An estimated 50 million people around the world currently live with Alzheimer’s disease or other dementias, dementia being a collective term for progressive syndromes that affect various expressions of cognitive function, such as memory and emotional expression. Alzheimer’s disease accounts for the majority of cases (50 to 70%, varying by country, based on Alzheimer’s Disease International and World Health Organization figures). For those directly affected and their loved ones, dementia can be a frightening experience, particularly as it is so poorly understood. However there remains little or no understanding of dementia in many, and the stigmatization and misinformation that surrounds dementia remains a global issue.

World Alzheimer’s Day is organized annually by Alzheimer’s Disease International to challenge the stigma that surrounds dementia and raise awareness. The goal of this international campaign is to join all Alzheimer associations together to concentrate efforts, raise awareness and bring dementia to the global attention of governments, opinion leaders and medical professionals for patients and their families.

To support researchers, clinicians and other interested parties focusing on dementia, Elsevier has curated a collection of book chapters and articles freely available on ScienceDirect. The collection is devoted to basic and clinical research in dementia, including important content on addressing the stigma that surrounds dementia. We hope that providing this content will not only help researchers working on prevention and cure, but also serve as a source of information for non-scientists and take away some of the fear and stigma around dementia. Let’s #ReducetheStigma and get better informed to help create a better world for everyone affected by dementia today and tomorrow.

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Featured Book Chapters Include:

Evidence-Informed Approaches for Managing Dementia Transitions – Chapter 1 – Improving the lived experience of dementia transitions

Neil Drummond, Linda Garcia, and Lynn McCleary

Dementia is a common, progressive, chronic condition associated with cognitive impairment, particularly in seniors. In the absence of a cure, much attention is focused on providing care for people with the disease and support for their families and friends who provide most of the care. As the condition changes, the care needs of people with dementia change too. The result is typically a long series of transitions in health status, locations, organizations, practices, and people. This chapter introduces aspects of the lived experience, management, and epidemiology of dementia and some of the significant transitions that people with the disease and their caregivers frequently encounter. It then considers some research designed to identify factors associated with good transitions in dementia care and finally to discuss the nature of “good” itself, in the context of living with dementia.

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Assessments, Treatments and Modeling in Aging and Neurological Disease – Chapter 11 – Dementia or no dementia in the elderly. Why?

Lewis H. Kuller

Dementia is a syndrome, not a unique disease and rarely occurs in the absence of substantial brain pathology. However, many older individuals can have similar brain pathology without dementia. About 65% of older individuals aged 90+ have evidence of dementia usually due to Alzheimer’s disease (AD) pathology and vascular disease. The AD neurodegenerative process is associated with Aβ amyloid and phosphorylated tau deposition and usually coexists with vascular disease and other proteinopathies. Individuals who survive to age 90+ free of dementia, about 5%–10% of the population, include two populations: (1) little vascular and amyloid pathology and low risk of clinical AD (50%); and (2) others with pathology and cognitive reserve (50%).

We do not know the initial pathological event that leads to neuronal death. Brain microvascular disease and blood–brain barrier dysfunction are probably playing an important role in development of AD pathology in relation to clearance and metabolism of beta amyloid 1–42 (Aβ1-42). Major determinants of successful survival without dementia to older ages 85–90+ include low atherosclerosis and arteriosclerosis burden, less brain microvascular disease and neurodegeneration and fitness.

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Diagnosis and Management in Dementia – Chapter 9 – Genetics of dementia: a focus on Alzheimer’s disease

Francesca Fernandez and Jessica L. Andrews

This chapter focuses on providing a brief overview of genes associated with sporadic (late-onset) Alzheimer’s disease (AD). Despite decades of research, no current and reliable test is currently available for the diagnosis of AD. Genetic biomarkers are promising for both diagnostic tools and tailored profiling therapy. Genes associated with sporadic AD through linkage, association, and genome-wide association case studies are briefly described. We also discuss the genes underlying cognitive function in the context of AD.

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Dementia Rehabilitation – Chapter 3 – Communication interventions for people with dementia and their communication partners

Sarah El-Wahsh, Penelope Monroe, Fiona Kumfor, and Kirrie Ballard

This chapter reviews behavioral interventions and strategies for spoken communication for people with dementia and their communication partners. Communication changes in dementia are influenced by factors including dementia etiology, location of neuropathology, and disease stage. Comprehensive communication assessment aims to cover all levels of the World Health Organization’s International Classification of Functioning, Disability, and Health framework (ICF). Communication intervention should take a person-centered approach that focuses on co-designing functional and personally meaningful goals. Four communication interventions are reviewed: word retrieval intervention, script training, memory books, and communication partner training. Currently, there is strongest evidence supporting communication partner training and memory book use across various dementia etiologies. Word retrieval intervention and script training have only been evaluated for use in primary progressive aphasia (PPA). Health professionals with expertise in the assessment and management of communication are an integral part of the multidisciplinary care team of people with dementia.

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Neuropsychological Tools for Dementia – Chapter 8 – A short guideline for the neuropsychological differential diagnosis of the dementias

Helmut Hildebrandt

Short overview on characteristic features of neurodegenerative diseases and how to assess them to validate or to reject the suspected diagnosis.

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Molecular Mechanisms of Dementia – Chapter 3 – Neurochemical Aspects of Alzheimer’s Type of Dementia

Akhlaq A. Farooqui

Alzheimer’s disease (AD) is a complex and progressive neurodegenerative disease, which is accompanied by multiple cellular changes along with loss of synapses. Major cellular changes implicated in the pathogenesis of AD include: (1) oligomerization of β-amyloid (Aβ) and accumulation of senile plaques; (2) hyperphosphorylation of tau and accumulation of intracellular neurofibrillary tangles; (3) abnormalities in mitochondrial structure and function; and (4) induction of oxidative stress and neuroinflammation due to increase in production of lipid mediators. Aβ-derived diffusible ligands are responsible for damaging mitochondria and synapses in neurons mediating alterations in AD. These processes are responsible for neurodegeneration in AD.

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Neuroprotection in Autism, Schizophrenia and Alzheimer’s Disease – Chapter 10 – Tau-based therapies for Alzheimer’s disease: Promising novel neuroprotective approaches

Carmen Laura Sayas

Tau neurofibrillary tangles and amyloid-β plaques are the two main hallmarks of Alzheimer’s disease (AD). In AD, tau undergoes conformational changes and subsequent seeding, aggregation, and trans-neuronal spreading, contributing to the propagation of tau pathology in the brain in a prion-like fashion. Notably, the progression of cognitive decline in AD correlates much better with tau pathology than with deposition of Aβ plaques. For decades, the development of potential therapies for AD has been centered in counteracting the formation of amyloid-β plaques, with complete failure in clinical trials. As a consequence, the focus of AD drug discovery has been switched toward tau. In this chapter, current tau-targeting therapies for AD are summarized, from tau-kinase inhibitors to acetylation inhibitors, microtubule stabilizers, aggregation inhibitors, monoclonal anti-tau antibodies or active tau vaccines. Special emphasis has been placed on the most promising therapeutic agents that have reached clinical trials.

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Click here to access the complete special issue collection.