Alzheimer’s disease is one of the newer pandemics. And this pandemic, which will not subside even in a few years, since there is still no complete cure for the disease, in which more and more people are involved.
Alzheimer’s disease affects 55 million people worldwide, which will increase to 75 million by 2030 and 132 by 2050.
In Greece, this problem affects about a million people, patients and their families. The number of people with dementia is estimated at 160,000, and those with mild mental retardation (the precursor to dementia) at 280,000.
After two years of impressive action in our country, the Greek Initiative Against Alzheimer’s Disease (HIAAD), with the participation of leading clinicians and neuroscientists from around the world, has taken another step.
The “Journey of Hope”, as the initiative was called, began in Greece through a series of meetings of specialist scientists with stakeholders, patients and their caregivers. For the first time, so that the latter can find out what they may face in our country in an effective battle with the disease. To keep abreast of new scientific tools with which they can fight it, to keep abreast of the services that can be provided to them in their place of residence. Because for patients and their caregivers, Alzheimer’s is an extremely difficult case. Each patient needs one to three dedicated people to care for him every day. People trained to cope with memory loss, confusion,
The first “Journey of Hope” that people from all over Greece could watch on the Internet took place last Saturday at the Concert Hall of Athens. There, the pioneers and key pillars of HIAAD and the Alzheimer’s Society of Athens, who co-hosted the event, joined with caregivers and stakeholders in a common pulse of concern about timely prognosis and the best possible treatment for a still-incurable disease.
Speakers – Professor Konstantinos Liketsos, Founder and Director of the Center of Excellence for Medical Accuracy in Alzheimer’s Disease at Johns Hopkins University, Nikos Skarmeas, Professor of the EKPA School of Medicine, Associate Professor of Medicine, President of the University Research Center of the Ionian University Panagiotis Vlamos, Dr. Ioannis Tarnanas, Academic Supervisor in Altoida, Washington, D.C. Fellow, Institute for Research and Technology, and nonprofit representative. They met with the public after presenting impressive advances, innovative methods for early detection of diseases, methods of prevention and rules of care.
It was a touching moment when family members, in conversation with Notis Paraskevopoulos, described their daily “battle”. Pediatrician Andronica Anastasiu takes care of both her parents with dementia day and night, and her main concern is to preserve their dignity and express her love to them. Retired banker Eleni Pavlopoulou does not miss a minute of her husband’s life. “In a reality that is unpleasant in itself, let’s find ways for this trip to have a great time,” she says. Retired banker Christos Anagnostis takes care of his mother. “Her world is getting narrower, but the important moments remain and give us courage,” he said.
The children’s questions about how to behave with their grandmothers with symptoms of dementia were also touched. And also what the journalist Rena Kuvelioti said about this disease: “My brain is different from others, but this does not give me any right to see life in black colors every day.” He works “12 hours a day”, and I am raising two wonderful children. Diversity made me look at life from a better perspective – in terms of gratitude. Every day I wake up happier than before, because I enjoy every moment of ours. It worries me that we are ashamed to talk about our diversity, and while it passes through my heart, I will prove that we can do whatever is necessary. “
Following a remote or live welcome from Education Minister Niki Kerameos, Deputy Education Minister Angelos Sirigos, Chairperson of the Parliamentary Subcommittee on Persons with Disabilities Anna Karamanlis, Secretary of the ND Political Committee Pavlos Marinakis, Governor of Attica Georgios Patulis and President of the National Observatory of Dementia and the Alzheimer’s Society Athens Paraskevi Sakka Professor Liketsos spoke about the continuation of the “Journey of Hope” in other cities, in April in Ioannina and June in Heraklion, and presented the two-year activity of the initiative.
