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The Alzheimer’s disease (AD) Detect and Prevent consortium organized its first webinar on 23^rd June 2020. This virtual meeting focussed on “Enhancing the early detection of Alzheimer’s disease through digital technologies” and brought together the perspectives of leading experts on some of the challenges and opportunities provided by digital health solutions. The webinar also enabled the developers of the AD Detect and Prevent tool to present updates on the development of this innovative solution.

The webinar was attended by approximately 80 participants, mainly representing scientific societies, patient groups, academics and other health stakeholders.

Kim Baden-Kristensen, CEO and Co-founder of the Danish digital therapeutics company Brain+, kicked-off the meeting by introducing the speakers and highlighting some of the present-day challenges presented by AD and dementia.

The introduction was followed by a testimony by Dr. Helen Rochford-Brennan, the current Chair of the European Working Group of People with Dementia (EWGPWD) and a Global Dementia Ambassador, who provided a moving and powerful message (delivered by Carmel Geoghegan on Dr. Rochford-Brennan’s behalf) as a patient advocate living with the Alzheimer’s type of dementia. Through her testimony, Dr. Rochford-Brennan shared how this condition has impacted her life and the lives of her family and loved ones as well as how she became involved in cognitive rehabilitation research and patient advocacy. In particular, the testimony of Dr. Rochford-Brennan highlighted the need to create a culture in which people living with AD have a voice and are included in driving action on the illness: “For me, it is important to be at the heart of the fight for change, I need to influence change in the way we talk about Alzheimer’s and how we develop Alzheimer-inclusive societies.”

The next speaker was Prof. Masud Husain, Professor of Neurology and Cognitive Neuroscience at Oxford University, who shared his perspective on the application of digital technologies in detecting cognitive decline. As part of his presentation, Prof. Husain shed light on the rationale for applying digital technologies, elaborating on issues such as large-scale screening for dementia, detecting the earliest manifestations of dementia, possibilities for remote assessment and the potential of cognitive training for altering the trajectory of cognitive decline. He then provided various examples of how digital technologies are being applied, including the “Sea Hero Quest” app that was designed to assess people’s navigation skills. He closed with highlighting the potential of emerging digital tools, including improved screening, early diagnosis and remote monitoring, but also some potential negative outcomes associated with using these technologies.

The second key opinion leader to speak was Prof. Martin Rossor who is the NIHR National Director for Dementia Research and a Principal Research Associate at the UCL Queen Square Institute of Neurology. He underlined that the emergence and deployment of digital technologies is an exciting development and elaborated on some of the opportunities provided by these tools to enhance novel clinical trial designs. Though, more generally, he also highlighted some of the challenges in gaining molecular diagnoses as well as issues around the conceptualization of both AD and dementia.

This presentation was followed by Prof. Eric Salmon, Medical Director of the GIGA Cyclotron Research Centre, who shared his perspective on cognitive and neuroimaging challenges associated with preclinical AD. Prof. Salmon highlighted some of the issues in searching for an early synaptopathy that is more directly related to cognitive difficulties. He also shared his perspective on the relation between cognitive efficiency and lifestyle factors in normal and late midlife.

The webinar concluded with a presentation by Prof. Masud Husain and Ulrik Ditlev Eriksen on the work that is being conducted within the framework of the EU-funded AD Detect and Prevent project. A key highlight of this presentation was the introduction to the gamified “Starry Night” tablet task that uses stellar constellations to assess short-term memory. Moreover, Ulrik Eriksen explained the wider objectives of the project, i.e. those related to risk detection and risk reduction, as well as the key challenges associated with early engagement, screening and lifestyle intervention that the digital health tool aims to tackle. He also introduced the main steps in the AD Detect and Prevent solution, including its potential for health risk and AD screening.

Please contact contact@addp.eu should you wish to receive further information about the webinar or the AD Detect and Prevent project.

A graphic brochure presenting the aims, wider ambitions and latest work of the EU-funded Alzheimer’s disease (AD) Detect and Prevent project is now available. It can be accessed here. 

In addition to the latest project-related updates as well as a presentation of all involved partners, the brochure elaborates on the main issues, particularly concerning the early detection of AD as well as the lifestyle-related risk of AD dementia, that the project aims to tackle.  

Keep on following us for further news! 

Alzheimer's disease (AD), which is the underlying cause in 70% of dementia cases, has a severe impact on individuals as well as their relatives and society at large. Yet, despite the high prevalence of AD dementia across Europe, it is often challenging to detect AD before clear symptoms emerge. When this condition is diagnosed, it has in many cases already caused significant nerve damage leading to impaired memory, thought processes, behaviour and social skills.       

