Escolar Documentos
Profissional Documentos
Cultura Documentos
Alzheimer Disease:
A Jordanian
Experience
Marina Hadidi, M.D., Ph.D.
Amman, Jordan
Severe - 2 (4%)
Does Illiteracy Affect
Treatment Choice and
Compliance?
Literate Illiterate
Started on 50 12 (85%)
AChEI (90%)
Reported 38 2 (15%)
positive chan- (70%)
ges after 3 m
Uninterrupted 34 1 (7%)
treatment for (60%)
> 9 months
Limitations:
Our group is not representative of the
whole population of Jordanian
patients with dementia because of:
- small size of group
- patients seeking help from a private
doctor
- predominantly urban patients
Illiteracy in Jordanian
patients with AD (preliminary
conclusions)
Illiteracy is more common in female
than male AD patients
Illiterate patients were more often
diagnosed in moderate and severe
stage, as opposed to mild
Illiterate patients and their relatives
less often report improvement on
treatment with AChEI and are less
probable to remain on it for the
prolonged period of time
Converging Pathogenic
Mechanisms Of Vascular
Dementia And Stroke VS
Neurodegenerative Dementia
AD
Hypertension
Diabetes
Hyperlipidemia
VaD Stroke
Hypertension:
Elevated midlife systolic blood
pressure is an independent risk
factor for AD, according to several
prospective population-based studies
(Kivipelto et al, 2001, Skoog et al, 1996)
Antihypertensive treatment may
protect against demetia in older
patients with systolic HTN, according
to Syst-Eur study (Forette et al, 2002)
Diabetes Mellitus:
Diabetes increases risk of AD
according to epidemiological studies
(Knopman et al, 2002; Arvanitakis et al,
2004)
Possible mechanisms may include
IDE (insulin-degrading enzyme)
which hydrolyses several regulatory
peptides including insulin, glucagone,
Ab and APP intracellular domain
(Duckworth et al 1998, Tanzi et al 2004).
Modifiable Risk Factors
In 1st Ever
Ischemic Stroke
UK : Jordan:
Hypertension -52% - 57%
CAD or MI - 36%
-38%
- 41%
Current smoking - 55%
-27%
- 5%
Diabetes Mellitus
-10%
TIA
M.Hadidi,200
-14% 1
Prevalence of Diabetes
Mellitus In 70 Jordanian
Patients Diagnosed With AD
in 2002-2005
Alzheimer Patients -
21%
Ischemic Stroke Patients -
55%
Controls (non-stroke, non- -
17% AD patients )
Future Steps
Jordanian Alzheimer Association is in
the process of establishing. It will
include interested professionals,
caregivers and social workers.
Epidemiological study evaluating
prevalence of MCI and dementia in
Jordanian population and
investigation into a possible risk
factors is underway
THANK YOU