway, provision of post diagnostic support, interruptions to research and trials. Alzheimer's Disease International responded quickly to support our global network of 102 associations, many challenged with having to re‐invent their services, including withdrawal of face‐to‐face support & confronting income crises; plus providing timely information, support and advocacy interventions to partners.MethodEarly 2020 ADI engaged our global associations to gauge the concern around COVID‐19, with insight from our member association in China. Regular contact with the WHO and our international partners gave us impetus to adapt our programme of work.ResultADI produced an online COVID‐19 resource; a go‐to for information, advice, experience and learning. A key resource, an advisory video from Prof. Huali Wang, China, offering health and care advice ‐ subsequently translated into a number of co‐authored articles in The Lancet; followed by a paper on 'Difficult decisions about hospital admission and triage' Through series of global webinars ADI provided up to the minute experience & information focussing on key areas ‐ care homes; the scarcity of resources; life/ deaths decision making and the rights of people with dementia to treatment. Future gazing sessions followed to ascertain the impact of COVID‐19 on the diagnosis pathway, national plans, trials and on prevalence rates. Thorough our engagement with the WHO, ADI contributed to the creation of an inter‐agency mental health and psychosocial support resource and participated in the Civil Society Working Group on NCDs. Media engagement brought vital attention and coverage to dementia, through titles including BBC World & Futures, The Economist, The Telegraph.ConclusionTimely responses, interventions and the provision of COVID‐19 resources has enabled our global associations to adapt their operations to better respond to the crisis and to review operational and policy strategies. Through partnership working, timely sharing of information and advice, we have facilitated a strong reaction and positive response throughout the dementia sector to this extraordinary period.

Twinning program: The Netherlands‐Indonesia

AbstractBackgroundAlzheimer Indonesia &amp; Alzheimer Netherlands have a strong collaboration under the Twinning Program of Alzheimer's Disease International. This is a 3 years collaboration for 2017‐2019. To exchange information, support &amp; learn from each other and for Alzheimer Indonesia to benefit from the experience from Alzheimer Netherlands to improve quality life of people with dementia &amp; caregivers.Method6 work areas: Knowledge transfer from science &amp; practice; Building network of volunteers for Indonesia Netherlands (ALZI – NL); Development of support activities of the Alzheimer's Organization in Indonesia; Organizing a public event in Indonesia; Train the trainer program (Dementia Care Skills training) in Indonesia; Project coordinationResult• Knowledge transfer &amp; support: ADI Asia Pacific Conference on 2‐5 November 2017, the 1st integrated multidisciplinary gathering on Dementia in Jakarta, Indonesia with 7 expert speakers from the Netherlands. Attended by over 700 participants from 20 countries (healthcare workers, ALZI Chapter leaders, youth community leaders, general public, government officials &amp; volunteers). • Capacity building for Alzheimer Indonesia by extending it's network to 22 chapters/cities, conducted 173 caregivers meetings and 12 intergenerational home visits across Indonesia. • 3 Dementia Care Skills training conducted with participation from 26 caregivers. • Hosted Hope Love Care on Dementia, medical symposium and public event on 19‐21 October 2018 in Malang, East Java. Over 700 participants (healthcare workers, ALZI Chapter leaders, youth community leaders, general public, government officials and volunteers) with 6 international speakers &amp; 8 national speakers. • Chapter Meeting on 22‐24 November in Denpasar Bali Attended by all chapter manager across Indonesia and overseas (through zoom) to have workshop &amp; sharing session. Conducted Alzheimer’s Indonesia Annual Chapters Meeting as part of internal organization strengthening and capacity building. • Support activities for Indonesians in the Netherlands through Stichting Alzheimer Indonesia Nederland. • Knowledge transfer by book adaptation ‘Dementie? en nu?’ ‐ Alzheimer Nederland to Indonesian language and culture ‘Demensia? Lalu Bagaimana’.ConclusionExtension for the project is needed. The first 3 years build a good foundation&amp; at least another 3 years to reach sustainable organization. Other countries with related culture and historical should consider of doing this.

Contactless Interactive Fall Detection and Sleep Quality Estimation for Supporting Elderly with Incipient Dementia

Abstract In recent years, the demographic change in conjunction with a lack of professional caregivers led to retirement homes reaching capacity. The Alzheimer Disease International stated that over 50 million people suffered from dementia in 2019 worldwide and twice the amount will presumably be effected in 2030. The field of Ambient Assisted Living (AAL) tackles this problem by facilitating technical system-aided everyday life. AUXILIA is such an AAL system and does not only support elderly people with dementia in an early phase, but also monitors their activities to provide behaviour analysis results for care attendants, relatives and physicians. Moreover, the system is capable of recognizing emergency situations like human falls. Furthermore, sleep quality estimation is employed to be able to draw conclusions about the current behaviour of an affected person. This article presents the current development state of AUXILIA.