The emergence and development of digital health technologies creates new opportunities for enhancing the early detection of AD as well as addressing the lifestyle-related risk associated with AD dementia. In the light of this, the AD Detect and Prevent consortium will organize the webinar “Enhancing the early detection of Alzheimer's disease through digital technologies” that aims to address key questions such as: How does AD affect individuals as well as the people around them? What are the main challenges in detecting AD before the onset of clear symptoms? How can lifestyle-related factors affect a person’s risk of developing AD dementia? What potential role could digital technologies play in enhancing the early detection of AD? 

Please find the programme below:

Introduction
Kim Baden-Kristensen - CEO & Co-founder, Brain+

Testimony
Dr. Helen Rochford-Brennan - Chair, European Working Group of People with Dementia

Applying digital technologies in detecting cognitive decline
Prof. Masud Husain - Professor of Neurology & Cognitive Neuroscience, Oxford University

Pitfalls and challenges in early detection
Prof. Martin Rossor - NIHR National Director for Dementia Research and Principal Research Associate, UCL Queen Square Institute of Neurology

Cognitive and neuroimaging challenges associated with preclinical Alzheimer’s disease
Prof. Eric Salmon - Medical Director, GIGA Cyclotron Research Centre, University of Liege

Introduction to AD Detect and Prevent
Prof. Masud Husain - Professor of Neurology & Cognitive Neuroscience, Oxford University & Ulrik Ditlev Eriksen - Co-Founder, COO & CSO, Brain+

Open discussion
Moderated by Kim Baden-Kristensen - CEO & Co-founder, Brain+

Alzheimer's disease, a neurodegenerative condition that slowly and progressively destroys brain cells, has a severe impact on individuals as well as the people around them. Moreover, it is often challenging to detect this condition before the emergence of clear symptoms. In the light of this, Prof. Martin Rossor, NIHR National Director for Dementia Research and Principal Research Associate at the UCL Queen Square Institute of Neurology, shares his views on some of the challenges in detecting Alzheimer’s as well as the opportunities provided by digital health technologies. 

How is AD dementia affecting people in the UK and in Europe? And particularly, what are the implications of AD dementia for countries with ageing populations?

Since we currently have no cure for AD it is progressive and will in the vast majority of cases lead to dementia or severe impairment. This not only affects individuals with the disease but also spouses and family. Moreover, AD as well as AD dementia are also common as we get older. Estimated numbers for dementia, all forms and causes included, are at least 1 million in the UK and more than 9.5 million in Europe. This also has major economic impact. According to the World Health Organization (WHO), the annual costs of dementia are approximately €275 billion (US$ 300 billion) for the WHO European Region.

Could you elaborate on the current challenges in detecting AD before the emergence of clear symptoms?

There are a number of challenges in detecting AD before clear symptoms emerge. A major issue is what we mean by AD in this context. Currently, AD is a clinicopathological concept, i.e., a combination of clear symptoms and underlying plaques and tangles. The identification of tau and amyloid deposition in the brain is now feasible with PET imaging and for amyloid also identifiable in CSF by lumbar puncture. However, we are still not able to predict reliably the prognosis following detection of tau and amyloid. This is particularly true in the elderly. Moreover, in the absence of a treatment early detection outside a research context may be of limited value or, in some instances, harmful.

Could you elaborate on the link between lifestyle factors and the risk of developing AD dementia? 

The two major risks for AD are genetic and advanced age. In very rare instances, AD can be inherited as an autosomal dominant disorder due to mutations in the presenilin and APP genes. The APOE4 genotype also confers an increased risk but is neither sufficient nor necessary to cause AD. Age is the other major factor, but AD is less clearly defined in the elderly and usually coexists with vascular disease and other neurodegenerative processes. A number of lifestyle factors have been identified that lead to an increased risk of dementia, rather than specifically to AD. These include smoking, hypertension, diabetes and obesity. The general rule is that what is good for the heart is also good for the head. Improvement in managing high blood pressure may be linked to the reported reduction in some countries of the incidence of dementia, although the prevalence is expected to increase with increased longevity. Many lifestyle factors are modifiable, but it is not yet known to what extent they may modify Alzheimer's Disease. There is an excellent review by Livingstone and colleagues (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31363-6/fulltext).

What are, in your opinion, the main challenges and opportunities associated with using digital health technologies to enhance the early detection of AD?

There are many opportunities from understanding early symptoms, through to providing care and support. Testing individual domains of cognition using tests of graded difficulty is the standard approach to assessment of cognitive impairment. This is most powerful when serial assessments can detect change within an individual. With the ubiquity of data from phone usage through to shopping patterns, there is an opportunity to detect change in how an individual interacts with a complex environment. This has opportunities for research but also for support when in the early stages of vulnerability. For example, in managing financial matters whereby subtle changes in decisions can alert family members. With more advanced disease, digital health technology via the internet of things gives the opportunity for individuals to maintain independence. The major challenge is to ensure security, autonomy and privacy in the handling of individuals data.