4th Adi Non-Latin Caribbean Regional Conference On Alzheimer’s and Other Dementias

Feature Address By His Excellency Anthony Thomas Aquinas Carmona ORTT, SC President Of The Republic Of Trinidad And Tobago
At The 4th Adi Non-Latin Caribbean Regional Conference
On Alzheimer’s and Other Dementias
At The Radisson Hotel, Trinidad – June 8, 2017

A warm, heartfelt welcome to everyone gathered at the 4th Alzheimer’s disease International (ADI) Non-Latin Caribbean Regional Conference on Alzheimer’s and other Dementias.  It is a startling piece of data, that by the year 2050, approximately one million people in the Caribbean Region will be affected by Alzheimer’s disease and other Dementias. The motif of the Conference, “Dementia in the Caribbean: No time to lose” bares testimony to the crisis that awaits us. We, together as a region, must face this challenge as one Caribbean people and it is another component that supports the ever-present philosophy of a genuine Caribbean Integration Movement, that creates and finds solutions for the Region, of the Region and by the Region. The solutions that we seek, lie in a sound, strategic and united approach by State Agencies and Institutions, Non-Governmental Organizations (NGOs), a progressive and proactive political will and civil society through information, education, research and compassion.

This Conference serves to invoke an urgent, much needed regional mandate, to stakeholders and movers and shakers in governance, to confront and alleviate the personal and social challenges associated with Dementia and Alzheimer’s disease in the Region. It further provides for a laudable objective, that is, the launch of a regional organization, The Alzheimer’s Associations of the Caribbean (AAC). This Association ultimately will provide for the advocacy that will raise much needed awareness, inform, educate, devise action plans, lobby and support persons with Alzheimer’s disease and Dementia. The hope is, that such will trigger and enhance healthcare systems in the Caribbean region that will incorporate not only the customary primary, emergency and preventive care but specifically an elderly care involving Hospice Care, new drugs and experimental drugs.

There is a growing global recognition of the need for universal healthcare and the imperative, that it must be grounded in inclusivity, accessibility and quality healthcare. Director-General of the World Health Organization (WHO), Dr Tedros Adhanom Ghebreyesus is a firm believer in the 2030 Global Agenda, with its 17 Sustainable Development Goals (SDGs) referencing access to quality health services for all that has at its core a simple but profound message, no one will be left behind. He stated, “The term “leave no-one behind” means just that. It sounds easy in theory but practice is more challenging. The most important requirement is information: average achievements for individual health-related variables, disguise significant inequities that can only be revealed if the information is dis-aggregated. Statistics can tell us the numbers of people who do not receive specific services, but further investigation is needed to assess who these people are and why they are excluded.” This bares relevance to the lack of appropriate data on Alzheimer’s and Dementia in the Caribbean Region. Alzheimer’s and Dementia and the lack of hospice care have not been generally integrated enough as part of a sustainable regional healthcare system. The cruel fact in our Caribbean society is that we have stopped taking care of the old and the elderly as we once did.

Alzheimer’s disease is an emotional minefield for the unsuspecting and the unaware. I have seen the hurt, pain and anguish of the children of patients of Dementia and Alzheimer’s disease, when a mother or father cannot remember their child. It is heart-breaking, when persons you have known all your life, your first teachers, nurturers and family members, in the throes of Dementia, are unable to recognize, bond and even communicate with you. We therefore need a vibrant, unflinching advocacy in the Caribbean Region as it relates to Dementia and Alzheimer’s disease.

Advocacy can assume many forms and initiatives through Conferences, NGOs, workshops, training modules and importantly sometimes through the power of one. That power of one, is demonstrated by the commendable advocacy work of Riana Patterson, from the Commonwealth of Dominica, who at the age of 18, founded the Dominica Dementia Foundation, launched on the 2nd of September, 2016. She and her Foundation represent a regional youth template for immediate action, her grandfather having died from Dementia. Dementia for her became a health priority and through the power of her youthful vision, her foundation was born with its salutary aims to accomplish the following:

  • Raise awareness of Dementia
  • Raise funds for families affected
  • Provide emotional support to caregivers, those who suffer from Dementia and their families
  • Facilitate research towards Dementia.

