New ERC Project on Cognitive Aging

You find the latest news and publications of the Cognitive Ageing project here.

Almost every one of us has a family member who suffers from cognitive impairment or dementia, and there are not many things that scare many of us more than the fear that we forget our memories, who we are, and who our loved ones are. Yet, dementia affects many people at older ages, with the most common form of dementia being Alzheimer’s Disease. There are currently almost 10 million people affected by dementia in Europe. Devastatingly, there is no medical cure available to halt or reverse the progress of the disease. There is now some first evidence available that multimodal interventions can to some extent delay cognitive decline for those at risk. Consequently, we need to know more about who is at risk, and which behavioral interventions work for whom.

For the better part of a decade, I have been working in the field of cognitive aging and dementia, both at the university as a researcher at the Institute for Research on Socio-Economic Inequality, but I also volunteer in a worldwide network of young professionals, the World Young Leaders in Dementia, and I have realized Dementia Awareness Workshops with teenage students at a secondary school in Luxembourg.

Two questions have been driving my research during the last years, the first, how does the immediate and more distant environment, such as parental household, schooling and job opportunities, shape to which extent cognitive potential can be fully realized? It is quite common knowledge that the conditions during the life course determine the amount of cognitive reserve we need to buffer brain pathology later in life. So it should be extremely important to live in a society where children can go to those schools that best enable them to reach their full potential (opposite to societies where parental status determines what children can or cannot achieve in life). Equally, both girls and boys should be able to reach their full potential: First in school, and later in vocational training or higher education, and, even later, as adults during their working life. However, there is little research systematically investigating the determinants of cognitive functioning across different environments. Especially unequal educational systems and gender inequalities in different domains such as the labor market should have an impact on the building up of cognitive reserve, and this impact should still be visible at older ages.

The second research question is a more statistical one. Often when I ran analyses with the state-of-the-art methods in my field to try to explain cognitive functioning and aging, I was dissatisfied with the reduction of complexity in the models. When you investigate how cognitive functioning in older people evolves over time, you often see amazingly different trajectories. Some people unfortunately decline at a very early old age already. Some people show stable cognitive performance over a very long time, and of those, many even gain quite substantially during the first couple of testings. Some people have sharp drops, others more complex declines in their performance. An additional complexity arises with the many exposures that influence cognitive decline and incidence of dementia: From genetic risk to social and behavioral factors such as having good friends, good health behaviors, and good sleep, from clinical conditions to mere age, there are many, many risk and protective factors at work. These complexities are very hard to capture in conjunction with traditional models, and as convincing proof to this, we have strong difficulties to predict at individual level who will decline and who will remain stable. However, knowing better about the exact individual risks, we could ideally help to reduce risk of decline and support people to remain cognitively stable.

In a nutshell, these research questions have been guiding my ERC project proposal. First, I want to understand better the differences in cognitive aging of middle-aged and older people across different countries by investigating how inequalities in education and by gender at different points in the life course may determine cognitive reserve and, consequently, cognitive aging in later life. Second, I employ new machine learning techniques to overcome some of the limitations of traditional statistical modeling to explain exactly, who is at risk of cognitive aging, and what works for whom at which point in time to delay cognitive aging. Here, it is important to know that for complex (social and behavioral) constructs like cognitive functioning, it is not well-advised to blindly use machine learning techniques that have been developed for more traditional big data applications. In many cases in the social sciences, we will be interested in questions of causality – what exactly is driving cognitive decline, or, why do some people decline in their cognitive performance and others don’t? (Judea Pearl has just published The Book of Why, which I can only recommend for all that are new to questions of causality!). So, machine learning methods should be in those cases combined with methods to establish causal inference. Ideally, the project will, through the acknowledging and further developing of knowledge of different disciplines, such as social epidemiology, sociology, psychology, computational and data science, gain new insights on the drivers of cognitive aging.

