Day 1 :
Full Professor, University of South Florida, USA
L. Volicer courtesy Full Professor, School of Aging Studies, College of Arts and Sciences, University of South Florida, USA.
Two common behavioral symptoms of dementia that often decrease quality of life for people with dementia and increase stress of their carers are agitation that occurs when the person is solitary, and rejection of care which may lead to reactive aggression. Agitation can be managed by providing meaningful activities on a daily basis. Rejection of care improves when people with dementia are used to touch. Namaste Care can reduce both agitation and rejection of care. There are two main principles of Namaste Care: (1) Providing a calm, comfortable environment and (2) Using loving touch approach to all interactions and offering activities of daily living (ADLs) as meaningful activities. This program was designed for people with advanced dementia, who cannot participate in traditional activities. The Namaste Care program takes place in a space that is a free from distractions as possible, lights are lowered, relaxing music is playing and the scent of lavender permeates the room. Residents are placed in reclining chairs, assessed for pain and a warm blankets are tucked around them. The loving touch approach is provided by the Namaste carer who gently massages the persons’ hands, arms and legs. Hair is lovingly brushed. The carer is not wearing gloves and is gently speaking to the resident as they are being offered these meaningful activities. People with advanced dementia become used to being touched and when they are not in the Namaste Care program, they rarely reject care. The calm environment and loving touch improve communication, decrease agitation and improve symptoms of depression. Namaste Care allows decrease of psychotropic medications and increases job satisfaction of caregivers. Families are encouraged to participate in Namaste Care, they visit more often, and are more satisfied with the care that is provided. Namaste Care helps families, who often feel helpless, to get involved with their relatives as staff teach them how to offer hand massages, play religious music if the person was active in a particular faith, and talk with them when they are in the dying process. Namaste Care was developed for person who is cared for in a long-term institution but it can also be taken to the bedside. Many hopsices are offering the loving touch and creating a calm environment wherever the patient is living, at home in a nursing facility or inpatient hospice unit. This program is provided until the person dies. Namaste Care can be implemented without additional staff and with very limited expenses. It is now offered in 11 countries.
Prof. Fändrich is acknowledged for his pioneer work on using M2-polarize anti-inflammatory macrophages in allogeneic and autologous settings for tolerance induction in kidney transplantation and age-related diseases including neurodegenerative diseases, respectively. Prof. Fändrich chairs the Dept. of Applied Cellular Medicine which was established in 2008 at the University UKSH, Campus Kiel, with the focus to translate basic acaedemic research in the field of cellular medicine into clinical application.
Lately, there is accumulating evidence evidence for silent inflammation as a major contributor to Alzheimer Disease (AD), associated as one potential underlying pathomechanism. This includes innate immunity, specifically M1-polarised inflammatory macrophages which trespass the blood brain barrier. Using wild-type and amyloid precursor protein β protein transduced mice we compared the cognitive abilities of four different experimental groups (n=8). 1. Wild type mice (not transduced with APPβ), 2. APPβ+ animals treated with saline, 3. APPβ+ mice treated with radiated (7 gy) REMs (M2-polarized anti-inflammatory macrophages), and 4. APPβ+ mice treated with non-radiated REMs. REMs (radiated and non-radiated) were injected intravenously into APPβ+ animals at the age of 2 months. Cognitive capacity was tested using a water-maze and labyrinth test model, at the age of two months (young mice) and at 6 months (old mice) of age. We found a significant reduced capacity of learning and orientation capacities in all four groups when comparing young and old mice. There was a significant cognitive decline when comparing wild-type animals with APPβ+ animals treated with saline (p<0.01) or radiated REMs (p<0.01). Treatment with non-radiated REMs prevented the development of AD in all 8 animals tested whose cognitive functional scores did not differ significantly from wild-type animals. In a pilot observation n=7 Alzheimer patients were treated with autologous REM´s generated from patient’s monocytes. Based on MMSE (MINI-Mental-State-Examination) n=4 patients had an improvement of the cognitive activity. Our results indicate that the anti-inflammatory properties of regenerative M2-polarized REM macrophages is able to prevent astrocyte and microglial activation in APPβ+ animals and underscores silent inflammatory-based neuronal damage as a major pathomechanism in this animal model. Additionally, first clinical results show that this cellular therapy has a positive effect on the cognitive activity of Alzheimer patients.
Respiratory Research and Rehabilitation Laboratory, Portugal
She completed her Master's Degree in Gerontology - Equipment Management from the University of Aveiro in 2015. She published 2 papers in the minutes of events. It has 3 items of technical production. In her professional activities, she interacted with 2 collaborators in co-authorship of scientific works.
Physical capacity (PC) is an important determinant for physical activity (PA). Nevertheless, an increase in PC does not imply a more physically active lifestyle but the relationship between these two domains is still unknown in people with dementia. We explored the relationship and the distribution of people with dementia across the four quadrants of PC and PA levels.
