Dementia and its Risk Factors and prevention.pptx

Dementia is a collective name given to diseases and conditions that result in a decline in mental ability leading to the deterioration of one's memory, language, problem-solving capacity, thinking skills, and ability to function normally severe enough to interfere with daily life. It is caused by damage to the brain cells. This damage interferes with the ability of brain cells to communicate with each other. Thinking, behavior, and feelings can be affected when brain cells cannot communicate normally.

1. Prof. / Dr. Faisal A. Alnaser   MBBS, FPC, MICGP, FRCGP, FFPH, FAM(USA), PhD Honorary Faculty, Imperial College London General Secretary, International Society for the History of Islamic Medicine WHO EMRO Temp. Adviser WONCA EMR Regional Adviser Bahrain representative in Anti-Smoking International Alliance Chair; Home Health Care Centre Former: Chairman: Dept. of Family & Community Medicine Vice President: Arabian Gulf University President: Scientific Council of Family & Community Medicine Risk factors for Dementia www.faisalalnasir.com

2. 13-Aug-22 F. Alnaser: Risk factors for Dementia 2 Dementia is a decline in mental ability severe enough to interfere with daily life. It is caused by  damage to brain cells which interferes with the ability of brain cells to communicate with each other. When brain cells cannot communicate normally, thinking, behavior, and feelings can be affected.

3. 13-Aug-22 F. Alnaser: Risk factors for Dementia 3 10 warning signs of dementia: Sign 1: Memory loss that affects day-to-day abilities Sign 2: Difficulty performing familiar tasks Sign 3: Problems with language Sign 4: Disorientation to time and place Sign 5: Impaired judgment Sign 6: Problems with abstract thinking Sign 7: Misplacing things Sign 8: Changes in mood and behavior Sign 9: Changes in personality Sign 10: Loss of initiative

4. 13-Aug-22 F. Alnaser: Risk factors for Dementia 4 Incidence of dementia: More among the elderly population From 65 to 69, around 2 in every 100 people have dementia In the USA in 2003 it was the fifth and eighth leading cause of death in women and men the aged ≥ 65 years Now 50 million people worldwide have dementia the number of people living with the disease is expected to triple over the next 30 years.

5. 13-Aug-22 F. Alnaser: Risk factors for Dementia 5 Risk factors: Familial form of dementia Aspects of lifestyle, Health conditions, & environment

6. 13-Aug-22 F. Alnaser: Risk factors for Dementia 6 Risk factors: The Familial is caused by an Autosomal dominant mutation that accounts for less than 5%. To date, only one such factor has been identified in AD. The Apolipoprotein E gene presents in three allelic forms (e2, e3, and e4), of which the e4 allele is a risk factor for AD. Family history: Having a parent or sibling with Alzheimer’s disease.

7. 13-Aug-22 F. Alnaser: Risk factors for Dementia 7 Risk factors: Aspects of lifestyle, Health conditions, & environment are; Age. Is the biggest risk factor which goes up as you get older. Most people with dementia are older than 65. A person’s risk increases as they age, doubling every five years. This means that, of those aged over 90, around 33 in every 100 people have dementia.

8. 13-Aug-22 F. Alnaser: Risk factors for Dementia 8 Risk factors: Gender. Women get the disease more often than men Ethnicity: people from Black African, Black Caribbean, and South Asian ethnic groups are more likely to get dementia (Sheikh et al, 2021) Alzheimer's disease is the leading cause.

