Memory training - Rete Alzheimer

Over 65 nel mondo (ref. Index Mundi)*
* Esclusi i paesi
con superficie < 1000 Kmq
1
Japan
24.8%
2013
2
Italy
21.2%
2013
3
Germany
20.9%
2013
4
Sweden
20.5%
2013
5
Greece
20.1%
2013
6
Bulgaria
18.9%
2013
7
Austria
18.9%
2013
8
Belgium
18.7%
2013
9
Latvia
18.5%
2013
10
Portugal
18.4%
2013
44
USA
13.9%
2013
Indice di vecchiaia in Europa
(Fonte: Eurostat 2012)
Ranking
Country name
Ageing index
1
Germany
157,1
2
Italy
150,0
3
Bulgaria
140,9
4
Greece
135,8
5
Latvia
129,9
6
Portugal
129,4
7
Austria
123,7
8
Lithuania
123,3
9
Croatia
120,0
10
Slovenia
117,7
LIGURIA
UE 27
238.0
115.4
Genoa’s Socio-demographic context
Structural indicators
Main structural indicators. Data at 01.01.2013
Old age index
Aging index
Elderly dependency
ratio
Genoa
27.7
238.8
45.3
Liguria Region
27.8
238.0
45.6
North-Western Italy
22.5
162.5
34.4
Italy
21.2
151.0
32.7
18.2
115.4
Region
EU 27
27.5
Source: Istat, Eurostat
6
ITALIA 2038 – LIGURIA 2013
LIGURIA 2013 *
ITALIA 2013 *
ITALIA 2038 °
>64
27.7 %
21.2 %
28.2 %
>74
14.6 %
10.6 %
13.6 %
>84
4.4 %
3.0 %
3.5 %
IV
238 %
151 %
227 %
IDA
45.6 %
32.7 %
49.1 %
IV= Indice di vecchiaia – IDA= Indice Dipendenza Anziani
* Dati Istat
° Proiezioni Istat (ipotesi centrale)
Prevalenza di demenza, per classi di età
Italia, Rocca 1990
40
Canada, Canadian Study 1994
Spagna, Lobo 1995
Prevalenza (%)
USA, Bachman 1992
30
Olanda, Ott 1995
Giappone, Ogura 1995
20
10
0
65-69
70-74
75-79
80-84
Età (anni)
85-89
>90
Lo scenario attuale:
oltre la terapia farmacologica
Le strategie di intervento NON
FARMACOLOGICHE
riguardano:
il soggetto il caregiver
l’ambiente le tecniche gli
ausili
Deficit cognitivi
RIATTIVAZIONE
GLOBALE
Disturbi comportamentali
Deficit funzionali
Alzheimer Dis Assoc Disord, 2008, 22(2):158-62
PREVENTION
Department of Gerontology and Motor Sciences – Galliera Hospital, Genoa, Italy
Memory Training and Memory Garden
The pilot (2010), tested by city of Genoa with small scale investments, wants to
prevent the cognitive decline of elderly people thanks to memory training
exercises and to create aggregative/recreational moments
1st phase: realization of the first training course for “Memory
Instructor”,
2nd phase:  realization of specific courses for memory training
designed for over65 years old citizens (Memory training);
 set up of a “Memory Garden”: the park of Villa Imperiale
has been staged with several boards with mental exercises for the visitors.
25
25
Memory Training and Memory Garden
The memory training courses:
•every course is composed by 10 weekly one hour and half long
lessons, carried out in groups composed by 15 elderly people (over
55 years old) each and managed by expressly trained teachers
•during the lessons teachers submit memory training exercises
connected with the everyday life matters
•since 2013, 17 courses have been realized in Liguria Region and
230 elderly people have been involved
•together with the courses it has been undertook a scientific
research by Modena Geriatric Unit (Luc De Vreese – A. Fabbo) and
Geriatrics Dept. Galliera Genoa Hospital, to verify the actual efficacy
of these courses in avoiding or delaying elderly people’s invalidating
mental disabilities along the time
•The outputs of the courses are very positive, according to the
appreciation(from participants), the very high frequency and the
actual validity (tests have been shown a real improvement in the
learning skill and in the responsiveness = difference in the trial
performance before and after the course).
Memory Training and Memory Garden
The Memory Garden consists of 10
stations/ panels along the path of
the park. Each panel shows an
operation on an aspect of memory
or related functions:
•first is defined a memory process
and its role in everyday life
•an exercise with its variants
•finally, some advice is given for the
life of every day
A notebook and pencil be brought.
The exercises can be performed
alone or in company.
