A presentation at the IAGG conference in 2013 Seoul about the role of geographic information science in developing our understanding of global disease and dementia patterns.
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Globalising the study and analysis of Alzheimer’s disease
1. Globalising the Study and Analysis of Alzheimer’s Disease:
A Digital Earth Model
Authors
Hamish Robertson*, Doctoral Student, AIHI, University of NSW, AUSTRALIA
Nick Nicholas, Managing Director, The Demographer’s Workshop, Sydney
Joanne Travaglia, PhD, Faculty of Medicine, UNSW
Associate Professor Andrew Georgiou, AIHI, UNSW
Associate Professor Julie Johnson, AIHI, UNSW
2. Contents
• Introduction
• Dementia and AD prevalence under
population ageing and health transition
• Environmental change and urban growth
• Spatial technology, methods and visualisation
• Model to date
• Potential applications
• Conclusion
• Future directions
3. Introduction
• Taking a spatial approach to population ageing, disease
expression and potential systemic responses
• Developing and extending our knowledge and options
by modelling
• Using spatial simulation and visualisation as tools for
engagement and potential interventions (clinical,
research, policy and practice)
• Improving access to developmental concepts and
methods for a global community of knowledge on
ageing
• Supporting older people, advocates and service
providers
5. Significant Data Limitations – Still!
Ferri et al, (2005) “Global prevalence of dementia: a Delphi consensus study”, The Lancet
6. Issues with Modelling Prevalence
• The dementias in general and AD in particular
• Differential rates including sub-types vary by
location
• Quality and currency of population data
• Coverage in low resource and/or conflict settings
• Global population and prevalence estimations
• Dynamic variables such as rates by sub-type,
diagnosis, educational levels, economic capacity,
training, workforce, safety in the field etc
• Population-level knowledge versus clinical studies
versus informed estimates
7. ADI Global Consensus Rates
Source: Alzheimer ’s Disease International Fact Sheet 2008
13. Current Limitations
• Changes in administrative boundaries a common occurrence
• Changes in political boundaries less common but still happen e.g.
South Sudan
• Changes in names/naming systems/language use and
transliteration into English
• Some issues with the database i.e. online system has some data
gaps in oldest age cohorts in some countries
• Prevalence estimate is still somewhat coarse for a billion plus
people and population growing
• Not age or sex-standardised in this version (but this is feasible
and can be upgraded)
• 2011 version of the database (annual release)
• Remaining problem of limited clinical and population-level
research data at this time
14. Conclusion
• Population ageing is multi-scalar: from the global down
to the very local and so too is the epidemiology of
ageing
• Spatial science offers a potential answer to a variety of
issues including systemic complexity, multiple data
sources and limited data availability
• Neurodegeneration, dementia and sub-type patterns
are likely to be dynamic across geography and over time
(e.g. MCI data, educational levels etc)
• Health concerns are increasingly embedded in highly
dynamic natural and human environmental interactions
e.g. climate change, urbanisation, migration, food
production etc!
15. Future Directions
• Complete data, error checking and scale issues
• Finer grained modelling and visualisation e.g.
below provincial administrative level (Admin 1)
• 3 dimensional modelling including urban area
modelling for dynamic cities e.g. Lagos, Accra
• Spatial interpolation to produce topographies of
health conditions such as dementia/AD
• Spatial data mining to identify correlations
between significant or emerging variables
• Scenario modelling to test potential outcomes of
different approaches