The University of Luxembourg will be host institution of my project CRISP – Cognitive Aging: From Educational Opportunities to Individual Risk Profiles. ERC Starting Grants are awarded to talented early-career scientists with a scientific track record showing great promise and an excellent research proposal. The grants may be awarded up to 1.5 million Euros for a period of five years. Feel free to contact me at anja.leist(at)uni.lu.

 

ERC StG 2018 Project CRISP. Cognitive Aging: From Educational Opportunities to Individual Risk Profiles

Cognitive impairment and dementia have dramatic individual and social consequences, and create high economic costs for societies. In order to delay cognitive aging of future generations as long as possible, we need evidence which contextual factors are most supportive for individuals to reach highest cognitive levels relative to their potential. At the same time, for current older generations, we need scalable methods to exactly identify individuals at risk of cognitive impairment. The project intends to apply recent methodological and statistical advancements to, firstly, comparatively assess contextual influences on cognitive aging, with a focus on inequalities related to educational opportunities, gender and economic inequalities, using longitudinal, population-representative, harmonized cross-national aging surveys that will be merged with contextual information. Secondly, the project will employ recent, robust statistical learning techniques to quantify the ability of individual characteristics, such as socioeconomic background, and behavior changes to predict cognitive aging and diagnosis of dementia. Applying statistical learning techniques in the field of cognitive reserve will open new research avenues for efficient handling of large amounts of data, among which most prominently the accurate prediction of health and disease outcomes. Quantifying the role of contextual inequalities related to education and gender will guide policymaking. Assessing risk profiles of individuals at risk of cognitive aging will support efficient and scalable risk screening of individuals. Identifying the value of behavioral interventions to delay cognitive impairment will guide treatment plans for individuals affected by dementia.

SDG lab: Young Entrepreneurs to Advance Local Economies and Community Health in Africa

– Voir ci-dessous pour la version française –

Africa_well

Future Earth and Stockholm Resilience Center have recently called for applications to hold SDG labs to come up with innovative, brilliant solutions to address the Sustainable Development Goals. Our application for an SDG lab to be hosted by the PEARL Institute for Research on Socio-Economic Inequality (IRSEI) and ADA Microfinance was successful. We are happy to have been selected in the global competition.

Here is the executive summary of our application:

Background. An extraordinary number of young adults and less developed local labor markets call for innovative economic solutions in African countries. Innovations should both increase labor market participation of young adults and transform local economies. At the same time, in many African countries there are serious threats to community health through water or vector borne diseases. Lack of clean drinking water and unimproved sanitation facilities put communities in dire need to find sustainable solutions to improve community health.

An economic innovation with pilot status is ADA Microfinance Luxembourg’s Young Entrepreneurs Initiative. It provides microloans and financial training to help young people to start their own business in three African countries, Niger, Togo, and Rwanda. So far, ADA’S business model is not sustainable yet, as financial training and advice are externally funded. The first aim of the proposed SDG lab will be to find solutions how to transform ADA’s initiative into a sustainable business model. The second aim of the lab will be to enable innovative ideas how to improve community health with the means of microfinance. A focus will be on providing access to clean drinking water and improving sanitation.

Method. Experts from African microfinance, research, local economy, and policymaking will participate in a two-day social innovation workshop, hosted by IRSEI and ADA.

Results. The SDG lab will produce a sustainable business model for the Young Entrepreneurs initiative, ready for implementation in the three African countries, which will serve as a showcase for further developing countries. It will further enable one or more innovative solutions how to improve community health, ready for feasibility tests.

Conclusion. Making the Young Entrepreneurs Initiative sustainable could successfully address the SDGs of reducing poverty and gender inequalities, improving health and well-being for all, and contribute to sustainable societies.

Impact:

  • Increase the conditions of the Young Entrepreneurs and their families by raising living standards, providing steady income for housing and health
  • Enrich local economies through creation of jobs
  • Provide access to improved living conditions, with potential to improve individual and community health
  • Via improved health, innovations could alleviate further pressing societal problems. For instance, fewer waterborne diseases in children would lead to lower rates of stunting, higher rates of school attendance and education, with possible benefits for occupation and earnings of future generations

The SDG lab will take place in Luxembourg before August 2017. Updates will be posted. Please contact me (anja.leist(at)uni.lu) for questions.