“Dementia is the next pandemic, the number of patients doubling every 20 years because the world’s population is aging. In Greece, more than 400,000 people suffer from dementia or mild cognitive impairment. This number will double in 20 years. Our actions are based on the following facts: the drugs on the market do not reverse the course of dementia. There are ways to effectively treat the disease, which are not applied in Greece, because the appropriate structures have not been created, but progress is evident. There are prevention options and the public needs to be informed. We are making progress in understanding this disease, but public participation in research is essential. Our goal is to provide the necessary amount of accessible services, improve the quality of care and increase national investment in research. Our vision must be realized. “
The maps produced by the initiative, Mr Lyketsos said, show the number of patients in each region of the country. Based on them, services will be distributed, which will be updated with each new forecast. The University of Crete Publications publishes an extremely informative collaborative book When Logic Chases Memory, translated into a Greek Nursing Guide written by Mr. Lyketsos and his colleagues at Johns Hopkins. An inventory of memory clinics, day centers, housing programs for people with dementia in Greece was carried out. Three standard memory clinics of the Alzheimer’s Society of Athens and two clinics in Eginitio (A. Politis in psychiatry and N. Skarmeas in a neurological clinic) have been certified based on operating standards verified in the USA. One is in Patras under the direction of Professor P. Alexopoulos, and the approval of others is expected in Crete, Larissa, Thessaloniki and Alexandroupolis. The initiative is “launching” pilot programs to support caregivers, organizing training programs for them by the Metropolitan College, supporting the 1102 Alzheimer’s Athens Help Line, and creating a Thalo phone support service 212 (87). He also develops research programs and organizes conferences and seminars, and is preparing the creation of the Alzheimer’s Center at FORTH, which will integrate research programs in the country.
Prevention and aggravating factors
Mr Liketsos and Mr Skarmeas responded to public questions such as the link between the coronavirus and Alzheimer’s disease (worsening due to cessation of activity while investigating the possibility of dementia after a serious illness, they said) and heredity. 5-10% of cases are associated with hereditary factors, while up to 50 genes have been identified, which together predispose to the disease. Mr. Skarmeas spoke about the factors that contribute to prevention: the Mediterranean diet, which is traditionally based on plant foods, legumes, vegetables, fruits, a little meat, fasting, fish, olive oil as the main source of fat, a little alcohol. Exercise, weight control, mental and social performance are important. Aggravating factors include anxiety, depression, traumatic brain injury, diabetes, and smoking.
The initiative has established two awards: the Outstanding Offer, which Mr Vlamos presented to Notis Paraskevopoulos, one of the instigators of the Thalo Method, and the Valuable and Unique Offer, which was given to family members Eleni Pavlopoulou and Christoforos Anagnostis.
Creation of an innovative biobank and grouping of patient profiles
Ms Macharaki and Mr Tarnanas presented the impressive potential of both basic research and bioinformatics. “We have treated thousands of laboratory mice with the approaches we have developed, but none have been successful in humans. Despite significant investment in research in recent decades, the causes of Alzheimer’s disease and related disorders remain unclear. In recent years, there has been growing evidence that Alzheimer’s is not a disease but a multitude of diseases that vary greatly from patient to patient, so developing tailor-made solutions requires an approach with medical precision, ”said Vasiliki Macheiraki. – One of the advances in research aimed at elucidating the causes of the disease is the formation of stem cells from the patient’s blood. Stem cells allow us to create three-dimensional organs of the brain in the laboratory, study the mechanisms of manifestation and progression of the disease in them, and try individual methods of treatment. Also important are discoveries in the rapidly developing field of research on extracellular vesicles, which are secreted by all cells in the human body. Today we have the opportunity to isolate from the blood the cerebral vesicles that carry proteins or factors associated with the disease, and get a picture of the progression of the disease in the brain. “
Dr. Ioannis Tarnanas spoke about the revolutionary contribution of digital biomarkers to predicting dementia and patient care. “There are various tools for determining the future risk of developing Alzheimer’s disease. Both those that collect information about proteins in the blood, and those that collect data on movements, speech and behavior of a person. By analyzing this data with artificial intelligence tools, we can predict risk well before symptoms appear, ”says Tarnanas. The information collected through the questionnaires is insufficient. “We also need information that we collect using sensors on our arms, legs, neck, which accurately measure how someone speaks, walks, and behaves. Altoida technology introduces the patient to augmented reality exercises, for example, asks him to hide some objects in real space and then find them at a specific time.
Clinical trials conducted over four years by European universities have collected the results of this exercise, other digital indicators, as well as traditional blood biomarkers, encephalograms, images and brain function of the patient, recorded with great accuracy. It was concluded that there are behavioral signatures that appear very early and reflect any mental dysfunction. A new four-year study showed the same result. We are currently working with Mr Vlamos, who heads the Ionian University’s Bioinformatics and Electrophysiology Laboratory (BiHeLab), to organize a five-year study to collect biomarkers, both traditional and digital, that look like toys. Our goal is to create an innovative biobank – today it includes 800 biomarkers and has been approved by the FDA and CE – where different patient profiles will be grouped, and using artificial intelligence models, the clinician can easily categorize the patient. Digital biomarkers are already being used in memory clinics and hospitals in Europe as part of the pan-European RADAR ID program. All that remains is to create an ecosystem of institutions that will spread the use of digital biomarkers in all countries of the world. “