Search results for: struggles of dementia
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 291

Search results for: struggles of dementia

231 We Are the Earth That Defends Itself: An Exploration of Discursive Practices of Les Soulèvements De La Terre

Authors: Sophie Del Fa, Loup Ducol

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This presentation will focus on the discursive practices of Les Soulèvements de la Terre (hereafter SdlT), a French environmentalist group mobilized against agribusiness. More specifically, we will use, as a case study, the violently repressed demonstration that took place in Sainte-Soline on March 25, 2023 (see after for details). The SdlT embodies the renewal of anti-capitalist and environmentalist struggles that began with Occupy Wall Street in 2009 and in France with the Nuit debout in 2016 and the yellow vests movement from 2019 to 2020. These struggles have three things in common: they are self-organized without official leaders, they rely mainly on occupations to reappropriate public places (squares, roundabouts, natural territories) and they are anti-capitalist. The SdlT was created in 2021 by activists coming from the Zone-to-Defend of Notre-Dame-des-Landes, a victorious 10 yearlong occupation movement against an airport near Nantes, France (from 2009 to 2018). The SdlT is not labeled as a formal association, nor as a constituted group, but as an anti-capitalist network of local struggles at the crossroads of ecology and social issues. Indeed, although they target agro-industry, land grabbing, soil artificialization and ecology without transition, the SdlT considers ecological and social questions as interdependent. Moreover, they have an encompassing vision of ecology that they consider as a concern for the living as a whole by erasing the division between Nature and Culture. Their radicality is structured around three main elements: federative and decentralized dimensions, the rhetoric of living alliances and militant creatives strategies. The objective of this reflexion is to understand how these three dimensions are articulated through the SdlT’s discursive practices. To explore these elements, we take as a case study one specific event: the demonstration against the ‘basins’ held in Sainte-Soline on March 25, 2023, on the construction site of new water storage infrastructure for agricultural irrigation in western France. This event represents a turning point for the SdlT. Indeed, the protest was violently repressed: 5000 grenades were fired by the police, hundreds of people were injured, and one person was still in a coma at the time of writing these lines. Moreover, following Saint-Soline’s events, the Minister of Interior Affairs, Gérald Darmin, threatened to dissolve the SdlT, thus adding fuel to the fire in an already tense social climate (with the ongoing strikes against the pensions reform). We anchor our reflexion on three types of data: 1) our own experiences (inspired by ethnography) of the Sainte-Soline demonstration; 2) the collection of more than 500 000 Tweets with the #SainteSoline hashtag and 3) a press review of texts and articles published after Sainte-Soline’s demonstration. The exploration of these data from a turning point in the history of the SdlT will allow us to analyze how the three dimensions highlighted earlier (federative and decentralized dimensions, rhetoric of living alliances and creatives militant strategies) are materialized through the discursive practices surrounding the Sainte-Soline event. This will allow us to shed light on how a new contemporary movement implements contemporary environmental struggles.

Keywords: discursive practices, Sainte-Soline, Ecology, radical ecology

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230 The Predictive Utility of Subjective Cognitive Decline Using Item Level Data from the Everyday Cognition (ECog) Scales

Authors: J. Fox, J. Randhawa, M. Chan, L. Campbell, A. Weakely, D. J. Harvey, S. Tomaszewski Farias

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Early identification of individuals at risk for conversion to dementia provides an opportunity for preventative treatment. Many older adults (30-60%) report specific subjective cognitive decline (SCD); however, previous research is inconsistent in terms of what types of complaints predict future cognitive decline. The purpose of this study is to identify which specific complaints from the Everyday Cognition Scales (ECog) scales, a measure of self-reported concerns for everyday abilities across six cognitive domains, are associated with: 1) conversion from a clinical diagnosis of normal to either MCI or dementia (categorical variable) and 2) progressive cognitive decline in memory and executive function (continuous variables). 415 cognitively normal older adults were monitored annually for an average of 5 years. Cox proportional hazards models were used to assess associations between self-reported ECog items and progression to impairment (MCI or dementia). A total of 114 individuals progressed to impairment; the mean time to progression was 4.9 years (SD=3.4 years, range=0.8-13.8). Follow-up models were run controlling for depression. A subset of individuals (n=352) underwent repeat cognitive assessments for an average of 5.3 years. For those individuals, mixed effects models with random intercepts and slopes were used to assess associations between ECog items and change in neuropsychological measures of episodic memory or executive function. Prior to controlling for depression, subjective concerns on five of the eight Everyday Memory items, three of the nine Everyday Language items, one of the seven Everyday Visuospatial items, two of the five Everyday Planning items, and one of the six Everyday Organization items were associated with subsequent diagnostic conversion (HR=1.25 to 1.59, p=0.003 to 0.03). However, after controlling for depression, only two specific complaints of remembering appointments, meetings, and engagements and understanding spoken directions and instructions were associated with subsequent diagnostic conversion. Episodic memory in individuals reporting no concern on ECog items did not significantly change over time (p>0.4). More complaints on seven of the eight Everyday Memory items, three of the nine Everyday Language items, and three of the seven Everyday Visuospatial items were associated with a decline in episodic memory (Interaction estimate=-0.055 to 0.001, p=0.003 to 0.04). Executive function in those reporting no concern on ECog items declined slightly (p <0.001 to 0.06). More complaints on three of the eight Everyday Memory items and three of the nine Everyday Language items were associated with a decline in executive function (Interaction estimate=-0.021 to -0.012, p=0.002 to 0.04). These findings suggest that specific complaints across several cognitive domains are associated with diagnostic conversion. Specific complaints in the domains of Everyday Memory and Language are associated with a decline in both episodic memory and executive function. Increased monitoring and treatment of individuals with these specific SCD may be warranted.

