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W6 Flashcards

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1
Q

what does CCNA stand for?

A

Canadian Consortium on Neurodegeneration in Aging

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2
Q

what is the aim of the CCNA?

A

national initiative aimed at tackling the growing onset of dementia and related illnesses and improving the lives of Canadians with illnesses and families and caregivers

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3
Q

who was the Minister of Health that launched the CCNA?

A

Rona Ambrose

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4
Q

what are the 3 themes for research?

A
  • delaying onset
  • prevention
  • improve QOL
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5
Q

what was the general aim of CCNA?

A

combine expertise from across Canada and multiple disciplines
- broaden understanding of how NDD develop and the impact
- determine how to prevent, delay, modify progression and cope

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6
Q

what are the 4 objectives of CCNA?

A
  • strengthen and synergize research
  • become Canadian hub for leading and participating in international research
  • reinforce international positioning, competitiveness and impact of Canadian research at global level
  • improve QOL and quality of services
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7
Q

what are the 4 categories that are integrated?

A
  • research
  • synergy
  • talent
  • inclusion
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8
Q

what is the orientation to prevention?

A

primary
secondary
tertiary

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9
Q

what is primary prevention?

A

protect healthy individuals from developing NDD
- risk assessment
- education about PFs
- risk reduction

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10
Q

what is secondary prevention?

A

stop or delay the progress of NDD after risk classification or early diagnosis
- risk control and management
- monitor disease progress

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11
Q

what is tertiary prevention?

A

manage disease progress -> co-morbidities that may exacerbate rate of disease progression

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12
Q

what was phase1 of CCNA?

A

funding from multiple sources

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13
Q

what was participant flow in COMPASS-ND?

A
  • recruitment into CCNA
  • informed consent signed
  • history, physical, cognitive eval
  • questionnaires
  • psychometric testing
  • biosamples - blood, saliva, CSF
  • sample processing
  • sample shipping to biobank
  • mri imaging acquistion
  • mri it and databasing
  • brain donation program and follow-up in clinic
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14
Q

what are the 6 goals of CCNA phase 2?

A
  • understanding subgroups
  • develop or test new treatment molecules
  • develop prevention strategies
  • allow earlier diagnosis
  • innovate life improvements
  • optimize health care delivery
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15
Q

what are the platforms associated with CCNA?

A

neuroimaging
can-thumbs up
Loris
COMPASS-ND

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16
Q

how many teams are there for CCNA?

A

19

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17
Q

what are the cross-cutting programs?

A
  • knowledge translation and exchange
  • training and capacity building
  • women, sex, gender, dementia
  • ethical, legal and social implications
  • engagement of people with lived experience
  • indigenous cog health
  • social inclusion and stigma
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18
Q

what is the NDD diagnoses approach 1?

A

focus on “pure” cases of each (strict inclusion and exclusion criteria)

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19
Q

what is the narrow focus on approach 1?

A

craft diagnostic criteria to produce homogenous groups that represent a fraction of dementia population

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20
Q

what is the purity involved with approach 1?

A

exclude co-morbidities and mixed dementias

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21
Q

what was NDD diagnosis approach 2?

A

broader choice of inclusion and exclusion criteria

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22
Q

what is the inclusivity of approach 2?

A

broadly inclusive will produce heterogenous groups that will cover entire dementia population

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23
Q

what is the ecological representation of approach 2?

A

includes almost all co-morbidities and mixed

24
Q

what is the rationale behind approach 2?

A

difficult to specify criteria and detect pure disease cases

25
Q

what is the limitation to approach 2?

A

heterogeneity within diagnostic groups

26
Q

what is NDD diagnosis approach 3?

A

moderate application of inclusion and exclusion criteria

27
Q

what is the compromise with approach 3?

A

“rather broad” criteria: produce less homogenous groups that represent most of dementia pop

28
Q

who is represented in approach 3?

A

co-morbidities and mixed dementias

29
Q

are all mixed diseases included in approach 3?

A

no only most

30
Q

who will be excluded from approach 3?

A

brain disease
major psychiatric disturbance
drug addiction

31
Q

what model did Kaarin Ansety create?