An exploratory cross-sectional study with community-dwelling people with dementia was conducted. PA was assessed with accelerometery (ActiGraph GT3X+). Participants wore the device for 7 consecutive days during waking hours on the right side of their hip. Data of at least 4 days and minimum of 8h/day were used for analysis. PC was measured with the 2 Minute Step Tests (2MST). Receiver operating characteristic curve was performed to establish a cut-off point for 2MST able to discriminate physically active from non-physically active people with dementia. Correlations were explored with the Spearman Correlation Coefficient.
Twenty-five people with dementia (79 [72-83] years old; 16[64%] female) participated in this study. A cut-off of 34 steps was found for the 2MST (91.7% (95%CI 61.5-99.8%) sensitivity and 69.2% (95%CI 38.6-90.9%) specificity). Significant, moderate and positive correlations (rs=0.66; p<0.001) were found between PC and PA (Figure 1).
In this study, people with dementia who presented low or high PC were also low or high physically active, respectively. Future studies with larger samples should be conducted to corroborate these results, exploring other characteristics of participants and to understand their influence on physically active lifestyle behaviour in this population.
Professor of Machine Learning at Ben-Gurion University, Israel
Boaz Lerner is a Professor of Machine Learning at Ben-Gurion University, where he also did his Ph.D. After Ph.D., he did research at Aston University and Cambridge University. Lerner has been investigating, developing, teaching, and consulting in machine learning, undertaking many projects funded by, or in co-operation with, different agencies/authorities/companies. He has been a reviewer for many journals and conferences and has served on various conference PCs. Lerner has supervised around 50 graduate students and has published around 100 papers in peer-reviewed journals and conference proceedings. Current main interests are in Bayesian network structure learning, precision medicine, and precision agriculture.
Objective: ALS disease state prediction usually assumes linear progression and uses a classifier evaluated by its accuracy. Since disease progression is not linear, and the accuracy cannot tell large from small prediction errors, we dispense with the linearity assumption and apply ordinal classification. We identify the most influential variables in predicting and explaining the disease. In contrast to conventional modeling of the patient's total functionality, we model separate patient functionalities (e.g., in walking or speaking). We extend our system to other neurodegenerative diseases (ND), e.g., Parkinson’s (PD) and Alzheimer’s (AD).
Methods: We introduce ordinal classifiers that already during training account for error severity in predicting the disease state in the last clinic visit for 3,772 patients in the PRO-ACT database. We use feature-selection methods and the classifiers to determine the most influential variables in predicting the disease from demographic, clinical, and laboratory data collected in different clinic visits, and interrelations among these variables and their relations with the disease state. We apply these machine-learning (ML) methods to: 1) model ALS patient functionalities; 2) diagnose PD and AD; and 3) predict PD severity.
Results: We show that ordinal classifiers outperform classifiers that do not account for error severity. We identify clinical and lab test variables important to ALS prediction, and specific value combinations of these variables that occur more frequently in patients with severe deterioration than in patients with mild deterioration and vice versa. Further, we accurately predict AD, PD, and PD severity from data using ML.
Conclusions: Ordinal classification of ALS state is superior to conventional classification. Important ALS variables and their interrelations help explain disease mechanism. By modeling separate patient functionalities, variables and their connections to different aspects of the disease are related to different body segments. We conclude that ML methods can successfully help ND analysis from data.
Principal of Ishwar Deshmukh Institute of Pharmacy, india
Dr. Rahul Hajare has been a hard worker all his academic life. After his Ph.D in Pharmacy from VMRF Salem which he completed with flying colours, he is fortunate to work NARI primer HIV research Institute to complete Post Docunder the of World Renowned Scientist Respected Dr. R.S.Paranjape., Retired Director & Scientist ‘G’ National AIDS Research Institute Pune. Dr. Rahul Hajare has Associate Professor of Pharmaceutical Medical Chemistry to Pune University (until 2020), he has serviced three times AssociateProfessor in Pharmaceutical Science and Analytical Science. Graduated from Amravati University in 2003, after an assignment he worked as an M.Pharm Scholar in the Institute of Pharmaceutical Education and Research passed with distinction, he has Post Graduate Teacher for Master of Pharmacy, he has more than 30 scientific and methodological works, 3 patents of scientific research.
Dr. Rahul Hajare now Principal of Ishwar Deshmukh Institute of Pharmacy affiliated combined Amravati University and All India Council of Technical education New Delhi.