SDGlabs_pic

Résumé exécutif du projet de « SDG Lab 2017 »

(SDG=Sustainable Development Goals / ODD = Objectifs de développement durable)

Jeunes entrepreneurs pour le développement des économies locales et de la santé publique en Afrique

Contexte. Un très grand nombre de jeunes adultes des pays africains les plus pauvres, ainsi que les acteurs des marchés du travail de ces pays, veulent travailler sur des solutions économiques innovantes pour leur développement. Ces innovations devraient accroître la participation des jeunes adultes au marché du travail et transformer les économies locales. En même temps, dans de nombreux pays africains, la santé publique des communautés locales est gravement menacée, en particulier par la faible qualité de l’eau, par les maladies transmissibles et celles dites vectorielles (paludisme, malaria, etc.). Le manque d’eau potable et d’installations d’assainissement fiables représentent de lourdes difficultés aux communautés dans leur recherche de solutions durables pour améliorer la santé publique.

L’Initiative de jeunes entrepreneurs de l’ADA-Microfinance Luxembourg propose une innovation économique pilote. Cette institution fournit des microcrédits et une formation financière pour aider de jeunes entrepreneurs à créer et développer leurs projets dans trois pays africains, le Niger, le Togo et le Rwanda. Jusqu’à présent, le business modèle d’ADA cherche à devenir soutenable en développant la capacité des acteurs locaux à développer leur propre formation et conseils financiers.

Le premier objectif du laboratoire ODD (« SDG Lab ») est l’élaboration de solutions pour assurer la durabilité de l’initiative d’ADA. Le second objectif consiste en l’émergence d’idées novatrices pour améliorer la santé communautaire avec les moyens de l’initiative ADA. L’accent sera donc mis sur l’accès à l’eau potable et l’amélioration de l’assainissement.

Méthode. Des experts de la microfinance africaine, de la recherche, de l’économie locale et de l’élaboration des politiques participeront à un atelier d’innovation sociale de deux jours, organisé par l’IRSEI et l’ADA.

Résultats. Le « SDG Lab » élaborera un business model durable pour développer l’initiative des Jeunes entrepreneurs, prêt à être mis en œuvre dans les trois pays africains et qui pourra servir de mode d’emploi dans d’autres contextes nationaux. Il permettra en outre une ou plusieurs solutions novatrices pour améliorer la santé communautaire, prêtes pour des tests de faisabilité.

Conclusion. Cette initiative jeunes entrepreneurs veut contribuer à la mise en œuvre des ODD, à réduire la pauvreté et les inégalités entre les sexes, améliorer la santé et le bien-être dans des sociétés durables.

Impact:

  • Améliorer les conditions des Jeunes Entrepreneurs et de leurs familles en élevant le niveau de vie, en fournissant un revenu stable pour le logement et la santé
  • Enrichir les économies locales par la création d’emplois
  • Offrir l’accès à des conditions de vie meilleures, à la santé individuelle et communautaire
  • Atténuer les problèmes sociaux les plus urgents. Par exemple, par l’amélioration de la qualité de l’eau, et la réduction consécutive des maladies parasitaires et vectorielles chez les enfants, et la baisse des taux de retard de croissance, une amélioration de la fréquentation scolaire et du niveau d’éducation, avec des avantages possibles pour le travail et le revenu des générations futures

Dissémination. Les résultats seront diffusés au congrès « Resilience Stockholm 2017 » le 24 août 2017, à la semaine africaine de la microfinance (octobre 2017), au cours des « Assemblées parlementaires de la Francophonie » à Luxembourg (juillet 2017) et par les canaux de communication de l’ADA et de l’Université.

Organisateurs de l’appel pour les SDG Lab: Future Earth and Resilience Stockholm.

Almost 50 teenage students in Luxembourg already trained in dementia!