Keywords: alzheimer’s disease, dementia, memory complaints, mild cognitive impairment, risk factors, subjective cognitive decline

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229 An Analysis on the Hidden Transcripts and Power: A Cultural Study on Confliction between Mother and Daughter-in-Law in Contemporary Chinese Television Dramas

Authors: Xiaohui Pan

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As the most influential media for the dissemination of Chinese culture, films and television dramas have played cognitive orientation in guiding young audience to understand its cultural value. Taking a retrospective overview of the Chinese domestic film and television dramas in the last decade, it is tangible to notice that Westernization has become irresistible force in the presentation of Chinese youth culture, such as the rise of sensibility, publicity of subjectivity, and the resistance to mainstream discourse. However, the process of deconstruction and transition of these film and television works on Western youth culture brought about more comprehensive conflicts and integration rather than providing a panoramic interpretation to young Chinese. Issues of tradition and modernization, oriental and Western, and serious thinking and the spirit of entertainment overwhelmed those Chinese works. This study attempts to examine the mechanism of young Chinese’s resistance, compromise and re-construction in their marriages during the dynamic cultural intergration between traditional Chinese culture and Western culture. To investigate such a mechanism, this study analyzed four Chinese television dramas themed on family ethics to reveal the conflictions between two generations, mother-in-law and daughter-in-law, aiming to identify their strategies of their struggles. Incorporating the theory of Scott's weapons of the weak, this study examines the dynamic model of the struggles content analysis on their hidden language and the power. The finding shows that young Chinese identified their self-awakening during the resistance. The study also finds out that the external factors might have the functions of switching the power from the strong end to the weak end. The finding of this study can provide useful insights for researchers in this area and for those in the process of exploring cultural integration issues.

Keywords: intergration, integration, resistance, youth culture

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228 Homosexuality and Culture: A Case Study Depicting the Struggles of a Married Lady

Authors: Athulya Jayakumar, M. Manjula

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Though there has been a shift in the understanding of homosexuality from being a sin, crime or pathology in the medical and legal perspectives, the acceptance of homosexuality still remains very scanty in the Indian subcontinent. The present case study is a 24-year-old female who has completed a diploma in polytechnic engineering and residing in the state of Kerala. She initially presented with her husband with complaints of lack of sexual desire and non-cooperation from the index client. After an initial few sessions, the client revealed, in an individual session, about her homosexual orientation which was unknown to her family. She has had multiple short-term relations with females and never had any heterosexual orientation/interest. During her adolescence, she was wondering if she could change herself into a male. However, currently, she accepts her gender. She never wanted a heterosexual marriage; but, had to succumb to the pressure of mother, as a result of a series of unexpected incidents at home and had to agree for the marriage, also with a hope that she may change herself into a bi-sexual. The client was able to bond with the husband emotionally but the multiple attempts at sexual intercourse, at the insistence of the husband, had always been non-pleasurable and induced a sense of disgust. Currently, for several months, there has not been any sexual activity. Also, she actively avoids any chance to have a warm communication with him so that she can avoid chances of him approaching her in a sexual manner. The case study is an attempt to highlight the culture and the struggles of a homosexual individual who comes to therapy for wanting to be a ‘normal wife’ despite having knowledge of legal rights and scenario. There is a scarcity of Indian literature that has systematically investigated issues related to homosexuality. Data on prevalence, emotional problems faced and clinical services available are sparse though it is crucial for increasing understanding of sexual behaviour, orientation and difficulties faced in India.

Keywords: case study, culture, cognitive behavior therapy, female homosexuality

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227 Exploring Pre-Trained Automatic Speech Recognition Model HuBERT for Early Alzheimer’s Disease and Mild Cognitive Impairment Detection in Speech

Authors: Monica Gonzalez Machorro

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Dementia is hard to diagnose because of the lack of early physical symptoms. Early dementia recognition is key to improving the living condition of patients. Speech technology is considered a valuable biomarker for this challenge. Recent works have utilized conventional acoustic features and machine learning methods to detect dementia in speech. BERT-like classifiers have reported the most promising performance. One constraint, nonetheless, is that these studies are either based on human transcripts or on transcripts produced by automatic speech recognition (ASR) systems. This research contribution is to explore a method that does not require transcriptions to detect early Alzheimer’s disease (AD) and mild cognitive impairment (MCI). This is achieved by fine-tuning a pre-trained ASR model for the downstream early AD and MCI tasks. To do so, a subset of the thoroughly studied Pitt Corpus is customized. The subset is balanced for class, age, and gender. Data processing also involves cropping the samples into 10-second segments. For comparison purposes, a baseline model is defined by training and testing a Random Forest with 20 extracted acoustic features using the librosa library implemented in Python. These are: zero-crossing rate, MFCCs, spectral bandwidth, spectral centroid, root mean square, and short-time Fourier transform. The baseline model achieved a 58% accuracy. To fine-tune HuBERT as a classifier, an average pooling strategy is employed to merge the 3D representations from audio into 2D representations, and a linear layer is added. The pre-trained model used is ‘hubert-large-ls960-ft’. Empirically, the number of epochs selected is 5, and the batch size defined is 1. Experiments show that our proposed method reaches a 69% balanced accuracy. This suggests that the linguistic and speech information encoded in the self-supervised ASR-based model is able to learn acoustic cues of AD and MCI.

Keywords: automatic speech recognition, early Alzheimer’s recognition, mild cognitive impairment, speech impairment

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226 Experiences of Social Participation among Community Elderly with Mild Cognitive Impairment: A Qualitative Research

Authors: Xue Li, Hui Xu

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Mild cognitive impairment (MCI) is a clinical stage that occurs between normal aging and dementia. Although MCI increases the risk of developing dementia, individuals with MCI may maintain stable cognitive function and even recover to a typical cognitive state. An intervention to prevent or delay the progression to dementia in individuals with MCI may involve promoting social engagement. Social participation is the engagement in socially relevant social exchanges and meaningful activities. Older adults with MCI may encounter restricted cognitive abilities, mood changes, and behavioral difficulties during social participation, influencing their willingness to engage. Therefore, this study aims to employ qualitative research methods to gain an in-depth comprehension of the authentic social participation experiences of older adults with mild cognitive impairment, which will establish a foundation for designing appropriate intervention programs. A phenomenological research was conducted. The study participants were selected using the purposive sampling method in combination with the maximum differentiation sampling strategy. Face-to-face semistructured interviews were conducted among 12 elderly individuals suffering from mild cognitive impairment in a community in Zhengzhou City from May to July 2023. Colaizzi 7-step method was used to analyze the data and extract the theme. The real experience of social participation in older adults with mild cognitive impairment can be summarized into 3 themes: (1) a single social relationship but a strong desire to participate, (2) a dual experience of social participation with both positive and negative aspects, (3) multiple barriers to social participation, including impaired memory capacity, heavy family responsibilities and lack of infrastructure. The study found that elderly individuals with mild cognitive impairment and one social interaction display an increased desire to engage in society. To improve social participation levels and reduce cognitive function decline, healthcare providers should work with relevant government agencies and the community to create a comprehensive social participation system. It is important for healthcare providers to note the social participation status of the elderly with mild cognitive impairment.