A

CHELM

32
Q

what does CHELM stand for?

A

cognitive health environment lifecourse model

33
Q

what approach is close to CHELM?

A

CLASS

34
Q

why is the CHELM approach similar to CLASS?

A
  • core ideas in brain/cog aging and dementia
  • importance of longitudinal approaches
  • adding multi-modal RF to DPM
35
Q

what is the overlap and relatedness between CHELM and CLASS?

A

differential changes, intra-individual, mechanisms, plasticity
cascades of risk (broader focus)

36
Q

what are the 2 types of reserve capacity?

A

brain: passive, cognition affected after accumulation of pathology
cognitive: active, cognition continues despite brain pathology

37
Q

what is the chain for the CHELM model?

A

biomarkers to RF -> controllable RF -> modifiable RF -> bio-clinical outcomes -> prism of neurocognitive resources -> cognitive or clinical outcomes

38
Q

what is the Lancet Commission?

A

comprehensive review
- life course projection

39
Q

how many modifiable RFs are there?

A

12
- education
- hearing loss
- hypertension
- obesity
- alcohol/tbi
- smoking
- depression
- physical inactivity
- social isolation
- diabetes
- air pollution

40
Q

what are the 3 identified mechanisms of ND risk?

A
  • reduction in brain/cognitive reserve/resilience
  • increasing brain damage as a fxn of disease and insult
  • spreading brain inflammation
41
Q

what is the goal of the Lancet?

A

aim for reducing specific RF in order to modify risk mechanisms

42
Q

what is Anstey’s “umbrella review”?

A

systematic review of world-wide evidence on RFs of dementia

43
Q

what are the 3 conclusions from Anstey’s review?

A
  • evidence base varies by NDD
  • lack of “early” effect evidence
  • much variability in geographical representation of evidence
44
Q

what is the IRNDP?

A

international research network on dementia prevention
- how systematic and diverse studies of RA can contribute to understanding differential pathways toward or away from ADRD

45
Q

who founded IRNDP?

A

Anstey

46
Q

what is the purpose of the risk assessment?

A

allows for early detection of risk and for application to RCTs and RR protocol

47
Q

what are the 6 health factors contributing to vascular risk for unhealthy brain aging and dementia?

A

stroke
obesity
smoking
high cholesterol
hypertension
diabetes

48
Q

what are the 4 points from CULTURAL?

A
  • need for cross-national and cultural investigations
  • need for linking RFs with associated mechanisms
  • need for harmonization
  • exploring new research targetsw
49
Q

what is the summary of CULTURAL?

A

scientific, ethical, and practical imperative to expand dementia risk and prevention research across nations, cultures, regions and under-represented populations

50
Q

what are the 4 directions for the IRNDP research?

A
  • expand diversity research
  • expand attention to life course exposure variations
  • expand evidence base
  • expand long-term follow-up research
51
Q

what are some social determinants of health affecting degree of or access to potential RF change?

A
  • income and social status
  • education and literacy
  • employment and working conditions
  • early childhood development
  • physical environment and housing
  • social supports
  • access to health services
  • biology and genetics
  • gender
  • culture
  • race
  • disability and ableism
52
Q

what is the principle of SSDH?

A

person’s social and structural “context” affects RF, RR, possibilities for modifying risk or protection

53
Q

what are SSDH?

A

non-medical, social, and economic factors that occur within everyday and working conditions of people and substantially influence the extent and direction of dementia risk

54
Q

what are the challenges of SSDH?

A

modifiable RF and PF do not operate uniformly or universally, but only within the SSDH context of individuals

55
Q

what is the implication of SSDH?

A

effectiveness of interventions to modify RFs and PFs depend on SSDH context

56
Q

what are the communities of dementia and dementia risk?

A
  • indigenous - growing # of older Ind and impacts of social determinants of health
  • racialized - ethnic profile of older people is growing
  • sex and gender
  • chronological age - early onset poses a challenge
57
Q

what is the Tom Kitwood quote?

A

when you’ve met one person with dementia, you’ve met one person with dementia

Psych 403 (10 decks)

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