Postgraduate Course in Dementia Care No. II

Session 3–- Dementia : Diagnosis, Management & research

Diagnosing & Management

April 8, 2025

9 am-4 pm Egypt -Hybrid

Meeting Summary for Dementia Workshop

Apr 08, 2025 10:08 AM Beirut ID: 842 6769 6536

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Quick recap

Abdulrazak led a discussion on a workshop on dementia, emphasizing the need for early diagnosis and prevention, and the importance of a multidisciplinary approach to dementia prevention and management. The presentation covered advances in biomarkers and new imaging techniques for diagnosing dementia, emerging therapies for Alzheimer's disease and dementia, and the importance of early diagnosis of dementia in multi-ethnic communities. The conversation ended with a discussion on the development of a particular approach that focuses on learning in a restricted sense, dependent on some understanding of nonlinear dynamics, and its potential for early detection of cognitive disorders and its application in training and rehabilitation.

Next steps

Research Team: Establish a multi-domain collaborative research team across MENA region to study dementia genetics and early diagnosis methods

Dr. Abyad's Team: Develop and implement a protocol for DMD treatment in Kuwait, including setting up a multidisciplinary team with radiologists, memory assessment program, ICU, infusion center, genetic testing, and pharmacy

Research Teams: Work on establishing a regional database of patients for genetic studies, aiming for 4,000-5,000 patients to study gene interrelations with APOE and other genes

Healthcare Professionals: Develop training programs for healthcare teams on early dementia diagnosis and assessment techniques

Hospital Teams: Prepare infrastructure and protocols for implementing Disease Modifying Drugs treatment, including MRI facilities, biomarker testing, and specialized care teams

Dr. Abyad & Team: Create awareness programs about dementia for both healthcare professionals and the public in the MENA region

University of Reading Team: Continue development and validation of multi-ethnic diagnostic tools for dementia assessment

Clinical Teams: Implement comprehensive assessment protocols including limb apraxia testing for early dementia diagnosis

Healthcare Facilities: Develop caregiver support programs and training modules for families of dementia patients

Policy Makers: Work on developing national dementia strategies and plans in MENA countries

Professor Samra & Team: Continue data analysis of the limb apraxia assessment pilot study in Lebanon and expand testing to larger sample sizes

Professor Douglas & Team: Continue collecting normative distribution data from older adults for the binary sequence learning assessment tool

Research Teams: Develop training programs for clinicians to better recognize atypical dementia syndromes in the MENA region

Dr. Abyad & Professor Samra: Further develop collaboration on multi-ethnic diagnostic tools suitable for the MENA region population

University of Reading Team: Initiate discussions about development and delivery of training programs to address capability gaps in diagnosis

Summary

Cairo Workshop on Dementia Diagnosis

Abdulrazak led a discussion about a workshop on dementia, which is the third of its kind in Cairo. The workshop is a collaboration with the University of Reading and will focus on early dementia diagnosis. A researcher from Reading University will present their diagnostic studies in the afternoon. The attendees were welcomed, and Abdulrazak expressed his gratitude for their attendance and the guest speakers' contributions.

Dementia's Global Burden and Economic Impact

Abdulrazak presents an overview of the global burden of dementia, highlighting its rapid increase, especially in developing countries. He notes that by 2050, there will be 152 million people with dementia worldwide, with 70% living in developing countries. The economic impact is significant, with global costs expected to reach $2 trillion by 2030. Abdulrazak emphasizes the need for early diagnosis, caregiver support, integrated care models, dementia-friendly communities, and development of healthcare professionals specializing in dementia care. He concludes that addressing the dementia care gap is a public health priority that requires urgent attention.

Dementia Diagnosis Challenges in Elderly Patients

The discussion focuses on the challenges of diagnosing dementia, particularly in elderly patients. Abdulrazak explains that dementia is often underdiagnosed, with up to 75% of cases lacking formal diagnosis, especially in low-income countries. He emphasizes the importance of early detection and the need to differentiate between normal aging, mild cognitive impairment, and dementia. Abdulrazak also highlights the complexity of dementia diagnosis due to symptom overlap with other conditions, atypical presentations, and the limitations of diagnostic tools. He stresses the need for a comprehensive, multi-modal approach to diagnosis, including patient history, neuropsychological testing, neuroimaging, and biomarkers.