Some preliminary data of the courses' outputS
N=215 subjects; Mean Age (±SD)72.08±5.05; Females=164 (76.3%); Males=51(23.7%)
There is a statistically significant improvement in the tests after the courses (p<0.0001)
Memory Assessment Clinic Questionnaire
20
17
GERIATRIC DEPRESSION SCALE
4
3
14
2
11
1
8
5
Before
After
LEARNING 3 LIST OF 10 WORDS
0
Before
20
30
17
27
14
24
11
21
8
18
5
Before
Before
After
After
After
VERBAL FLUENCY
15
Before
Genoa - Landscape of the ancient port
After
The future
 to follow the Regional law “Active Ageing’s guidelines” that foresee the
creation of a governance, composed of public entities (municipalities and
Local Health Autorities), third sector organizations, organizations representing
the elderly, as well as any other public or private subjects.
 to consolidate and disseminate a wide participatory process aimed at
promoting initiatives for active aging. The planning and the participatory
consultation will be set throughout local round tables at a district level. This
method helps to realize useful actions for the development of active aging
local pacts and specific operational steps and timelines, to be respected in
order to present and to launch any further initiative.
 to promote and to implement memory training courses in every district.
 the export of "Memory" as a good practice.
30
Improving health for elderly people: an international health
promotion and disease prevention agenda.
Besdine RW, Welte TF
The Warren Alpert Medical School of Brown University, Providence, RI 02912, USA.
Current approaches to health care rely on late detection and
treatment of disease, and some of the most expensive systems
of care have population health outcomes that are poor to
mediocre. A majority of deaths and disability result from progression of
preventable chronic diseases for which human behaviors are major
contributing factors. An organized and aggressive agenda in health
promotion and disease prevention emerges as an important part of the
strategy to both promote health and control costs. After reviewing data
on determinants of health and contribution of behavioral factors to
morbidity and mortality, this paper presents the evidence for efficacy and
effectiveness of specific behavioral and clinical interventions to reduce
risk for many of the problems accounting for death and disability among
elders.
Aging Clin Exp Res. 2010 Jun;22(3):219-30.
Andamento della popolazione fragile in Liguria in rapporto
alle stime ISTAT nei prossimi 15 anni
e fabbisogno stimato di pl di RSA
2010
2015
2020
n. Over 74 x1000
224
246
255
n. Fragili x1000
40(18%)
44(18%)
N posti RSA (30%) x1000
12,0
13,2
46(18%)
13,8
2025
265
48(18%)
14,4
Andamento della popolazione fragile in Liguria in rapporto
alle stime ISTAT nei prossimi 15 anni
e fabbisogno stimato di pl di RSA
con riduzione della fragilità/cronicità dell’1% ogni 5 anni
2010
2015
2020
2025
n. Over 74 x1000
2010
224
2015
246
2020
255
2025
265
n.
x1000
n. Over
Fragili74x1000
224
40(18%)
246
42(17%)
n. Fragili x1000
40(18%)
44(18%)
N posti RSA (30%) x1000
12,0
12,6
12,3
12,0
N posti RSA (30%) x1000
12,0
13,2
13,8
14,4
255
41(16%) 265
40(15%)
46(18%)
48(18%)
T
I T LE
O F
P
RO POSAL
R e fe re n c e S ite s N e tw o rk fo r P re v e n tio n a n d
C a re o f F ra ilty a n d C h ro n ic C o n d itio n s in
c o m m u n ity d w e llin g p e rs o n s
(S U N F R A IL )
Applicant No*
o f E U C o u n trie s
1 (Coordinator)
Applicant organisation name
EIP-AHA Reference Site - Regione Emilia
Romagna-Agenzia Sanitaria e Sociale (RERASSR)
Country
Italy
2
EIP-AHA Italian Reference Sites Network
(Piemonte)
Italy
3
EIP-AHA Italian Reference Sites Network
(Liguria)
Italy
4
EIP-AHA Italian Reference Sites Network
(Campania)
Italy
5
EIP-AHA Reference Site: Languedoc
Roussilon
France
EIP-AHA Action Group: University of LodzHealthy Ageing Research Group
te
Poland
EIP-AHA Reference Site: Northern Ireland
UK
EIP-AHA Reference Site: Basque Country
Spain
Gerontopole - European Union Geriatric
Medicine Society (EUGMS)
France
EUREGHA
Belgium
O 5
T
1
A
0
V
2
.
O
1
R 9.0
P
P
0
A
6
7
8
9
10
"Lentamente muore chi diventa schiavo dell'abitudine,
ripetendo ogni giorno gli stessi percorsi, ...chi non cambia
la marca, il colore dei vestiti, chi non parla a chi non
conosce .
Muore lentamente chi evita la passione,
chi preferisce il nero su bianco e i puntini sulle "i"
piuttosto che un insieme di emozioni, proprio quelle che fanno
brillare gli occhi, quelle che fanno di uno sbadiglio un sorriso,
quelle che fanno battere il cuore davanti all'errore e ai
sentimenti.....
..... Lentamente muore chi abbandona un progetto prima
di iniziarlo, chi non fa domande sugli argomenti che non
conosce, chi non risponde quando gli chiedono
qualcosa che conosce.”
P. Neruda
He who gets old last,
gets old best
He who gets old last,
gets old best
Thank you for the attention
