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Dementia awareness raising program for Nasik Police on the occasion of Kumbh-Mela 2015

– by Mangal Kardile (Founder – Mental Health Aims)

About 15 lecture series program has been completed about - Dementia awareness raising and its significance to Kumbh-Mela for all Nasik city Police stations including Riot control unit between 16 July’15 to 04 August’15.

 
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Research Work Profile
 

Important research product development in Memory and Cognitive impairment diagnostic tool and Neuro-rehabilitation brain exercises

Brief introduction to UMACE- Diagnostic tool

Universal Memory And Cognitive Exam (UMACE) a diagnostic tool for memory and cognitive impairment

Background

Since 2011, a diagnostic tool, titled UMACE (Universal Memory and Cognitive Exam) has been tested on more than 350 samples comprising normal (literate and illiterate), psychiatric and neurological patients rendering substantial quantitative and qualitative data.

With a growing concern regarding an increase in the number of people affected by Alzheimer’s & Dementia in India with an alarming10 million + patients by the year 2020. There is an estimated 46.8 million people worldwide living with dementia in 2015 and this number will almost be doubled every 20 years, reaching 74.7 million in 2030 and 131.5 million in 2050. Much of the increase will be in developing countries. Already 58% of people with dementia live in developing countries, but by 2050 this will rise to 68%.

The fastest growth in the elderly population is taking place in China, India, and their south Asian and western Pacific neighbours. (Kounteya Sinha,TNN, 2009, based on global dementia & aging reports by, WHO, NIH, NIA and ADI, ARDSI).

The research work regarding UMACE was initiated with the help of local psychiatrists and neurologists in 2011. This project concluded in mid-2014 and was accomplished in three phases.

The development of UMACE started in June 2011 when it raised the need for an instrument that could be used to detect cognitive impairments in the illiterate population while developing a technology based therapy for dementia. The therapy research work was carried out using available MMSE test with minimal number of participants and the research paper titled: “Cohesion of Cognitive and Technological inference for treating Dementia” was presented in - The Fifth International congress of the Asian Society Against Dementia, Jointly organized by - Asian Society against Dementia, The Chinese Dementia Research Association, The Hong Kong College of Psychiatrists— Hong Kong, Nov. 2011

The UMACE diagnostic tool for memory and cognitive impairments has been developed in three different phases.

* First phase – Development of items with a diagnostic kit with verbal and non-verbal tasks with the statistical assessment for tool validity, comparing UMACE with MMSE with two Normal sample groups (Literate and Illiterate N=78).

The research paper based on these studies was presented in Australia 2012. Title - “Using a Multicultural Model to develop an Universal Diagnostic Tool for Cognitive and Memory Impairments” International Psychogeriatric Association International Meeting, Cairns, Australia, 7-11 September, 2012

* Second phase - The UMACE testing was performed for a group of 35 male and female patients with varied psychiatric disorders in private psychiatric clinics using the original UMACE item structure and was compared with MMSE with a group of 35 male and female Normal population (N=70)

* Third phase - In the third phase different neurological disorder groups were administered in a private neurology clinic (total 7 groups- Vertigo, Migraine with and without aura, Epilepsy & Seizure disorder, Stroke, Parkinson, Brain diseases, Other neurological disorders) for 205 neurological disorder patients. This study excluded the patients previously diagnosed with Alzheimer’s & Dementia.

The additional test assessment functions are added in the third phase to assess the patients with Stroke or similar disorder having disabilities in speech and motor coordination.

The above mentioned UMACE diagnostic tool research work has been carried out by the researcher through her own expenses owing to the lack of funding opportunities in India for this particular venture. At the final stage the researcher was awarded AUD 3500, through “Capacity Australia”, an NGO run by experienced and eminent psychogeriatricians in Sydney, Australia. Through these funds, she was able to complete statistical procedure and research documentation with the help of two Australian authors in 2015.

The current UMACE diagnostic tool is suitable to assess all people having no cut off criteria based on education or disability, except for the visually impaired and persons having an IQ below 70.

 

*The research paper titled - “Excellence in diagnosis in culturally diverse settings: the development of Universal Memory and Cognitive Exam (UMACE)” will be presented in oral presentation in "The 26th Annual Conference of Alzheimer Europe" which will take place in Copenhagen, Denmark from 31 October–2 November 2016.

 

In 2015 the existing UMACE diagnostic tool was improved to analyze memory and cognitive impairment of the visually impaired population named as UMACE-VIP with added features which is applicable around the globe.

About the UMACE-VIP tool

India shoulders the largest burden of global blindness, about 15 million across the country (around 38 million visually impaired populations worldwide) with 30,000 new cases being added each year. The 75% of these cases are of avoidable blindness, but India has acute shortage of optometrists, while India needs 40,000 optometrists, it has only 8,000 (http://www.netradaan.com/blind-statistics-india.php).


The global population about 38 million persons at present who are blind and, by definition, cannot walk about unaided. They are usually in need of vocational and/or social support.