Keywords: mild cognitive impairment, the elderly, social participation, qualitative research

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225 Implementation of an Induction Programme to Help the International Medical Graduates in the NHS

Authors: Mohammad K. Rumjaun, Sana Amjed, Muhammad A. Ghazi, Safa G. Attar, Jason Raw

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Background: National Health Service (NHS) in England is one of the leading healthcare systems in the world and it heavily relies on the recruitment of overseas doctors. 30.7% of the doctors currently serving in NHS are overseas doctors. Most of these doctors do not receive the essential induction required to work in the NHS when they first arrive and therefore, they mostly struggle to work effectively in the first few months of their new jobs as compared to UK graduates. In our hospital, the clinical need for a dedicated induction programme for the International Medical Graduates (IMGs) was identified for their initial settling period and this programme was designed to achieve this. Methods: A questionnaire was designed for the previous 7 IMGs (Group 1) in order to identify the difficulties they faced in their initial phase. Thereafter, an induction programme consisting of presentations explaining the NHS and hospital framework, communication skills practice sessions, the clinical ceiling of care and patient simulation training was implemented for 6 new IMGs (Group 2). Another survey was done and compared with the previous. Results: After this programme, group 2 required only 1 week to understand the complexity of the IT systems as compared 3 weeks in group 1. 83% of group 2 was well-supported for their on-call duties after this programme as compared to 29% and 100% of group 2 was aware of their role in the job after the induction as compared to 0%. Furthermore, group 2 was able to function independently and confidently in their roles after only 1 month as compared to an average of 3 months for group 1. After running the PDSA cycles, our results show clear evidence that this programme has tremendously benefitted the IMGs in settling in the NHS. The IMGs really appreciated this initiative and have given positive feedback. Conclusion: Leaving your home country to begin your career in a different country is not an easy transition and undoubtedly, everyone struggles. It is important to invest in a well-structured induction programme for the IMGs in the initial phase of their jobs as this will improve not only their confidence and efficacy but also patients’ safety.

Keywords: induction programme, international medical graduates, NHS, overseas doctors struggles.

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224 Diagnostic Contribution of the MMSE-2:EV in the Detection and Monitoring of the Cognitive Impairment: Case Studies

Authors: Cornelia-Eugenia Munteanu

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The goal of this paper is to present the diagnostic contribution that the screening instrument, Mini-Mental State Examination-2: Expanded Version (MMSE-2:EV), brings in detecting the cognitive impairment or in monitoring the progress of degenerative disorders. The diagnostic signification is underlined by the interpretation of the MMSE-2:EV scores, resulted from the test application to patients with mild and major neurocognitive disorders. The original MMSE is one of the most widely used screening tools for detecting the cognitive impairment, in clinical settings, but also in the field of neurocognitive research. Now, the practitioners and researchers are turning their attention to the MMSE-2. To enhance its clinical utility, the new instrument was enriched and reorganized in three versions (MMSE-2:BV, MMSE-2:SV and MMSE-2:EV), each with two forms: blue and red. The MMSE-2 was adapted and used successfully in Romania since 2013. The cases were selected from current practice, in order to cover vast and significant neurocognitive pathology: mild cognitive impairment, Alzheimer’s disease, vascular dementia, mixed dementia, Parkinson’s disease, conversion of the mild cognitive impairment into Alzheimer’s disease. The MMSE-2:EV version was used: it was applied one month after the initial assessment, three months after the first reevaluation and then every six months, alternating the blue and red forms. Correlated with age and educational level, the raw scores were converted in T scores and then, with the mean and the standard deviation, the z scores were calculated. The differences of raw scores between the evaluations were analyzed from the point of view of statistic signification, in order to establish the progression in time of the disease. The results indicated that the psycho-diagnostic approach for the evaluation of the cognitive impairment with MMSE-2:EV is safe and the application interval is optimal. The alternation of the forms prevents the learning phenomenon. The diagnostic accuracy and efficient therapeutic conduct derive from the usage of the national test norms. In clinical settings with a large flux of patients, the application of the MMSE-2:EV is a safe and fast psycho-diagnostic solution. The clinicians can draw objective decisions and for the patients: it doesn’t take too much time and energy, it doesn’t bother them and it doesn’t force them to travel frequently.

Keywords: MMSE-2, dementia, cognitive impairment, neuropsychology

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223 Training for Search and Rescue Teams: Online Training for SAR Teams to Locate Lost Persons with Dementia Using Drones

Authors: Dalia Hanna, Alexander Ferworn

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This research provides detailed proposed training modules for the public safety teams and, specifically, SAR teams responsible for search and rescue operations related to finding lost persons with dementia. Finding a lost person alive is the goal of this training. Time matters if a lost person is to be found alive. Finding lost people living with dementia is quite challenging, as they are unaware they are lost and will not seek help. Even a small contribution to SAR operations could contribute to saving a life. SAR operations will always require expert professional and human volunteers. However, we can reduce their time, save lives, and reduce costs by providing practical training that is based on real-life scenarios. The content for the proposed training is based on the research work done by the researcher in this area. This research has demonstrated that, based on utilizing drones, the algorithmic approach could support a successful search outcome. Understanding the behavior of the lost person, learning where they may be found, predicting their survivability, and automating the search are all contributions of this work, founded in theory and demonstrated in practice. In crisis management, human behavior constitutes a vital aspect in responding to the crisis; the speed and efficiency of the response often get affected by the difficulty of the context of the operation. Therefore, training in this area plays a significant role in preparing the crisis manager to manage the emotional aspects that lead to decision-making in these critical situations. Since it is crucial to gain high-level strategic choices and the ability to apply crisis management procedures, simulation exercises become central in training crisis managers to gain the needed skills to respond critically to these events. The training will enhance the responders’ ability to make decisions and anticipate possible consequences of their actions through flexible and revolutionary reasoning in responding to the crisis efficiently and quickly. As adult learners, search and rescue teams will be approaching training and learning by taking responsibility of the learning process, appreciate flexible learning and as contributors to the teaching and learning happening during that training. These are all characteristics of adult learning theories. The learner self-reflects, gathers information, collaborates with others and is self-directed. One of the learning strategies associated with adult learning is effective elaboration. It helps learners to remember information in the long term and use it in situations where it might be appropriate. It is also a strategy that can be taught easily and used with learners of different ages. Designers must design reflective activities to improve the student’s intrapersonal awareness.

