Dr. Miia Kivipelto, the Deputy Head at the Aging Research Center and Alzheimer Disease Research Center at Karolinska Institute. Dr. Miia has conducted extensive research and is a recipient of numerous awards such as the Academy of Finland Award for Social Impact and the Junior Chamber International Award as Outstanding Young Person. Muntada is an innovative platform for sharing new ideas that stimulate creative thinking, learning and active discussions. It is through presenting enriching and locally relevant topics that Muntada aims to inform, update and empower the local community. Since its inauguration, Muntada has hosted a number of prominent speakers ranging through a variety of topics. For more info www.shf.ae

1. Dr. Miia KivipeltoProfessor of Clinical Geriatric Epidemiology at the Department of Neurobiology,
Care Sciences and Society Karolinska Institutet Sweden
Monday, September 16, 13

2. Is it possible to
prevent
Alzheimer’s disease?
Karolinska Institutet
Alzheimer Disease Research Center and
Aging Research Center, Sweden
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

3. What is dementia?
Dementia is not a specific disease.
It is an “umbrella term” used to describe the symptoms of a group of conditions that
impair memory, behaviors and thinking.
DEMENTIA
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

4. What is dementia?
Dementia is not a specific disease.
It is an “umbrella term” used to describe the symptoms of a group of conditions that
impair memory, behaviors and thinking.
60-80%
DEMENTIA
ALZHEIMER’S
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

5. What is dementia?
Dementia is not a specific disease.
It is an “umbrella term” used to describe the symptoms of a group of conditions that
impair memory, behaviors and thinking.
60-80%
Vascular
Dementia
Dementia with
Lewy Bodies
Fronto-temporal
Dementia
Parkinson’s
Disease
DEMENTIA
ALZHEIMER’S
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

6. Alzheimer’s Disease
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

7. Alzheimer’s Disease
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

8. What are the symptoms of Alzheimer’s ?
Memory loss:
Short-term memory
Dementia is progressive: as time advances, symptoms worsen.
Communication
difficulties:
finding the right words,
understanding what is
said
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

9. Dementia is progressive: as time advances, symptoms worsen.
Ability to focus &
concentrate:
E.g. following a
conversation
Mood changes:
Sadness, anger, fear,
irritability…
Miia Kivipelto, MD, PhD, Professor
What are the symptoms of Alzheimer’s ?
Monday, September 16, 13

10. Memory loss is a
normal part of aging
Common incorrect belief
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

11. Now we know that dementia is NOT a normal part of aging
Memory loss is a
normal part of aging
Common incorrect belief
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

12. Now we know that dementia is NOT a normal part of aging
Memory loss is a
normal part of aging
Common incorrect belief
If we have a family member who is showing signs of dementia, it is important to
see a doctor to determine the cause & follow the patient.
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

13. Expected lifetime
(Christensen et al. Lancet 2009)
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

14. CIA World Factbook 2012, Estimated Life Expectancy at Birth.
+80 +77 +75 +72 +70 +67
Expected lifetime
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

15. The proportion of older adults (65+) will reach 28% in 2050
The aging population in the UAE
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

16. 0
7.5
15
22.5
30
3.4 3.4 3.5
1.8 1.5 2.1 1.3 1.4 1.1 1 1 0.8 0.4 0.8 1.7
3.6
6.3
10.2
15.6
22.1
28
1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050
The proportion of older adults (65+) will reach 28% in 2050
The aging population in the UAE
Trends of UAE’s Elderly Population, 1950 - 2050
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

17. 0
7.5
15
22.5
30
3.4 3.4 3.5
1.8 1.5 2.1 1.3 1.4 1.1 1 1 0.8 0.4 0.8 1.7
3.6
6.3
10.2
15.6
22.1
28
1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050
The proportion of older adults (65+) will reach 28% in 2050
The aging population in the UAE
Trends of UAE’s Elderly Population, 1950 - 2050
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

18. 0
7.5
15
22.5
30
3.4 3.4 3.5
1.8 1.5 2.1 1.3 1.4 1.1 1 1 0.8 0.4 0.8 1.7
3.6
6.3
10.2
15.6
22.1
28
1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 2020 2025 2030 2035 2040 2045 2050
The proportion of older adults (65+) will reach 28% in 2050
The aging population in the UAE
Trends of UAE’s Elderly Population, 1950 - 2050
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

19. (Fratiglioni, Qiu, Oxford Textbook Old Age Psychiatry, 2013)
Advanced age: A major risk factor for dementia
Age-specific prevalence rates of
dementia across the world
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

20. Effects of Delay of Onset of Disease on Prevalence of Dementia
5 year delay in the onset of Alzheimer’s would decrease the disease prevalence by 50%
USprevalenceofAD(millions)
Delay
(years)
0
.5
1
2
5
1997
2007
2017
2027
2037
2047
Year
8
6
4
2
0
Brookmeyer et al., 1998, Jorm et al., 2005
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

21. Dementia: importance of life-long exposure to multiple factors
Mangialasche, Kivipelto et al., 2012
Birth
Childhood
2nd Decade
Adult Life - Middle Age Transition Old Age
0 20 60 75
Genetic EnvironmentHealthy Brain Alzheimer’s Brain
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

22. Modifiable risk factors for Alzheimer’s
Risk Factors Protective Factors
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