She recognised that persons with Dementia, are vulnerable, easy targets for criminals, helpless at performing their personal daily tasks, are mistreated intentionally and unintentionally by even family members and as she stated and I quote, “Most of this is due to a lack of understanding, training and knowledge about persons who have Dementia.” This type of proactive advocacy model is needed throughout the Caribbean Region so that all can be sensitized to become agents of social change and reform.

Alzheimer’s disease is not a pensioner’s affliction. It is not exclusive to or the sole domain of the very old and elderly. It is now making significant inroads and impacting among persons in their early 50s. Apart from possible fall out, due to genetics and even lifestyles, environmental factors may well be at play in the un-seeming progression of Alzheimer’s disease among our citizens of the Region. We simply cannot give up in ensuring and protecting a sustainable quality of life for those patients suffering from Alzheimer’s and Dementia.

A critical step in treatment protocols and care is early detection. In the Caribbean Region, early detection is minimal primarily because of a reactive healthcare philosophy. It must become a mandatory part of routine medical assessment to test for Alzheimer’s disease and other forms of Dementia in those vulnerable demographics. This can be done by our primary healthcare doctors in the Region, especially at Health Centres engaging in the following:

  • Enquiring from everyone over 50 and others at risk about your overall health, changes in your behavior and personality
  • Conducting tests of one’s memory, problem solving capabilities, attention span and use of language
  • Carrying out standard medical tests (Blood and urine) and performing brain scans where possible like Magnetic Resonance Imaging (MRI), computed tomography.

Optimism however, must still face reality and living with Alzheimer’s disease for everyone affected is an arduous road that engages a didactic from hope to treatment and a potential cure. Do not give up on life or living because there is no cure, as yet. Hope lives eternal and great things are happening in the world of science. Scientist are now able to clear the stick plaques from the brain which triggers Dementia and put a stop to mental diminution. Irreversible memory loss and cognitive decline have possibly found a foe in the drug, Adu-camu-mab. It has been described as, “The best news for Dementia in 25 years and a potential game changer for persons with Alzheimer’s.”

I am informed that Aducamumab is a treatment made up of antibodies and tiny wide shaped proteins that latch on to dangerous substances in the body acting like flags showing the immune system what to clear away. Dr David Reynolds, Chief Scientific officer at Alzheimer’s Research, UK in the light of clinical studies being conducted, evaluating the safety and efficacy of the drug has stated affirmatively and I quote, “The Findings suggest that Aducamumab may slow memory and thinking declines in people with early Alzheimer’s. It paints a positive picture for ongoing trials with the drugs.” It may well be an option available through the Ministers of Health in the Caribbean Region to collaborate with CARPHA and those research scientist in the United Kingdom to conduct similar clinical trials in the region.

Only last week Her Excellency Reema Carmona stated in Barbados at a Sub-Regional Consultation for the English and Dutch Speaking Caribbean on the GLOBAL STRATEGY FOR WOMEN’S, CHILDREN’S AND ADOLESCENTS’ HEALTH, 2016-2030 and I wish to quote her, “Having spoken to several stakeholders, the non-approval of new drugs, is further burdened by an environment that makes no comprehensive, informed provision for the execution of clinical trials involving new and experimental drugs.”

I wish to commend the Alzheimer’s Association of Trinidad and Tobago (AzATT) for their efforts thus far in highlighting the trials, tribulations and afflictions encountered by persons who suffer from Alzheimer’s disease and Dementia, their family members and caretakers. It is my fervent hope that, limited information, advice, research, policy, advocacy and support that obtain now, will soon be a thing of the past as you visionaries embark on this new project to bring about transformational change in the lives of the middle aged and the elderly. There is also a historical heritage imperative to this battle against Alzheimer’s disease and Dementia. We must seek to preserve and conserve, as far as possible, the institutional memory of the aged and elderly and in this case we need to do so medically.

My wish for this Conference over the three days is that it is filled with progressive and game changing dialogue. In the spirit of inclusive, accessible and quality healthcare for all, the esteemed pleasure is mine to declare this, the 4th Alzheimer’s Disease International (ADI) Non-Latin Caribbean Regional Conference on Alzheimer’s and other Dementias officially open, wishing you all God’s blessings and every success.

I thank you.