Keywords: training, OER, dementia, drones, search and rescue, adult learning, UDL, instructional design

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222 Trigonella foenum-graecum Seeds Extract as Therapeutic Candidate for Treatment of Alzheimer's Disease

Authors: Mai M. Farid, Ximeng Yang, Tomoharu Kuboyama, Yuna Inada, Chihiro Tohda

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Intro: Trigonella foenum-graecum (Fenugreek), from Fabaceae family is a well-known plant traditionally used as food and medicine. Many pharmacological effects of Trigonella foenum- graecum seeds extract (TF extract) were evaluated such as anti-diabetic, anti-tumor and anti-dementia effects using in vivo models. Regarding the anti-dementia effects of TF extract, diabetic rats, aluminum chloride-induced amnesia rats and scopolamine-injected mice were used previously for evaluation, which are not well established as Alzheimer’s disease models. In addition, those previous studies, active constituents in TF extract for memory function were not identified. Method: This study aimed to clarify the effect of TF extract on Alzheimer’s disease model, 5XFAD mouse that overexpresses mutated APP and PS1 genes and determine the major active constituent in the brain after oral intake of TF extract. Results: Trigonelline was detected in the cerebral cortex of 5XFAD mice after 24 hours of oral administration of TF extract by LC-MS/MS. Oral administration of TF extract for 17 days improved object location memory in 5XFAD mice. Conclusion: These results suggest that TF extract and its active constituents could be an expected therapeutic candidate for Alzheimer’s disease.

Keywords: Alzheimer's disease, LC-MS/MS, memory recovery, Trigonella foenum-graecum Seeds, 5XFAD mice

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221 A Text-Oriented Study on Treatises and the End of the Struggles in Silius

Authors: Arianna Sacerdoti

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This paper is original and fills, to our best Knowledge, a gap in secondary literature. It analyzes the presence of treatises in Silius Italicus’ Punica and what happens in the plot when a struggle ends. As a result, we will understand if treatises are stipulated or broken, and which narrative devices go with the presence of treatises and the end of the battles. Methodology will be text-oriented, and all the passages will be presented in the Latin language and discussed. In concluding, it is important to understand – in a poem based on war – the role of treatises and the end of battles in Silius Italicus.

Keywords: Flavian Epic, Silius Italicus, Punica, treatises

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220 Overcoming Urban Challenges through Culture and Social Sustainability in Caracas’ Barrios

Authors: Gabriela Quintana Vigiola

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Social sustainability is an issue scarcely addressed by different authors, being one of its key factors the psychosocial processes of sense of place, sense of community and appropriation. In Caracas’s barrios (Venezuela) these were developed through sharing the construction of the place and different struggles that brought the neighbours together. However, one of the main problems they face is criminal violence, hence being its social sustainability threatened and affected by it. This matter can be addressed by acknowledging communities’ sense of place and engaging in cultural events.

Keywords: Caracas’ barrios, cultural engagement, developing countries, social sustainability

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219 Factors Affecting Test Automation Stability and Their Solutions

Authors: Nagmani Lnu

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Test automation is a vital requirement of any organization to release products faster to their customers. In most cases, an organization has an approach to developing automation but struggles to maintain it. It results in an increased number of Flaky Tests, reducing return on investments and stakeholders’ confidence. Challenges grow in multiple folds when automation is for UI behaviors. This paper describes the approaches taken to identify the root cause of automation instability in an extensive payments application and the best practices to address that using processes, tools, and technologies, resulting in a 75% reduction of effort.

Keywords: automation stability, test stability, Flaky Test, test quality, test automation quality

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218 Global News Coverage of the Pandemic: Towards an Ethical Framework for Media Professionalism

Authors: Anantha S. Babbili

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This paper analyzes the current media practices dominant in global journalistic practices within the framework of world press theories of Libertarian, Authoritarian, Communist, and Social Responsibility to evaluate their efficacy in addressing their role in the coverage of the coronavirus, also known as COVID-19. The global media flows, determinants of news coverage, and international awareness and the Western view of the world will be critically analyzed within the context of the prevalent news values that underpin free press and media coverage of the world. While evaluating the global discourse paramount to a sustained and dispassionate understanding of world events, this paper proposes an ethical framework that brings clarity devoid of sensationalism, partisanship, right-wing and left-wing interpretations to a breaking and dangerous development of a pandemic. As the world struggles to contain the coronavirus pandemic with death climbing close to 6,000 from late January to mid-March, 2020, the populations of the developed as well as the developing nations are beset with news media renditions of the crisis that are contradictory, confusing and evoking anxiety, fear and hysteria. How are we to understand differing news standards and news values? What lessons do we as journalism and mass media educators, researchers, and academics learn in order to construct a better news model and structure of media practice that addresses science, health, and media literacy among media practitioners, journalists, and news consumers? As traditional media struggles to cover the pandemic to its audience and consumers, social media from which an increasing number of consumers get their news have exerted their influence both in a positive way and in a negative manner. Even as the world struggles to grasp the full significance of the pandemic, the World Health Organization (WHO) has been feverishly battling an additional challenge related to the pandemic in what it termed an 'infodemic'—'an overabundance of information, some accurate and some not, that makes it hard for people to find trustworthy sources and reliable guidance when they need it.' There is, indeed, a need for journalism and news coverage in times of pandemics that reflect social responsibility and ethos of public service journalism. Social media and high-tech information corporations, collectively termed GAMAF—Google, Apple, Microsoft, Amazon, and Facebook – can team up with reliable traditional media—newspapers, magazines, book publishers, radio and television corporates—to ease public emotions and be helpful in times of a pandemic outbreak. GAMAF can, conceivably, weed out sensational and non-credible sources of coronavirus information, exotic cures offered for sale on a quick fix, and demonetize videos that exploit peoples’ vulnerabilities at the lowest ebb. Credible news of utility delivered in a sustained, calm, and reliable manner serves people in a meaningful and helpful way. The world’s consumers of news and information, indeed, deserve a healthy and trustworthy news media – at least in the time of pandemic COVID-19. Towards this end, the paper will propose a practical model for news media and journalistic coverage during times of a pandemic.