9. 13-Aug-22 F. Alnaser: Risk factors for Dementia 9 Risk factors: Aspects of lifestyle, Health conditions, & environment are: Unhealthy behavior ( Kesse et al, 2014) Excessive alcohol use (Rehm et al, 2019) Smoking: Smokers show an increased risk of dementia, and smoking cessation decreases the risk to that of never smokers  (Zhong et al, 2015) Lack of physical activity

10. 13-Aug-22 F. Alnaser: Risk factors for Dementia 10 Risk factors: Aspects of lifestyle, Health conditions, & environment are: Poor diet Health Issues Diabetes ( Cholerton et al, 2016) High blood pressure (Sierra C, 2020) Obesity (Anjum et al, 2018)

11. 13-Aug-22 F. Alnaser: Risk factors for Dementia 11 Risk factors: Aspects of lifestyle, Health conditions, & environment are: Down Syndrome ( keator et al, 2020) Hearing loss (Mick et al, 2014)

12. 13-Aug-22 F. Alnaser: Risk factors for Dementia 12 Risk factors: Aspects of lifestyle, Health conditions, & environment are: Very common causes: Alzheimer Vascular dementia (Gerritsen et al, 2017) Parkinson's disease (Garcia et al,2016) Frontotemporal dementia (Adam et al, 2019 )

13. 13-Aug-22 F. Alnaser: Risk factors for Dementia 13 Risk factors: Aspects of lifestyle, Health conditions, & environment are: Very common causes: Severe head injury (Graham et al, 1996) Multiple sclerosis ( Sumowski et al, 2018) HIV (Kaul M, 2009) Rheumatoid arthritis (Sangha et al,2020) Kidney disease (Singh et al, 2022)

14. 13-Aug-22 F. Alnaser: Risk factors for Dementia 14 Risk factors: Life style, environmental & Illness factors are; Being widowed and never remarrying may raise the risk of dementia ( Förster et al; 2021) Depression Stress is closely linked to depression and anxiety learning disabilities (Franks et al,2021)

15. 13-Aug-22 F. Alnaser: Risk factors for Dementia 15 Risk factors: Aspects of lifestyle, Health conditions, & environment are: Cognitive reserve: it is a person’s ability to cope with the disease in their brain. It is built up by keeping the brain active over a person’s lifetime . Low levels of cognitive engagement. (Peter et al, 2019)

16. 13-Aug-22 F. Alnaser: Risk factors for Dementia 16 Risk factors: Life style, environmental & Illness factors are; The three most important factors that can lead to a smaller cognitive reserve are: Leaving education early Less job complexity Social isolation

17. 13-Aug-22 F. Alnaser: Risk factors for Dementia 17 Risk factors: Aspects of lifestyle, Health conditions, & environment are: Exposure to air pollution: small particles from traffic fumes and from burning wood in the house increase a person’s risk of dementia

18. 13-Aug-22 F. Alnaser: Risk factors for Dementia 18 Studies indicate a 20% increase in dementia risk with the presence of one risk factor and rising to 65% for two risk factors (Peters, et al, 2019)

19. 13-Aug-22 F. Alnaser: Risk factors for Dementia 19 How to protect yourself: Maintain systolic BP 130 mm or less as of age 40 Reduce obesity and diabetes Limit alcohol intake Stop smoking and passive smoking Reduce exposure to air pollution Encourage using hearing aids & reduce hearing loss Prevent head injury Lead an active, socially engaged life Keep on exercising most days.

