14 Apr 2016

Preventing dementia

From Our Changing World, 9:20 pm on 14 April 2016

Dementia researchers are recruiting people with mild cognitive impairment for a longitudinal study that aims to identify why some people go on to develop Alzheimers’s Disease, and some don’t.

brain cells

brain cells Photo: Wikimedia Commons

Alzheimer’s is the most common form of dementia, which usually includes memory loss and other impairments that are serious enough to interfere with day-to-day life. By 2050, the incidence of dementia is expected to triple, and Brain Research New Zealand is setting up three clinics to study how dementia progresses from the earliest changes in a person’s ability to remember.

Associate professor Lynette Tippett, national director of the Dementia Prevention Research Clinics and co-director of the Auckland clinic.

Associate professor Lynette Tippett, national director of the Dementia Prevention Research Clinics and co-director of the Auckland clinic. Photo: Supplied

The first Dementia Prevention Research Clinic launched in Auckland last week, and two more are planned for Christchurch and Dunedin later in the year. Lynette Tippett, a neuro-psychologist at the University of Auckland and the national director of the clinics, says everybody with dementia first goes through a period of experiencing mild cognitive impairment.

“But that doesn’t mean that everybody with mild cognitive impairment develops dementia. A small percentage will recover and their functioning returns to what would be appropriate for their age group. A reasonably large percentage don’t get worse, they don’t progress [to dementia] but we can’t tell yet who’s going to progress or what it is about the people who progress that distinguishes them from those who don’t.”

She says mild cognitive impairment is not the same as forgetfulness. “Mild cognitive impairment describes someone who has a significant impairment, most commonly in memory abilities, the formation of new memories, remembering what happened in the morning or yesterday. It’s something they’ll be aware off and that can be detected in tests, and it’s different from the normal changes in memory that occur with healthy ageing.”

What distinguishes it from dementia is that people don’t have problems in everyday life. “They are still able to compensate. They may rely on additional aids, but even though there is significant change in cognition, everyday life functionality is still normal.”

The team: Lynette Tippett, psychiatrists Gary Cheung and Erin Cawston, tissue bank research fellow 
Kiri Brickell, neurologist Christina Ilse, neuropsychologist Phil Wood, and clinical research nurse Karen Smith.

The team: national director of the clinic network, Lynette Tippett; psychiatrist Gary Cheung; Erin Cawston, tissue bank research fellow; Kiri Brickell, neurologist Christina Ilse, neuropsychologist; Phil Wood, geriatrician (and co-director of the Auckland clinic with Lynette Tippett), and clinical research nurse Karen Smith. Photo: Supplied

Study participants will receive an in-depth assessment of clinical and lifestyle factors and will be asked to provide blood samples for analysis. “And we’ll listen to them. It is a partnership and we definitely have a lot to learn from the experiences of people with this condition and from what their families have to offer as well.”

As the longitudinal study develops, participants will also have the opportunity to take part other studies and trials of interventions and treatments.

Once diagnosed, dementia is incurable. There are, however, several modifiable factors that determine the risk of developing the condition. Age is the strongest determinant, but the same risk factors that exist for heart disease are also important for dementia. Other factors include the level of cognitive or mental stimulation, social connectedness, stress and sensory function.

“The one thing we are learning is that there are multiple risk factors that elevate a person’s risk, and from individual to individual there will be different combinations of those risk factors. Perhaps one of the things that held back our findings was this search for the one thing that will tell us what’s happened to someone who gets Alzheimer’s, whereas there may be many routes of starting off the chain of events that lead to that pathology.”

The team involves clinicians and researchers, and Lynette Tippett says she’s hopeful that they will uncover processes and identify biomarker signatures that could help delay or even prevent the onset of dementia. However, she says she is also realistic. “Billions of dollars have been spent on the search for a cure and progress has been slow. We will be doing our utmost to identify factors that might prevent or reverse the cycle of changes that is actually occurring in the brains of people with these diseases. But we’re not going to rely just on that science, were also going to rely on trialing interventions that combine modifiable risk factors to see if we can slow the rate of progression in people who are already showing the early signs of change.”

 

 

 

 

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