Keywords: COVID-19, international news flow, social media, social responsibility

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217 Investigating Early Markers of Alzheimer’s Disease Using a Combination of Cognitive Tests and MRI to Probe Changes in Hippocampal Anatomy and Functionality

Authors: Netasha Shaikh, Bryony Wood, Demitra Tsivos, Michael Knight, Risto Kauppinen, Elizabeth Coulthard

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Background: Effective treatment of dementia will require early diagnosis, before significant brain damage has accumulated. Memory loss is an early symptom of Alzheimer’s disease (AD). The hippocampus, a brain area critical for memory, degenerates early in the course of AD. The hippocampus comprises several subfields. In contrast to healthy aging where CA3 and dentate gyrus are the hippocampal subfields with most prominent atrophy, in AD the CA1 and subiculum are thought to be affected early. Conventional clinical structural neuroimaging is not sufficiently sensitive to identify preferential atrophy in individual subfields. Here, we will explore the sensitivity of new magnetic resonance imaging (MRI) sequences designed to interrogate medial temporal regions as an early marker of Alzheimer’s. As it is likely a combination of tests may predict early Alzheimer’s disease (AD) better than any single test, we look at the potential efficacy of such imaging alone and in combination with standard and novel cognitive tasks of hippocampal dependent memory. Methods: 20 patients with mild cognitive impairment (MCI), 20 with mild-moderate AD and 20 age-matched healthy elderly controls (HC) are being recruited to undergo 3T MRI (with sequences designed to allow volumetric analysis of hippocampal subfields) and a battery of cognitive tasks (including Paired Associative Learning from CANTAB, Hopkins Verbal Learning Test and a novel hippocampal-dependent abstract word memory task). AD participants and healthy controls are being tested just once whereas patients with MCI will be tested twice a year apart. We will compare subfield size between groups and correlate subfield size with cognitive performance on our tasks. In the MCI group, we will explore the relationship between subfield volume, cognitive test performance and deterioration in clinical condition over a year. Results: Preliminary data (currently on 16 participants: 2 AD; 4 MCI; 9 HC) have revealed subfield size differences between subject groups. Patients with AD perform with less accuracy on tasks of hippocampal-dependent memory, and MCI patient performance and reaction times also differ from healthy controls. With further testing, we hope to delineate how subfield-specific atrophy corresponds with changes in cognitive function, and characterise how this progresses over the time course of the disease. Conclusion: Novel sequences on a MRI scanner such as those in route in clinical use can be used to delineate hippocampal subfields in patients with and without dementia. Preliminary data suggest that such subfield analysis, perhaps in combination with cognitive tasks, may be an early marker of AD.

Keywords: Alzheimer's disease, dementia, memory, cognition, hippocampus

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216 Motherhood Constrained: The Minotaur Legend Reimagined Through the Perspective of Marginalized Mothers

Authors: Gevorgianiene Violeta, Sumskiene Egle

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Background. Child removal is a profound and life-altering measure that significantly impacts both children and their mothers. Unfortunately, mothers with intellectual disabilities are disproportionately affected by the removal of their children. This action is often taken due to concerns about the mother's perceived inability to care for the child, instances of abuse and neglect, or struggles with addiction. In many cases, the failure to meet society's standards of a "good mother" is seen as a deviation from conventional norms of femininity and motherhood. From an institutional perspective, separating a child from their mother is sometimes viewed as a step toward restoring justice or doing what is considered "right." In another light, this act of child removal can be seen as the removal of a mother from her child, an attempt to shield society from the complexities and fears associated with motherhood for women with disabilities. This separation can be likened to the Greek legend of the Minotaur, a fearsome beast confined within an impenetrable labyrinth. By reimagining this legend, we can see the social fears surrounding 'mothering with intellectual disability' as deeply sealed within an unreachable place. The Aim of this Presentation. Our goal with this presentation is to draw from our research and the metaphors found in the Greek legend to delve into the profound challenges faced by mothers with intellectual disabilities in raising their children. These challenges often become entangled within an insurmountable labyrinth, including navigating complex institutional bureaucracies, enduring persistent doubts cast upon their maternal competencies, battling unfavorable societal narratives, and struggling to retain custody of their children. Coupled with limited social support networks, these challenges frequently lead to situations resulting in maternal failure and, ultimately, child removal. On a broader scale, this separation of a child from their mother symbolizes society’s collective avoidance of confronting the issue of 'mothering with disability,' which can only be effectively addressed through united efforts. Conclusion. Just as in the labyrinth of the Minotaur legend, the struggles faced by mothers with disabilities in their pursuit of retaining their children reveal the need for a metaphorical 'string of Ariadne.' This string symbolizes the support offered by social service providers, communities, and the loved ones these women often dream of but rarely encounter in their lives.

Keywords: motherhood, disability, child removal, support.

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215 Indo-Pak Relationship: Understanding the Past to Make Sense of the Future

Authors: Aneri Mehta, Krunal Mehta

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The unpredictable and vacillating relationship between India and Pakistan since days of Independence struggle is known world over. And this instability has never lost its magnitude to decrease the tensions between the two countries. Since India aspires to run for the race of future superpower and Pakistan struggles to remove the tag of a highly fickle and under developed economy; ruined largely not by the outsiders, but its own people and systems; it becomes really important to gauge what steps would these neighbors take in years to come. The progress and stability of both countries heavily relies on the favorable equations between the two nations. Therefore the paper tries to trace some roots of their faltering relationship and attempts to predict their future in a multidimensional perspective.

Keywords: economy, faltering relationship, multidimensional perspective, international relations

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214 Mental Disorders and Physical Illness in Geriatric Population

Authors: Vinay Kumar, M. Kishor, Sathyanarayana Rao Ts

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Background: Growth of elderly people in the general population in recent years is termed as ‘greying of the world’ where there is a shift from high mortality & fertility to low mortality and fertility, resulting in an increased proportion of older people as seen in India. Improved health care promises longevity but socio-economic factors like poverty, joint families and poor services pose a psychological threat. Epidemiological data regarding the prevalence of mental disorders in geriatric population with physical illness is required for proper health planning. Methods: Sixty consecutive elderly patients aged 60 years or above of both sexes, reporting with physical illness to general outpatient registration counter of JSS Medical College and Hospital, Mysore, India, were considered for the Study. With informed consent, they were screened with General Health Questionnaire (GHQ-12) and were further evaluated for diagnosing mental disorders according to WHO International Classification of Diseases (ICD-10) criteria. Results: Mental disorders were detected in 48.3%, predominantly depressive disorders, nicotine dependence, generalized anxiety disorder, alcohol dependence and least was dementia. Most common physical illness was cardiovascular disease followed by metabolic, respiratory and other diseases. Depressive disorders, substance dependence and dementia were more associated with cardiovascular disease compared to metabolic disease and respiratory diseases were more associated with nicotine dependence. Conclusions: Depression and Substance use disorders among elderly population is of concern, which needs to be further studied with larger population. Psychiatric morbidity will adversely have an impact on physical illness which needs proper assessment and management. This will enhance our understanding and prioritize our planning for future.