20. 13-Aug-22 F. Alnaser: Risk factors for Dementia 20 References: 1- Risk factors for dementia. Factsheet 450LP June 2021. Alzheimer Society https://www.alzheimers.org.uk/sites/default/files/pdf/factsheet_risk_factors_for_dementia.pdf 2- Peters R, Booth A, Rockwood K, Peters J, D'Este C, Anstey KJ. Combining modifiable risk factors and risk of dementia: a systematic review and meta-analysis. BMJ Open. 2019 Jan 25;9(1):e022846. doi : 10.1136/bmjopen-2018-022846. PMID: 30782689; PMCID: PMC6352772. 3- Kesse-Guyot E, Andreeva VA, Lassale C, et al.. Clustering of midlife lifestyle behaviors and subsequent cognitive function: a longitudinal study.  Am J Public Health  2014;104:e170–e177. 10.2105/AJPH.2014.302121 4- Chen JH, Lin KP, Chen YC. Risk factors for dementia. J Formos Med Assoc. 2009 Oct;108(10):754-64. doi : 10.1016/S0929-6646(09)60402-2. PMID: 19864195. 5-Zhong G, Wang Y, Zhang Y, Guo JJ, Zhao Y. Smoking is associated with an increased risk of dementia: a meta-analysis of prospective cohort studies with investigation of potential effect modifiers. PLoS One. 2015 Mar 12;10(3):e0118333. doi : 10.1371/journal.pone.0118333. Erratum in: PLoS One. 2015;10(4):e0126169. PMID: 25763939; PMCID: PMC4357455. 6-van der Flier WM, Scheltens P. Epidemiology and risk factors of dementia. J Neurol Neurosurg Psychiatry. 2005 Dec;76 Suppl 5(Suppl 5):v2-7. doi : 10.1136/jnnp.2005.082867. PMID: 16291918; PMCID: PMC1765715. 7- Förster F, Luppa M, Pabst A, Heser K, Kleineidam L, Fuchs A, Pentzek M, Kaduszkiewicz H, van der Leeden C, Hajek A, König HH, Oey A, Wiese B, Mösch E, Weeg D, Weyerer S, Werle J, Maier W, Scherer M, Wagner M, Riedel-Heller SG. The Role of Social Isolation and the Development of Depression. A Comparison of the Widowed and Married Oldest Old in Germany. Int J Environ Res Public Health. 2021 Jun 29;18(13):6986. doi : 10.3390/ijerph18136986. PMID: 34210083; PMCID: PMC8297151. 8- Lichtenstein P, Gatz M, Pedersen NL, Berg S, McClearn GE. A co-twin--control study of response to widowhood.  J Gerontol B Psychol Sci Soc Sci.  1996;51(5):279–89. 9- Andel R, Crowe M, Hahn EA, Mortimer JA, Pedersen NL, Fratiglioni L, et al. Work-related stress may increase the risk of vascular dementia.  J Am Geriatr Soc.  2012;60(1):60–7. 10- Gerritsen L, Wang HX, Reynolds CA, Fratiglioni L, Gatz M, Pedersen NL. Influence of Negative Life Events and Widowhood on Risk for Dementia. Am J Geriatr Psychiatry. 2017 Jul;25(7):766-778. doi : 10.1016/j.jagp.2017.02.009. Epub 2017 Mar 16. PMID: 28433549; PMCID: PMC5474139. 11- Garcia- Ptacek S, Kramberger MG. Parkinson Disease and Dementia. J Geriatr Psychiatry Neurol. 2016 Sep;29(5):261-70. doi : 10.1177/0891988716654985. PMID: 27502301. 12- Adam M Staffaroni , Peter A Ljubenkov , John Kornak , Yann Cobigo , Samir Datta, Gabe Marx, Samantha M Walters, Kevin Chiang, Nick Olney, Fanny M Elahi, David S Knopman , Bradford C Dickerson, Bradley F Boeve , Maria Luisa Gorno-Tempini , Salvatore Spina, Lea T Grinberg, William W Seeley, Bruce L Miller, Joel H Kramer, Adam L Boxer, and Howard J Rosen. (2019). Longitudinal multimodal imaging and clinical endpoints for frontotemporal dementia clinical trials. Brain. Pubmed . NCBI. doi:10.1093/brain/awy319. 13- Graham DI, Gentleman SM, Nicoll JA, Royston MC, McKenzie JE, Roberts GW, et al. Altered beta-APP metabolism after head injury and its relationship to the aetiology of Alzheimer's disease.  Acta Neurochir Suppl . 1996; 66: 96–102. 14- Franzblau M, Gonzales-Portillo C, Gonzales-Portillo GS, Diamandis T, Borlongan MC, Tajiri N, et al. Vascular damage: a persisting pathology common to Alzheimer's disease and traumatic brain injury.  Med Hypotheses . 2013; 81 (5): 842–845. 10.1016/j.mehy.2013.09.012

21. 13-Aug-22 F. Alnaser: Risk factors for Dementia 21 Thank you