Necessity for Tool Development

285 million people are estimated to be visually impaired worldwide: 39 million are blind and 246 have low vision. About 90% of the world's visually impaired live in low-income settings (Visual impairment and blindness Fact Sheet, WHO, N°282, 2014).

One out of every three blind people in the world lives in India (Anugraha Drishtidaan,2013, http://www.anugrahadrishtidaan.org/Blindness-Global-&-Indian-Scenario.htm)

Concerning the years lived with disability for all types of non-communicable chronic diseases; the ages 60 + blind population lives the longest years with disability which is 13.3 years lived with disability (21.5% of old age), (World Alzheimer report, ADI, 2009) and there has been little consideration regarding understanding how much percentage of cognitive impairments might be present within this population when they are already at the loss of a very important visual sensory information.

The loss of sight causes enormous human suffering for the affected individuals and their families. It also represents a public health, social and economic problem for countries, especially the developing ones, where 9 out of 10 of the world's blind live. In fact, around 60% of them reside in sub-Saharan Africa, China and India. If additional resources are not urgently mobilized and efforts are not made to curb this trend, by 2020 the global burden of blindness can double. The developing countries will bear the brunt (WHO, vision 2020, The right to sight).

In 2015, a group of 25 (ages 18 years and above) visually impaired adult populations has been tested with UMACE-VIP tool and the results are satisfactory. Further research work is in progress for the sample below 18 years.

In the clinical settings the UMACE-VIP tool proves to be useful for understanding memory and cognitive impairments in the Indian Army population posted at high altitude battle zones such as Siachen Glacier, above 6500 meters. There is documentation that the extreme weather conditions with low temperature below -50 degrees Celsius causes neuro-biological complications in otherwise healthy population (Usui et al., 2004, Shiota et, al., 1990, Javier et al., 2006). Still there is lack of study regarding impaired function at high altitudes with evidence of indicating motor, perceptual and behavioural deficits in adults (Javier et al., 2006).

Further research work for Army population with the UMACE-VIP will be carried out shortly to understand the audio-olfactory-visual and spatial impairment developed in a short time duration of deployment at high altitude.  

*Contact for details - “UMACE” & “UMACE-VIP” diagnostic tool

Email:Info.mentalhealthaims@gmail.com

 

***Based on the above diagnostic tool research data and clinical data a brain exercises kit “BrainNext” was developed.

Considering the utmost need for Neuro-rehabilitation for the neurologically disabled populations around the globe the “BrainNext” brain exercises kit has been developed comprising 18 sets with 500+ exercises. This kit can be useful to detect subtle changes in children below 6 years ages as many mild cognitive dysfunctions go unnoticed that are observed to be severe as the age advances.

*Timely precautions could be taken with the help of “BrainNext” kit.

BrainNext

Memory & Cognitive exercises for all ages

*Research work regarding developing the brain exercise kit

The need for the development of the “BrainNext” brain exercise kit emerged from present limitations for cure of neurodegenerative diseases such as Alzheimer’s and various forms of Dementia, developmental disorders in children and a variety of neurological disorders among all age groups. Considering the neural complexities of brain functions it is desirable to nourish the human brain with continuous sensory input to keep the neurons as active as possible for the entire life span after the person has been diagnosed with certain neural disability. The children who suffer from developmental disorders such as Autism spectrum, ADHD and various other clinically significant cognitive deficits regarding attention, general concentration and various degrees of mentally challenged population need long term cognitive rehabilitation.

While dealing with the clinical neurological population the researcher has identified the need for specially designed brain exercise kit for long term rehabilitation support.  Based on continuous research work, specific exercises have been designed to create, enhance and supply sensory nourishment for the less affected neurons to enable the affected brain to continue to be normal as long as possible.

At present we need to understand that the memory and cognitive activities required by the brain can only be fulfilled by supplying the utmost possible neural boost with the help of the care giver as the affected individual would not be able to do the exercise by himself/herself. Furthermore we need to know that at present neither is there any single clinical solution to stop or cure the neurodegeneration process nor is there any methodology that can act on all the memory and cognitive activities of the human brain at a time. We need to have multidimensional approach for better quality of life for the neurologically affected population.

The “BrainNext” brain exercises kit has all the possible exercise solutions which any normal human brain may perform and can be used for the entire life span of the affected person. The affected brain has to be exercised by another normal human brain as interaction between two human brains is the key to train and guide the affected neurons by healthy neurons. The particular deficits in the neural responses can only be judged by another healthy human brain to make the best of the “BrainNext” brain exercises.

The “BrainNext” kit comprises total 18 sets and any single set can be purchased individually or can be purchased as a single unit of 18 sets together.

The “BrainNext” neuro-cognitive rehabilitation kit will certainly create positive impact for all populations around the world and relief for the caregivers by enhancing the quality of life of an affected individual.

*Book your catalogue today - “BrainNext” catalogue has arrived !

Contact us for further details on-

Researcher and Clinical Professional

Dr. Mangal Kardile

MPsychClin, MPhil & IDMHL&HR

"Medical Neuroscience by Duke University" on Coursera

(Clinical Psychology)

Research/Work attention: Neuropsychology

 
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