Why do we in our society refuse to talk about the same thing that caused us to be born? Most women appreciate it when their partners want to make sure their needs are met. The harder you work to please her, the greater the chance she will reciprocate. We have all heard that women 'fake it', but did you know how many? According Psychology Today website, only about 25% of women said they orgasm regularly during sex -- certainly not a number that inspires confidence in the sexual prowess of the average male. Evidently, it doesn’t matter whether you’re from the land of the Kama Sutra or the home of KY Jelly; the numbers suggest that if you’re a man engaging in regular sex, you’re probably not doing a good enough job. Fortunately, and contrary to what most of you are afraid of hearing, it isn’t the size of the ship that matters, but the motion of the ocean. Even more simply put, how you’re doing is all about what you’re doing. So, in the spirit of literally helping out our fellow man, here are a few pointers on how to make sex more pleasurable for your partner.
sophomore at Ward Melville High School, USA
Jessica Guo is currently a sophomore at Ward Melville High School. She has completed a 6 week summer internship at the Weill Cornell Medical College, and is currently a student researcher at the SUNY Old Westbury Neuroscience Research Institute. She is mentored by Professor Wei Zhu, who received his Ph.D. from the Catholic University of Leuven, Belgium, and completed his Post- Doctoral fellowship at the Mind Body Medical Institute at Harvard University
Parkinson’s Disease (PD) is the second most common form of dementia and currently affects over 10 million people. Parkinson’s is a neurodegenerative disease that results in significant loss of cholinergic neurons. Symptoms include tremors, Bradykinesia (slowed movement), rigid muscles, impaired posture/balance, loss of automatic/unconscious movements, speech changes, and writing changes.
Rotenone is an odorless, colorless, crystalline isoflavone used as a broad-spectrum insecticide. By inhibiting the mitochondrial complex I, ROS (Reactive oxidative stress) levels substantially increase in the cells, and the number of dead cells is remarkably higher. As a result of this deficiency in complex I in the mitochondria, an increase in ROS and the reduction of energy stores ensues, eventually contributing to neurodegeneration of cholinergic neurons. Through this process, rotenone triggers morphological changes in cells. Rotenone is a naturally occurring insecticide that is used worldwide because it has broad pesticidal properties. Due to the widespread use of rotenone, the reversal of this neurotoxicity is the current need for Parkinson’s Disease patients. Because there is evidence that antioxidants Glutathione, Piperlongumine, and Piperlonguminine protect the mitochondrial complex I, this study focuses on the protective effects of these respective chemicals on Parkinson’s neuronal cells exposed to rotenone.
PhD Student in Health Psychology, The University of Auckland, Auckland, New Zealand
PhD Student in Health Psychology, The University of Auckland, Auckland, New Zealand
Objectives: The aim of this study was to examine the effects of passive music therapy (PMT) on cognitive function, depression, and quality of life (QoL) in patients with vascular dementia (VaD).
Methods: Adults who met the criteria for vascular dementia (n = 34; mean age = 62.2 years) were randomly allocated to the PMT group (n = 17) or control group (n = 17). PMT was performed under the supervision of a music therapist for 45 min a day, twice a week for 8 consecutive weeks (16 sessions). Outcome measures included cognitive function, depression, and quality of life.
Results: QoL decreased during standard care and increased during music therapy (p<0.01, F= 220.37). Depression increased significantly more often during standard care than during music therapy (p = 0.02). However, total scores on the Mini‐Mental State Examination (MMSE) did not significantly change, but the scores of two subscales, ‘language’ and ‘recall’, improved significantly (p = 0.023).
Conclusions: A well-structured music therapy was associated with positive changes in depression level related to cognitive decline and enhanced quality of life in adults with VaD. To confirm these promising results, further research with a larger sample is needed.
PhD Student in National Yang-Ming University.
Wei-Han Weng is a certified physical therapist in Taiwan, and now doing postgraduate study in National Yang-Ming University.
Dementia affects brain systems and impacts functional mobility skills which increase the risk of falls. Therefore, people with dementia are at high risks of falling, and the consequences of falls are usually more serious than healthy elderly. Therefore, how to improve functional mobility and decrease fall risk are crucial especially for people with dementia. Several studies have investigated the effects of exercise to improve functional mobility and to reduce fall risk in dementia. This review aimed to evaluate the evidence of exercise on functional mobility and fall rate in individuals with dementia.
Methods: Databases (medline, PubMed, Cochrane Library, Airiti Library and CINAHL) were searched from Jan, 2009 to May, 2019. Only randomized controlled trials (RCT) investigating the effect of exercise or physical activity in comparison to usual care in older adults with dementia were included. The PEDro score was used to assess the quality of the selected trials. The outcomes included incidence rate of falls and functional mobility, the timed-up and go test (TUG) and gait velocity. Studies without fall rate, TUG, or gait velocity as one of the outcomes and studies as the secondary analysis of RCT were excluded. Collected data were analyzed by Review Manager (5.3).
Results: Overall 522 subjects with dementia from four RCTs were included in this study. However, results show that exercise or physical activity led to nonsignificance in reducing fall rate (MD= 0.54, 95%CI=-0.53~1.6, p=0.32) and in improving the TUG (MD= 3.12, 95%CI=-2.85~9.10, p=0.31) and gait velocity (MD= -7.73, 95%CI=-29.98~14.52, p=0.5).
Discussion and conclusion: According to the results of this meta-analysis and systematic review, exercise might not be able to significantly decrease the fall rate and improve functional mobility in people with dementia. A multitude of factors contribute to the increased fall rates and decreased functional mobility observed among older adults, which may also be true for elderly with dementia. Therefore, in addition to exercise, other training or strategy should be incorporated for improving fall risk and functional mobility.