Forget me not

  • How can I support persons with dementia and their family caregivers?
  • How to communicate with a person with dementia who is not able to speak anymore?
  • Where does aggressive behavior come from, and how to deal with it?

 

These are three of many more questions that we discussed at our workshop ‘Understanding and supporting persons with dementia’. In February and March 2017, I held the first three workshops at the Lycée Bel-Val in Esch-sur-Alzette, Luxembourg. With funds from Rotary Club Luxembourg-Hearts, the three-hour workshop used quiz, empathy exercises, video, talks, and discussions in plenum and in small groups to expand students’ knowledge on dementia. The manual will be soon available in German language.

Students particularly enjoyed the interactive quiz. Here, different statements about dementia were displayed, and students could ‘vote’ with their mobile phones if the statements were accurate or not. After showing the voting results, I gave some background on the statement and, specifically, which scientific field had produced this knowledge and the scientific methods behind it.

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Workshop #1, Lycée Bel-Val
  • One example statement: “Dementia is part of the normal aging process” – True or false? The right answer is: No, dementia is NOT a part of normal aging, and you can live up to high ages without being affected by dementia. We know this from clinical and epidemiological research where large samples at higher ages are examined with cognitive tests and imaging methods.

Other questions were:

  • Is there medical treatment to slow down the progression of dementia?
  • Are people with dementia still able to make (financial and other) decisions themselves?
  • Can new methods detect the onset of dementia already 15 to 20 years in advance?

In a group discussion, students shared their experiences with people with dementia in the family and internships or vocational training. We discussed difficulties and ways to deal with complicated situations, e.g. dealing with repeated questions, requests that were not possible to fulfill, and the person with dementia forgetting that a loved one has died.

IMG_1_PD
Workshop #2, Lycée Bel-Val

It is important to keep in mind that the workshop can only disseminate the current knowledge on dementia, and, in the future, we will certainly know more about dementia, be it (hopefully!) a possible cure or better ways to care. Maybe new technologies will help people staying independent for longer, and will help interacting with others even in late stages of their disease. Knowing that the state-of-the-art in dementia will be very different in 5, 10 or 15 years, I shared a collection of different ways to get and stay informed about dementia. This collection included links to direct scientific evidence (e.g. relevant search engines, journals, books) and indirect information (e.g. publications from Alzheimer organizations, health organizations, the national information center Liewe mat Demenz, and reports by the WHO and NGOs).

 

At the end of the workshop, students received a certificate and a pin with the forget me not flower, which is a widely used symbol for a dementia-friendly society. Even if there is no national dementia awareness campaign in Luxembourg (although there certainly should be!), every society should become more dementia friendly. The trained students in Luxembourg can be proud to be knowledgeable and aware of dementia.

IMG_2_KR2
Workshop #3, Lycée Bel-Val

 

Improving dementia care, research and innovation globally: The World Young Leaders in Dementia join the efforts for a WHO Global Action Plan

The WHO is working to improve the global situation in dementia to lift each country’s response to dementia to a higher level. Therefore, the WHO will soon ask countries all over the world to adopt a set of public health principles and actions which can be considered state-of-the-art responses to dementia. The draft plan will be discussed end of January at the Executive Board. The World Health Assembly may adopt the plan in May.

I recently published a post on the Young Leaders‘ work to join the efforts for this WHO Global Action Plan on the Public Health Response to Dementia. You can find it at our WYLD website here.

The Dementia Awareness Workshop – Concept and Draft Program

projectii_dementiaworkshop29june2016

Aims of the workshop
Dementia is a disease that has serious consequences for those affected and their caregivers and families. Due to the aging of the population, the number of people at risk of getting dementia is increasing. In Luxembourg, there are currently around 6,000 people living with dementia (Report of the Luxembourg National Action Plan on Dementia, 2013). Yet, there is still a taboo on dementia for many reasons: People with dementia and their families do not always want to share their diagnosis and problems. Other persons who are not affected by the disease are unaware or do not know how to cope. With this workshop we aim to raise awareness about dementia among younger people.