Keywords: Geriatric, mental disorders, physical illness, psychiatry

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213 Oppugning LGBTQ+ Stereotypes in Gloc-9’s “Sirena”

Authors: Gerald S. Atchaso, Erwin L. Purcia, Angelo B. Velarde

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The study attempts to analyze and evaluate Gloc-9’s “Sirena” through Queer Critical Reading approach, which underscores that there exists sexual orientation fluidity within the LGBTQ+ spectrum. With this, the researchers found out that there is a need to oppugn stereotypes within and outside the spectrum, and there exist intrinsic and extrinsic struggles of people in the spectrum as deduced in the literary piece through identifying the characters’ sexual identities shaped and formed as exemplified in the literary piece, determining the prejudices that exist about the main character's sexuality, and distinctively demystifying the social forces or constructs that identify sexual identity.

Keywords: literature, LGBTQ+, spectrum, sexual orientation, queer critical reading

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212 Family-School-Community Engagement: Building a Growth Mindset

Authors: Michelann Parr

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Family-school-community engagement enhances family-school-community well-being, collective confidence, and school climate. While it is often referred to as a positive thing in the literature for families, schools, and communities, it does not come without its struggles. While there are numerous things families, schools, and communities do each and every day to enhance engagement, it is often difficult to find our way to true belonging and engagement. Working our way surface level barriers is easy; we can provide childcare, transportation, resources, and refreshments. We can even change the environment so that families will feel welcome, valued, and respected. But there are often mindsets and perpsectives buried deep below the surface, most often grounded in societal, familial, and political norms, expectations, pressures, and narratives. This work requires ongoing energy, commitment, and engagement of all stakeholders, including families, schools, and communities. Each and every day, we need to take a reflective and introspective stance at what is said and done and how it supports the overall goal of family-school-community engagement. And whatever we must occur within a paradigm of care in additional to one of critical thinking and social justice. Families, and those working with families, must not simply accept all that is given, but should instead ask these types of questions: a) How, and by whom, are the current philosophies and practices of family-school engagement interrogated? b) How might digging below surface level meanings support understanding of what is being said and done? c) How can we move toward meaningful and authentic engagement that balances knowledge and power between family, school, district, community (local and global), and government? This type of work requires conscious attention and intentional decision-making at all levels bringing us one step closer to authentic and meaningful partnerships. Strategies useful to building a growth mindset include: a) interrogating and exploring consistencies and inconsistencies by looking at what is done and what is not done through multiple perspectives; b) recognizing that enhancing family-engagement and changing mindsets take place at the micro-level (e.g., family and school), but also require active engagement and awareness at the macro-level (e.g., community agencies, district school boards, government); c) taking action as an advocate or activist. Negative narratives about families, schools, and communities should not be maintained, but instead critical and courageous conversations in and out of school should be initiated and sustained; and d) maintaining consistency, simplicity, and steady progress. All involved in engagement need to be aware of the struggles, but keep them in check with the many successes. Change may not be observed on a day-to-day basis or even immediately, but stepping back and looking from the outside in, might change the view. Working toward a growth mindset will produce better results than a fixed mindset, and this takes time.

Keywords: family engagment, family-school-community engagement, parent engagement, parent involvment

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211 Landbody: Decolonizing U.S. Intercultural Communication

Authors: Aimee Carrillo Rowe

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Drawing on theories of plurinationalism and Indigenous sovereignty, this essay argues for a “landbody” method of culture critique. This method analyzes the relationship between land and bodies in queer Xicana performances. The study finds that queer Xicana performances navigate complex relationships between settler and Indigenous positionalities. By shifting the focus in the field of U.S. intercultural communication from political struggles for inclusion within the settler nation-state to an interrogation of the land politics upon that underwrite sovereignty, the paper develops a decolonial, hemispheric approach to the field of intercultural communication.

Keywords: indigenous studies, settler colonial studies, critical ethnic studies, landbody, decolonization, Chicana feminism, queer Xicana performance

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210 Cognitive Function and Coping Behavior in the Elderly: A Population-Based Cross-Sectional Study

Authors: Ryo Shikimoto, Hidehito Niimura, Hisashi Kida, Kota Suzuki, Yukiko Miyasaka, Masaru Mimura

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Introduction: In Japan, the most aged country in the world, it is important to explore predictive factors of cognitive function among the elderly. Coping behavior relieves chronic stress and improves lifestyle, and consequently may reduce the risk of cognitive impairment. One of the most widely investigated frameworks evaluated in previous studies is approach-oriented and avoidance-oriented coping strategies. The purpose of this study is to investigate the relationship between cognitive function and coping strategies among elderly residents in urban areas of Japan. Method: This is a part of the cross-sectional Arakawa geriatric cohort study for 1,099 residents (aged 65 to 86 years; mean [SD] = 72.9 [5.2]). Participants were assessed for cognitive function using the Mini-Mental State Examination (MMSE) and diagnosed by psychiatrists in face-to-face interviews. They were then investigated for their each coping behaviors and coping strategies (approach- and avoidance-oriented coping) using stress and coping inventory. A multiple regression analysis was used to investigate the relationship between MMSE score and each coping strategy. Results: Of the 1,099 patients, the mean MMSE score of the study participants was 27.2 (SD = 2.7), and the numbers of the diagnosis of normal, mild cognitive impairment (MCI), and dementia were 815 (74.2%), 248 (22.6%), and 14 (1.3%), respectively. Approach-oriented coping score was significantly associated with MMSE score (B [partial regression coefficient] = 0.12, 95% confidence interval = 0.05 to 0.19) after adjusting for confounding factors including age, sex, and education. Avoidance-oriented coping did not show a significant association with MMSE score (B [partial regression coefficient] = -0.02, 95% confidence interval = -0.09 to 0.06). Conclusion: Approach-oriented coping was clearly associated with neurocognitive function in the Japanese population. A future longitudinal trial is warranted to investigate the protective effects of coping behavior on cognitive function.

