Brazilian Congress of Psychiatry, Oct 5, 2022.
- Title: Can we really prevent dementia? The status of the evidence”
- Chair: Prof Perminder Sachdev MD, PhD, University of New South Wales, Sydney
Speakers:
- Prof Gill Livingston MD, University College, London. Title: Modifiable risk factors for dementia: the 2020 Report of the Lancet Commission
- Prof Perminder Sachdev MD, PhD, University of New South Wales, Sydney. Title: Preventing dementia: the role of biomarkers
- Prof Henry Brodaty MD, DSc, University of New South Wales, Sydney. Title: Maintain Your Brain: the largest online trial to slow cognitive decline and prevent dementia
- A/Prof Susanne Röhr, PhD, MSc, Massey University, Palmerston North, New Zealand, & University of Leipzig, Germany. Title: Global efforts on multidomain interventions against cognitive decline: current evidence and future directions
Prof Perminder Sachdev Email
Prof Gill Livingston Email
Prof Henry Brodaty Email
A/Prof Susanne Röhr Email
Symposium summary:
Welcome to the Symposium on Preventing Dementia. This symposium is jointly sponsored by the International Neuropsychiatric Association and the Brazilian Association of Psychiatry.
There are currently no effective treatments for dementia, even though we have heard some exciting news about monoclonal antibodies for Alzheimer’s disease. Extensive research over the last three decades has, however, identified several modifiable risk factors, controlling which could potentially reduce the risk of dementia substantially by postponing its onset, slowing its progression from the predementia stage or preventing it altogether. Several prevention trails have been published, but the findings have been inconsistent. More consistent evidence is beginning to emerge from recent multi-modal interventions that are occurring around the world. There is emerging evidence that the incidence of dementia is falling in several high-income countries.
This symposium brings together leading experts in the field of dementia epidemiology and prevention to discuss different aspects of the challenge of preventing dementia.
Prof Gill Livingston, Prof of Old Age psychiatry at University College, London. She will present her work as leader of the Lancet Commission on Dementia Prevention, Intervention and Care 2020. In particular, she will discuss the 12 modifiable risk factors on which there are sufficient data to suggest that they collectively contribute about 40% of the risk for dementia at the population level.
Prof Sachdev will discuss the issue of prevention from the perspective of those at high risk by examining the role of biomarkers in selecting individuals for prevention trials.
Prof Henry Brodaty is Scientia Professor of Psychiatry of Old Age at UNSW Sydney. He will present recent data from the largest online trial for the prevention of cognitive decline and dementia – Maintain Your Brain – another multimodal trail but delivered entirely on the web.
A/Prof Suzanne Rohr works at Massey University in NZ as well as Univ of Leipzig, Germany, and is an Atlantic Fellow for Equity in Brain Health. She will summarise the world-wide effort toward obtaining evidence for prevention, with a particular focus on low resource settings. She will make a special reference to the World-Wide Fingers network.
Educational objectives:
- Learn about modifiable risk factors for dementia
- An up to date synthesis of information on dementia prevention at the population level.
Concluding comments:
You will agree that the data on multimodal interventions are accumulating, and there is world-wide interest. This is understandable because dementia is a global problem, and in fact the greatest increase is likely to occur in the low and middle income countries. In Brazil, more than 1 million people are living with dementia and the number is increasing rapidly. Even if effective anti-amyloid treatments become widely available and affordable, it will address only a fraction of the dementia problem. Control of vascular risk and modifiable lifestyle factors will remain the mainstay of primary prevention. While more work is needed, I believe that we already have sufficient information to begin public health campaigns and also attempt to incorporate prevention of dementia into health policy and practice. We owe it to the generations that will follow us.
Perminder Sachdev, Scientia Professor of Neuropsychiatry, Centre for Healthy Brain Ageing (CHeBA), UNSW Sydney
September 15th and 16th 2022
The Faculty of Neuropsychiatry, Royal College of Psychiatrists held its annual conference jointly with the INA. This was a hybrid meeting with over 200 people registered to attend in person or remotely. The first in person conference since 2019. The meeting was academically excellent and wide ranging covering autoimmune psychosis, epilepsy, women in psychiatry and metabolic disorders as well as our own INA sessions.
The Cajal Lecture was given by Professor Valerie Voon who is a neuropsychiatrist dividing her time between the University of Cambridge and Fudan University, Shanghai. She discussed ‘Deep brain stimulation: Insights into mechanism of addiction’. This was a tour de force presentation about how DBS can be used to understand the underlying neural mechanisms of how goal-directed behaviour becomes habitual and compulsive.
Award presented to Professor Valerie Voon by Professor Eileen Joyce
The Lishman Lecture was given by Professor Ludvic Zrinzo, who is a neurosurgeon at UCL Queen Square Institute of Neurology, London. He has significant experience of DBS or ablative neurosurgery for conditions such Tourette’s, OCD and depression. His talk was a persuasive evidence-based account of why psychiatrists should support neurosurgery for the most extreme, severe cases who have not been helped by standard treatments and whose life is blighted by their condition. He took a poll before and after his talk and there was compete agreement with his case!
Lishman Award presented by Professor Tony David to Professor Ludvic Zrinzo
The INA Presidential Symposium, chaired by Dr Niruj Agrawal, was on the topic of preventing dementia. There were two talks. The first was by our own INA member, Professor Ingmar Skoog who is a clinician and epidemiologist at the University of Gothenburg, Sweden. He presented his longitudinal data over many years of studying large populations as they age in order to understand the risk factors for dementia. We were surprised (and pleased) to learn that dementia is not as common as we are led to believe in the media and a proportion of people with signs of early dementia do not go on to develop dementia proper. Our second speaker was Professor John O’Brien who is an old age psychiatrist at the University of Cambridge. He discussed some results of the PREVENT study of ageing and dementia. More gloomy, is the finding that the development of Alzheimer neuropathology is probably even earlier than previously thought and preventative interventions, based of brain biomarkers of risk, would need to be implemented in middle age.
Eileen Joyce, Tony David and Niruj Agrawal
In 2024, the INA will be holding its international conference in Melbourne, Australia. This will be a joint event with The Royal Australian and New Zealand College of Psychiatry’s 13th Annual Neuropsychiatry and Behavioural Neurology conference.
We are planning an impressive array of international speakers, talks and workshops to run over three days:
- November 13-15
- Melbourne Convention & Exhibition Centre
Save the date!
Visit The Royal Australian and New Zealand College of Psychiatry’s website