Organization of the workshop

This workshop for teenagers (aged around 14 to 18 years) will take place in secondary schools across Luxembourg with the aim to inform about dementia, reduce stigma and raise awareness among adolescents. Ideally, young people who have attended the workshop will spread their knowledge and be able to support people affected by dementia in their families and neighborhood. They may even get involved by supporting persons living with dementia and/or their caregivers in their daily lives. If the concept is successful, we will also implement this workshop in the Netherlands and beyond.

After the workshop, students will:

  • be familiar with the diagnosis and progress of dementia
  • know about the impact of dementia on daily life for those affected and their caregivers
  • know about ways to support persons living with dementia to manage their daily routines and increase their well-being

The workshops taking place in Luxembourg are cost-free – donations of 200 EUR (50 EUR per workshop) have been collected at a conference and fundraiser on dementia on 29 June 2016. The workshop has been designed by Dr. Anja Leist, University of Luxembourg, and Dr. Marjolein van der Marck, Radboud university medical center, Nijmegen, the Netherlands.

Contact

Please contact Anja Leist (anja.leist@uni.lu) for questions and if you are interested in having the workshop realized at your school. See the draft program here.

 

Evening Symposium on Dementia

Last week, on 29th June 2016, we met on Luxembourg-Kirchberg to discuss latest research and developments in the fight against dementia. Coming from policy, life course research and geriatric medicine, the three speakers – Dr Jean-Claude Schmit, Dr Anja Leist, and Dr Carine Federspiel – informed about new evidence in the field of dementia. Prof. Rainer Klump, President of the University of Luxembourg, opened the symposium, René Friederici, Country Chair of Rotary in Luxembourg, closed the symposium. Dr Michèle Vallenthini moderated the symposium.

DSC_0932 (2)
(c) Lorenzo Pizzuti

The symposium was organized by the University of Luxembourg and Rotary Club Luxembourg Hearts. We especially thank the Faculty of Language and Literature, Humanities, Arts and Education, the Research Unit INSIDE and the PEARL Institute for Research on Socio-Economic Inequality for their support in organizing and realizing the conference.

With the aim of raising funds for Sahmet Hostel – Secondary Education for Girls in India, we asked attendees for donations, and are grateful for the considerable amount of donations raised that evening.

DSC_0926
(c) Lorenzo Pizzuti

 

The other good cause intended to raise funds for was already financed before the symposium:

Dementia_Awareness_Workshop16-06-29

The contents of the talks were manifold: Dr. Jean-Claude Schmit, Director of Health in Luxembourg, talked about international, European and national policy changes in the field of dementia, focusing on the Luxembourgish efforts during the EU Presidency to put dementia on the policy agenda, and supporting the WHO Call for Action. Due to longer life expectancy, costs of dementia are increasing in Luxembourg. Preventive efforts should be taken to address the challenges to the sustainability of the healthcare system.

Dr. Anja Leist, researcher at the University of Luxembourg and Steering Group member of the World Young Leaders in Dementia Network, spoke about research evidence how experiences throughout the life course can help to maintain cognitive function at older ages and reduce risk of dementia. Starting point of her talk is the phenomenon that despite similar neuropathology, people are very differently affected by dementia depending on their cognitive reserve. Several factors such as education, a healthy lifestyle and physical exercise in midlife can help delaying cognitive decline. She explained why investing in education will significantly help maintaining cognitive health of today’s children up to very old ages.

Dr. Carine Federspiel, Medical Director of Zitha Senior, first informed about methods of early diagnosis of dementia and possibilities for secondary prevention, such as the NEUROfit programme. Second, she mentioned the possibilities for information, treatment and care, discussing care arrangements for persons with lower or more complex care needs and presenting the work of Association Luxembourg Alzheimer. Lastly, Dr. Federspiel focused on ‘living well with dementia’ and on important resources to improve quality of life, such as a supportive environment.

For the full agenda and further information on our good cause, please see the Leaflet_program_Symposium_29June2016.

 

RCLH_UNI

If you have further questions or would like to support our good cause, please contact us.

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