Keywords: approach-oriented coping, cognitive impairment, coping behavior, dementia

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209 Brain Atrophy in Alzheimer's Patients

Authors: Tansa Nisan Gunerhan

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Dementia comes in different forms, including Alzheimer's disease. The most common dementia diagnosis among elderly individuals is Alzheimer's disease. On average, for patients with Alzheimer’s, life expectancy is around 4-8 years after the diagnosis; however, expectancy can go as high as twenty years or more, depending on the shrinkage of the brain. Normally, along with aging, the brain shrinks at some level but doesn’t lose a vast amount of neurons. However, Alzheimer's patients' neurons are destroyed rapidly; hence problems with loss of memory, communication, and other metabolic activities begin. The toxic changes in the brain affect the stability of the neurons. Beta-amyloid and tau are two proteins that are believed to play a role in the development of Alzheimer's disease through their toxic changes. Beta-amyloid is a protein that is produced in the brain and is normally broken down and removed from the body. However, in people with Alzheimer's disease, the production of beta-amyloid increases, and it begins to accumulate in the brain. These plaques are thought to disrupt communication between nerve cells and may contribute to the death of brain cells. Tau is a protein that helps to stabilize microtubules, which are essential for the transportation of nutrients and other substances within brain cells. In people with Alzheimer's disease, tau becomes abnormal and begins to accumulate inside brain cells, forming neurofibrillary tangles. These tangles disrupt the normal functioning of brain cells and may contribute to their death, forming amyloid plaques which are deposits of a protein called amyloid-beta that build up between nerve cells in the brain. The accumulation of amyloid plaques and neurofibrillary tangles in the brain is thought to contribute to the shrinkage of brain tissue. As the brain shrinks, the size of the brain may decrease, leading to a reduction in brain volume. Brain atrophy in Alzheimer's disease is often accompanied by changes in the structure and function of brain cells and the connections between them, leading to a decline in brain function. These toxic changes that accumulate can cause symptoms such as memory loss, difficulty with thinking and problem-solving, and changes in behavior and personality.

Keywords: Alzheimer, amyloid-beta, brain atrophy, neuron, shrinkage

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208 Dalit Struggle in Nepal: From Invoking Dalit to Becoming Part of the Nepalese Power

Authors: Mom Bishwakarma

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This research traces out how the Dalit in Nepal evolved from the early 1950s to the current day, from invoking Dalit against caste discrimination through to the asserting proportional representation in state structures. The research focused most closely on the formation of Dalit association and resistance, as well as on the different struggles throughout this period. It then discusses the expansion of Dalit movement in NGOs, its internationalization and responses. The research sees that Dalit movement has been influenced by its network with the national and international civil rights movement particularly Dalit movement in India and argues that Dalit movement in Nepal have in many ways, challenged the orthodox based caste stratification for Dalit equality and justice. It can be seen that at the same time as Dalit participation was increasing, divisions by caste line also emerged. Rather reshaping the power structures, Dalit movement encircled into division and contentious politics.

Keywords: Dalit, equality, justice, movements, Nepal

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207 Mimesis in William Shakespeare's Selected Sonnets

Authors: Roselyn T. Bustos

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Literature is an imitation of life. It depicts man's culture as well as his struggles. In short, literature is a part of man's way of life- a reflection of his personal or vicarious experiences. Using the qualitative-descriptive content analysis, this study investigates the mimetic signification in the five select sonnets of William Shakespeare.An in- depth analysis of the poetic elements such as the figurative language used and the themes extracted is made to draw out the universal meaning of his works. It is found out that his select sonnets use figurative languages such as simile, metaphor, personification, and hyperbaton which becomes a potent element that allows his sonnets to convey the themes of love and perseverance. With these findings, it is concluded that William Shakespeare's sonnets are evidently written within the context of the universals and that they are worthy of wide readership not only because of him being a renowned English poet and playwright but most importantly of the realities his sonnets signify.

Keywords: imitation, mimesis, potent, realities

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206 The Process of Sanctification: A Bourdieusian Approach to the Declension of Power in New England Puritan Clergy

Authors: W. Scott Jackson

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This paper explains the declension of Puritan clerical power following the Great Migration up until when Massachusetts lost its charter in 1684. Historian Perry Miller argued that an overall declension in Puritan culture occurred during this period. However, that notion has been dispelled. There is a resurging field exploring declension in areas outside of Miller’s scope of Puritan culture. I determine that colonial New England existed as a functional theocracy by using Pierre Bourdieu’s theory of symbolic capital to explain clerical power through symbolic and religious misdirection and conversion. I explore civil and economic power struggles in colonial New England during the decades following the Great Migration to establish that Puritan culture did not largely decline. Instead, it was the Puritan clergy’s power that waned during this period.

Keywords: Bourdieu, Historical Sociology, Symbolic Capital, Puritan

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205 Assessing Measures and Caregiving Experiences of Thai Caregivers of Persons with Dementia

Authors: Piyaorn Wajanatinapart, Diane R. Lauver

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The number of persons with dementia (PWD) has increased. Informal caregivers are the major providing care. They can have perceived gains and burdens. Caregivers who reported high in perceived gains may report low in burdens and better health. Gaps of caregiving literature were: no report psychometrics in a few studies and unclear definitions of gains; most studies with no theory-guided and conducting in Western countries; not fully described relationships among caregiving variables: motivations, satisfaction with psychological needs, social support, gains, burdens, and physical and psycho-emotional health. Those gaps were filled by assessing psychometric properties of selected measures, providing clearly definitions of gains, using self-determination theory (SDT) to guide the study, and developing the study in Thailand. The study purposes were to evaluate six measures for internal consistency reliability, content validity, and construct validity. This study also examined relationships of caregiving variables: motivations (controlled and autonomous motivations), satisfaction with psychological needs (autonomy, competency, and relatedness), perceived social support, perceived gains, perceived burdens, and physical and psycho-emotional health. This study was a cross-sectional and correlational descriptive design with two convenience samples. Sample 1 was five Thai experts to assess content validity of measures. Sample 2 was 146 Thai caregivers of PWD to assess construct validity, reliability, and relationships among caregiving variables. Experts rated questionnaires and sent them back via e-mail. Caregivers answered questionnaires at clinics of four Thai hospitals. Data analysis was used descriptive statistics and bivariate and multivariate analyses using the composite indicator structural equation model to control measurement errors. For study results, most caregivers were female (82%), middle age (M =51.1, SD =11.9), and daughters (57%). They provided care for 15 hours/day with 4.6 years. The content validity indices of items and scales were .80 or higher for clarity and relevance. Experts suggested item revisions. Cronbach’s alphas were .63 to .93 of ten subscales of four measures and .26 to .57 of three subscales. The gain scale was acceptable for construct validity. With controlling covariates, controlled motivations, the satisfaction with three subscales of psychological needs, and perceived social support had positive relationships with physical and psycho-emotional health. Both satisfaction with autonomy subscale and perceived social support had negative relationship with perceived burdens. The satisfaction with three subscales of psychological needs had positive relationships among them. Physical and psycho-emotional health subscales had positive relationships with each other. Furthermore, perceived burdens had negative relationships with physical and psycho-emotional health. This study was the first use SDT to describe relationships of caregiving variables in Thailand. Caregivers’ characteristics were consistent with literature. Four measures were valid and reliable except two measures. Breadth knowledge about relationships was provided. Interpretation of study results was cautious because of using same sample to evaluate psychometric properties of measures and relationships of caregiving variables. Researchers could use four measures for further caregiving studies. Using a theory would help describe concepts, propositions, and measures used. Researchers may examine the satisfaction with psychological needs as mediators. Future studies to collect data with caregivers in communities are needed.