Biomarkers and Imaging for Dementia

The presentation discusses advances in biomarkers and new imaging techniques for diagnosing dementia, particularly Alzheimer's disease. Dr. Rafminar explains that there is a shift towards biological diagnosis rather than clinical diagnosis, with biomarkers potentially detecting Alzheimer's disease 10-20 years before symptom onset. Various biomarkers are discussed, including CSF and blood-based markers, as well as imaging techniques like amyloid PET scans. The speaker also mentions new research into less invasive biomarker sources such as saliva, tears, and nasal swabs, and the potential use of artificial intelligence in integrating different diagnostic tools.

Multidisciplinary Dementia Prevention Strategies

The summary discusses the importance of a multidisciplinary approach to dementia prevention and management. Professor Ashton presents evidence-based strategies including nutrition, exercise, and social engagement. He emphasizes that multi-domain interventions are more effective than single-domain approaches and highlights the need for early intervention in high-risk populations. The presentation also covers the benefits of the Mediterranean diet, aerobic exercise, and cognitive training. Professor Ashton recommends integrating dementia prevention strategies into routine clinical practice and educating patients about modifiable risk factors.

Alzheimer's Therapies and Diagnostic Tools

The presentation discusses emerging therapies for Alzheimer's disease and dementia. Abdulrazak highlights new diagnostic tools and treatment approaches, including monoclonal antibodies targeting beta-amyloid and tau proteins. He mentions recently approved medications like Lecanemab and Donanemab, noting their potential benefits and challenges in implementation. The talk also covers other promising areas such as anti-tau drugs, multi-domain interventions, and repurposed medications. Abdulrazak emphasizes the importance of early treatment and prevention, as well as the need for a multidisciplinary approach in administering new therapies.

Alzheimer's Research: Early Diagnosis and Prevention

Professor Khaled from Ibanese University discusses genetic research on Alzheimer's disease. He emphasizes the need for early diagnosis and prevention, noting that the average age of diagnosis in their study was 79 years old, which is too late for effective treatment. Khaled argues for a multi-domain approach to research, combining genetics, environmental factors, and clinical studies. He highlights the importance of studying multiple genes beyond just APOE4, as well as considering factors like iron deficiency and vitamin deficiencies. Khaled calls for collaboration among researchers to create a large database of patients and genetic information to better understand the disease. He also stresses the importance of keeping elderly people active and engaged in society as a preventative measure.

Dementia Diagnosis in Multi-Ethnic Communities

Abdulrazak discussed the importance of early diagnosis of dementia in multi-ethnic communities. He highlighted the need for more accurate and sensitive diagnostic tools, particularly in assessing parietal structures and cognitive impairments. Abdulrazak presented the work of his lab, which has been developing a parietal toolbox of tasks to be incorporated into the assessment of Alzheimer's disease. He also discussed the challenges of diagnosing dementia in multi-ethnic communities, particularly the language barrier and the need for culturally appropriate assessments. Abdulrazak shared the results of a pilot study conducted in Lebanon, which showed promising results for the use of the Dementia Apraxia Test in differentiating Alzheimer's patients from healthy controls. He emphasized the need for further research and collaboration to develop more effective diagnostic tools for dementia in diverse communities.

Fractal Complexity in Cognitive Disorders

In the meeting, Abdulrazak discussed the development of a particular approach that focuses on learning in a restricted sense, dependent on some understanding of nonlinear dynamics. He highlighted the challenges of dealing with data from genomic and clinical observations, which often show complex nonlinear responses. Abdulrazak proposed using fractal dimensionality as a diagnostic tool to characterize the progress of morphological changes in the brain of Alzheimer's patients. He also discussed the use of binary or minimally distinct stimuli to drive learning or training tasks, and the importance of fractal complexity in cognitive tasks. The conversation ended with a discussion on the potential of using this approach for early detection of cognitive disorders and its application in training and rehabilitation.

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The International Institute on Ageing-United Nation-Malta (INIA)
The Advanced Postgraduate Course No. VI
Master Class in Geriatric : Session 6.2 Oct 25-27, 2018 :
Geriatric Giants & Palliative Care in Cairo Egypt
Organised by Egyptian Society of Geriatrics and Gerontology,
Abyad Medical Center, Lebanon and Middle East Longevity Institute, Lebanon
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National Postgraduate Course in Geriatrics 2016-2017
Monstair, Tunis
web : www.geriatrie-tn.org <http://www.geriatrie-tn.org/>