23. Modifiable risk factors for Alzheimer’s
Risk Factors Protective Factors
• Stroke
• High Blood Pressure
• High Blood Cholesterol
• Obesity
• Diabetes mellitus
• Smoking
• Depression/stress
• Head trauma
• ?
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

24. Modifiable risk factors for Alzheimer’s
Risk Factors Protective Factors
• Stroke
• High Blood Pressure
• High Blood Cholesterol
• Obesity
• Diabetes mellitus
• Smoking
• Depression/stress
• Head trauma
• ?
• High education
• Physical activity
• Active lifestyle
• Antioxidants
• Fish oils
• Coffee
• Antihypertensives
• Statins
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

25. Combined effect of vascular risk factors at midlife
Risk
BMI
>30 kg/m
2.1
Systolic
blood
pressure
>140mmHg
2.0
Cholesterol
>6.5 mmol/l 1.9
Kivipelto et al., Arch Neurol 2005
0
1.75
3.50
5.25
7.00
0 1 2 3
6
3
11
Number of risk factors present
2
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

26. Healthy, balanced diet can reduce the risk for memory problems
Luchinger et al., Curr Neurol Neurosci Rep 2007 - Scarmeas et al., Annals of Neurology 2006, JAMA 2009 - Mangialasche, Kivipelto et al., JAD 2010
• Fish
• Vegetables and fruits
• Vitamins B, C and E
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

27. Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

28. Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

29. Rovio, Kivipelto et al., Lancet Neurology 2005 Rovio, Kivipelto, et al. Neurobiol Aging 2009
Physical activity at midlife
Couch Potatoes Dementia Alzheimer’s
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

30. Rovio, Kivipelto et al., Lancet Neurology 2005 Rovio, Kivipelto, et al. Neurobiol Aging 2009
Physical activity at midlife
0.25
0.5
0.75
1
Couch Potatoes Dementia Alzheimer’s
Reduced
Risk
Miia Kivipelto, MD, PhD, Professor
100%
60%
70%
Monday, September 16, 13

31. Rovio, Kivipelto et al., Lancet Neurology 2005 Rovio, Kivipelto, et al. Neurobiol Aging 2009
Physical activity at midlife
Physical activity –
larger brain volume
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

32. (Karp et al, Dement Geriatr Cogn Disord 2005)
Leisure time activities in late life
0
0.25
0.5
0.75
1
High Mental Score High Physical Score High Social Score Low Score
Miia Kivipelto, MD, PhD, Professor
30% 40% 35% 100%
Reduced Risk
Monday, September 16, 13

33. Håkansson, Kivipelto et al., BMJ 2009 Håkansson et al., manuscript
Social and psychological factors
Social Factors Psychological factors Social+psychological
Loneliness
0
1.5
3
4.5
6
Risk Risk
Living Alone
Being
Widowed
Hopelessness
Alone+Lonely
Widowed+
Hopelessness
Loneliness
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

34. Håkansson, Kivipelto et al., BMJ 2009 Håkansson et al., manuscript
Social and psychological factors
Social Factors Psychological factors Social+psychological
Loneliness
0
1.5
3
4.5
6
Risk Risk
Living Alone
Being
Widowed
Hopelessness
Alone+Lonely
Widowed+
Hopelessness
Loneliness
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

35. Håkansson, Kivipelto et al., BMJ 2009 Håkansson et al., manuscript
Social and psychological factors
Social Factors Psychological factors Social+psychological
Loneliness
0
1.5
3
4.5
6
Risk Risk
Living Alone
Being
Widowed
Hopelessness
Alone+Lonely
Widowed+
Hopelessness
Loneliness
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

36. Loneliness
Loneliness
FUTURE
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

37. Loneliness
Loneliness
FUTURE
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

38. Clinical Trials
Finnish Geriatric Intervention Study to Prevent Cognitive
Impairment and Disability (FINGER)
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

39. Intervention Schedule
NUTRITION
EXERCISE
COGNITIVE TRAINING
MONITORING AND MANAGEMENT OF
METABOLIC AND VASCULAR RISK FACTORS
INTENSIVE INTERVENTION
InterventionKick-Off
Screening
1stBaselinevisit
2ndBaselinevisit
RANDOMIZATION
Months 3 6 9 12 15 18 21 24
Mini
Intervention
Miia Kivipelto, MD, PhD, Professor
REGULAR HEALTH ADVICE
Monday, September 16, 13

40. FINGER intervention
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

41. European Dementia Prevention Initiative
EDPI%
http://www.edpi.org/
Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability
Prevention of Dementia by Intensive Vascular Care
MAPT Multidomain Alzheimer Preventive Trial
FINGER
preDIVA
MAPT
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

42. Healthy Aging Through Internet Counseling in the Elderly
www.HATICE.eu
Miia Kivipelto, MD, PhD, Professor
New use of technology to improve dementia prevention
Monday, September 16, 13

43. (Mangialasche, Winblad, Kivipelto, et al., Lancet Neurol 2010)
Drug development in Alzheimer’s Disease
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

44. Is it possible to prevent dementia?
•Control blood pressure and other vascular risk factors
•Be active and maintain an active life
•Healthy, balanced diet
•Avoid negative stress
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

45. Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

46. LIFE MATTERS !
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13

47. THANK YOU
Karolinska Institutet
Alzheimer Disease Research Center and
Aging Research Center, Sweden
Miia Kivipelto, MD, PhD, Professor
Monday, September 16, 13