Keywords: caregivers, caregiving, dementia, measures

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204 Just Child Protection Practice for Immigrant and Racialized Families in Multicultural Western Settings: Considerations for Context and Culture

Authors: Sarah Maiter

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Heightened globalization, migration, displacement of citizens, and refugee needs is putting increasing demand for approaches to social services for diverse populations that responds to families to ensure the safety and protection of vulnerable members while providing supports and services. Along with this social works re-focus on socially just approaches to practice increasingly asks social workers to consider the challenging circumstances of families when providing services rather than a focus on individual shortcomings alone. Child protection workers then struggle to ensure safety of children while assessing the needs of families. This assessment can prove to be difficult when providing services to immigrant, refugee, and racially diverse families as understanding of and familiarity with these families is often limited. Furthermore, child protection intervention in western countries is state mandated having legal authority when intervening in the lives of families where child protection concerns have been identified. Within this context, racialized immigrant and refugee families are at risk of misunderstandings that can result in interventions that are overly intrusive, unhelpful, and harsh. Research shows disproportionality and overrepresentation of racial and ethnic minorities, and immigrant families in the child protection system. Reasons noted include: a) possibilities of racial bias in reporting and substantiating abuse, b) struggles on the part of workers when working with families from diverse ethno-racial backgrounds and who are immigrants and may have limited proficiency in the national language of the country, c) interventions during crisis and differential ongoing services for these families, d) diverse contexts of these families that poses additional challenges for families and children, and e) possible differential definitions of child maltreatment. While cultural and ethnic diversity in child rearing approaches have been cited as contributors to child protection concerns, this approach should be viewed cautiously as it can result in stereotyping and generalizing that then results in inappropriate assessment and intervention. However, poverty and the lack of social supports, both well-known contributors to child protection concerns, also impact these families disproportionately. Child protection systems, therefore, need to continue to examine policy and practice approaches with these families that ensures safety of children while balancing the needs of families. This presentation provides data from several research studies that examined definitions of child maltreatment among a sample of racialized immigrant families, experiences of a sample of immigrant families with the child protection system, concerns of a sample of child protection workers in the provision of services to these families, and struggles of families in the transitions to their new country. These studies, along with others provide insights into areas of consideration for practice that can contribute to safety for children while ensuring just and equitable responses that have greater potential for keeping families together rather than premature apprehension and removal of children to state care.

Keywords: child protection, child welfare services, immigrant families, racial and ethnic diversity

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203 Constructing Cultural Identity and Belonging: Defining Latvia's Diaspora in the Diaspora Law

Authors: Mara Simons

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There are many ways to define what 'diaspora' is in a global world as the term has become more and more fluid in the way it is understood and implemented. The main focus of the research has been on the definition of diaspora – arguments against and for the wider and inclusive definition versus the narrower and excluding one. Who can belong and who are supposed to be left out, who is 'ours' and who is 'other' – those struggles have been observed and researched in the content analysis of Latvia’s mass media, audio recordings from the Foreign Affairs Commission of the parliament of Latvia and official letters from the Ministries, deputies and NGO’s. Latvia’s case is interesting from the point of view of cultural studies as it has been a real struggle to define the term 'diaspora' and it's content in Latvia’s Diaspora law. Those in favour of a narrow definition warned of political risks for Latvia (such as voting demographics). The side arguing for a wide definition argued that anyone with a felt ‘connection’ should be eligible. This identity-based debate is still on-going in spite of the inclusive definition of diaspora being integrated into the law.

Keywords: belonging, cultural studies, diaspora, Latvia

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202 Projected Impact of Population Aging on Noncommunicable Disease Burden and Costs in the Kingdom of Saudi Arabia, 2020–2030

Authors: David C. Boettiger, Tracy Kuo Lin, Maram Almansour, Mariam M. Hamza, Reem Alsukait, Christopher H. Herbst, Nada Altheyab, Ayman Afghani, Faisal Kattan

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Background The number of people aged greater than 65 years per 100 people aged 20–64 years is expected to almost double in The Kingdom of Saudi Arabia (KSA) between 2020 and 2030. We therefore aimed to quantify the growing non-communicable disease (NCD) burden in KSA between 2020 and 2030, and the impact this will have on the national health budget. Methods Ten priority NCDs were selected: ischemic heart disease, stroke, type 2 diabetes, chronic obstructive pulmonary disease, chronic kidney disease, dementia, depression, osteoarthritis, colorectal cancer, and breast cancer. Age- and sex-specific prevalence was projected for each priority NCD between 2020 and 2030. Treatment coverage rates were applied to the projected prevalence estimates to calculate the number of patients incurring treatment costs for each condition. For each priority NCD, the average cost-of-illness was estimated based on published literature. The impact of changes to our base-case model in terms of assumed disease prevalence, treatment coverage, and costs of care, coming into effect from 2023 onwards, were explored. Results The prevalence estimates for colorectal cancer and stroke were estimated to almost double between 2020 and 2030 (97% and 88% increase, respectively). The only priority NCD prevalence projected to increase by less than 60% between 2020 and 2030 was for depression (22% increase). It is estimated that the total cost of managing priority NCDs in KSA will increase from USD 19.8 billion in 2020 to USD 32.4 billion in 2030 (an increase of USD 12.6 billion or 63%). The largest USD value increases were projected for osteoarthritis (USD 4.3 billion), diabetes (USD 2.4 billion), and dementia (USD 1.9 billion). In scenario analyses, our 2030 projection for the total cost of managing priority NCDs varied between USD 29.2 billion - USD 35.7 billion. Conclusions Managing the growing NCD burden in KSA’s aging population will require substantial healthcare spending increases over the coming years.

Keywords: aging, non communicable disease, costs, Saudi Arabia

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