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Global Fight Against Dementia

MARC WORTMANN
Executive Director, Alzheimers Disease International (ADI)
Disclaimer: The views expressed in this paper/presentation are the views of the author and do not necessarily
reflect the views or policies of the Asian Development Bank (ADB), or its Board of Governors, or the
governments they represent. ADB does not guarantee the accuracy of the data included in this paper and
accepts no responsibility for any consequence of their use. Terminology used may not necessarily be
consistent with ADB official terms.

Overview
What is dementia and Alzheimers
disease
Impact on person, family, society
Solutions: awareness, education,
health system response, dementia
friendly community no cure yet
Policy action: UN, WHO, G7, OECD
What can we do for LMIC

Alzheimers and dementia


Dementia: cognitive collapse syndrome
Dementia

Alzheimers disease (AD)


Vascular dementia (VD)
Lew body dementia (LBD)
Frontotemporal dementia (FTD)

First signs
Probably no single cause

Alois Alzheimer

Plaques and tangles


Under microscope

Neurofibrillary tangles

Neuritic plaques

Abnormal
Amyloid-b accumulation (CSF/PET)
Synaptic dysfunction (FDG-PET/fMRI)
Tau-mediated neuronal injury (CSF)
Brain structure (volumetric MRI)
Cognition
Clinical function

Normal

Preclinical

MCI

Dementia

Clinical Disease Stage

Figure adapted from Jack et al. 2010


Sperling et al Alzheimer & Dementia

Research results
Some drugs from A theory
Lots of drugs in pipeline
Anti amyloid, tau
Immune approach
Prevalence research
Earlier diagnosis: neuroimaging
Risk factors
Good quality care and non-medical
treatments

PiB-PET Scans: AD vs MCI vs control

From the online newspaper of Prof Yasser Metwally


http://yassermetwally.wordpress.com/dementia-alzheimer-type-and-others/neuroimaging-ofdementia/

The impact of dementia


Lot of impact on family and primary
caregiver
Both people with dementia and carers
report stigma, loss of contacts and friends
Family carers giving up their job
High levels of psychological morbidity,
depression in carers
Caring positives: companionship, fulfilment
Impact on children

Societal impact: World Alz Report 15


Systematic review of global
data on prevalence,
incidence and cost of
dementia
Based on results of more
than 200 studies
Key recommendations to
provide a global framework
for action on dementia
Independently researched
by Kings College London
and Karolinska Institute

www.worldalzreport2015.org

Estimated increase of people living


with dementia globally

www.worldalzreport2015.org

The global incidence of dementia

www.worldalzreport2015.org

The global prevalence of dementia

www.worldalzreport2015.org

The cost of global dementia care

www.worldalzreport2015.org

Impact on low and middle income


countries (LMICs)

www.worldalzreport2015.org

WHO report on dementia


Dementia: a public health priority
Launched on 11 April 2012
Joint ADI and WHO report
Recommends every country
to make a national plan
Also: awareness raising, timely
diagnosis, better quality
continuing of care, caregiver
support, workforce training,
social and financial support,
prevention and research and
creating a dementia-friendly
society

www.alz.co.uk/WHO-dementia-report

First Ministerial Conference on


Dementia
World Health Organization 16-17 March 2015

80 countries attended
Strong commitment from
WHO leadership
Many LMIC speaking
China: dementia growing
problem in our ageing
society; need for more
awareness, education and
training
Declaration accepted
Resolution and action plan
now prepared

September 2015: Agreement on


sustainable development goals
United Nations (UN) Health priorities included in
new Sustainable
Development Goals (SDG) for
2030
SDG 3: Health and wellbeing
for everyone at all ages
Infectious diseases like HIV
Maternal and child health
Non Communicable Diseases
(NCD): cancer, diabetes, heart,
lung, dementia
Discussion on indicators still
going

About Alzheimers
Disease International (ADI)
Established 1984
The umbrella organisation of
Alzheimer associations
around the world
83 member associations
Full partner in NCD Alliance
UN and WHO partnerships

Aims to help establish and strengthen associations,


raise global awareness about Alzheimer's disease and
other dementias and be the global voice representing
people with dementia and their families

Member map 2014-15

What do we do

ADI reports provide information and evidence for policy

Tracking of national plans in other countries on ADI-website


(www.alz.co.uk/national-plans)

Work with WHO in WPRO and SEARO regions

Full partner in NCD Alliance

Alzheimer University: training for staff and volunteers of


Alzheimer associations

Twinning Programme to link more and less established


associations

Train the Trainer to reach out with education to both family


carers and primary health care professionals

Alzheimer University
Training programme for
Alzheimer associations

Appropriate and reliable


information for
developing
organisational capacity
Annual programme for
emerging associations

Special programmes on
advocacy, fundraising,
organisational growth
and leadership
www.alz.co.uk/alzheimer-university

ADI Twinning Programme


Joins an established Alzheimer association and a
developing association in a mutually beneficial
relationship
Twins include(d):
India and UK

Indonesia and the Netherlands


Bangladesh and Western
Australia
Turkey and Germany
Nepal and Australia Vic

World Alzheimers Month 2015


Over 60 countries
participated
Memory Walks, media
appearances and
fundraising events
#WorldAlzheimersDay
trending on Twitter

www.worldalzmonth.org

Involvement of
People with Dementia
Involved in conference,
Alzheimer University
and advocacy work
Personal stories featured
in every Global
Perspective newsletter
Specific position for
person with dementia
on Elected Board
www.alz.co.uk/icaniwill

Partnership with
Dementia Alliance
International

Stages of Acceptance
(from ADI/WHO 2012)

Ignoring the
problem

Some awareness
First media
reporting
First caregiver
support

Building
dementia
infrastructure:
Alzheimer
association
Professional
meetings
Training of
caregivers

Advocacy efforts
More established
association
Publication of
data
Developing
professional
guidelines

Policies and
Alzheimer plans
or strategies
Standards of
dementia care
Legal framework
Public health
perspective

Normalisation
Acceptance of
dementia as a
disability

Dementia Friendly Communities: New


domains and global examples
Key strategic considerations

DFC efforts response to stigma and


exclusion
Six domains:

Public awareness and information access


Planning processes
The physical environment
Access and consideration for dementia among
local businesses and public services
Community-based innovation services through
local action
Access to transportation