By Oliver Shannon & Connor D Richardson
Alzheimer’s disease – the most common form of dementia – has a huge economic and social burden, impacting the lives of millions of individuals and their families. Although there is currently no cure for this condition, ongoing research is continually improving our understanding of this condition and identifying ways to help mitigate risk. With World Alzheimer’s Day just around the corner (21st of September), we took the opportunity to interview key researchers in this area within the Newcastle University Population Health Sciences Institute. With insight from early career and more experienced researchers, these interviews provide a great introduction to Alzheimer’s Disease research within our Institute and guide what the future may hold and how people can get involved.
Prof. Dame Louise Robinson – Professor of Primary Care and Ageing; Regius Professor of Ageing
What does World Alzheimer’s day mean to you?
A global opportunity to continue to raise both public and professional awareness about dementia
What is your research area?
My research focuses on dementia care with the key aim of trying to improve the quality of care, and quality of life, for people living with dementia and their families. Recent projects address this area nationally, including the PRIDEM programme (https://research.ncl.ac.uk/pridem/) and international working with collaborators in Lower Middle-Income Countries through an NIHR Global Health Research Group (https://research.ncl.ac.uk/global_health_depec/). This work has been presented to the World Dementia Council and will be included as a case study in the WHO/ADI World Alzheimer Report on Post diagnostic care, due for release in autumn 2022.
How did you get into this sphere?
As a young GP many decades ago, I was distressed by the lack of support available to my patients diagnosed with dementia; compared to people with cancer or other long-term illnesses like diabetes, there was very little available.
How has this area changed since you first became involved?
Unfortunately, not a great deal despite a national Dementia strategy in 2009. Our PRIDEM programme has shown that this is still the case in England, with considerable inequalities in dementia care services which are focused on the first year after diagnosis and are often fragmented and fragile due to a lack of long-term funding commitment.
What are the key challenges?
Ensuring implementation and scale-up of key research findings into practice to make a real difference in people’s lives.
Dr. Andrea Fairley – Lecturer in Nutrition & Dietetics
What does World Alzheimer’s day mean to you?
As a researcher working in dementia prevention, World Alzheimer’s Day is an excellent opportunity to raise awareness and highlight what can be done to reduce our dementia risk. As this condition was historically seen as an inevitable part of the ageing process, it is important that the message of dementia prevention reaches the wider public and that we spread the message of how we can protect our brain health.
What is your research area?
I am a registered dietitian and lecturer in human nutrition and dietetics. I am actively involved in research, being specifically interested in the role of diet in cognitive decline and dementia prevention. I am interested in the design, development and testing of diet and lifestyle interventions to promote behaviour change among at-risk populations, particularly those at greater risk of cognitive decline.
How did you get into this sphere?
I became interested in public health nutrition through my work as a dietitian. While studying for a PhD at Queen’s University Belfast, I became fascinated by the field of diet and dementia prevention.
How has this area changed since you first became involved?
When I started my PhD and began researching this area, there had been an array of observational evidence conducted within the field of diet and dementia prevention and a few landmark trials. At that time (2015), larger multidomain intervention studies focusing on modifiable risk factors such as diet, lifestyle and cognitive strategies were in the pipeline. Since then, we have seen the results of these studies, notably the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) trial. This multidomain intervention (diet, exercise, cognitive training, vascular risk monitoring) is applied in older people (60-77 years) at higher risk for dementia and has produced significant cognitive benefits after 2 years. This landmark study has inspired further research in this field to explore how these interventions are tailored among at-risk interventions – an area I am very much interested in!
What are the key challenges?
The research literature has shown significant associations between key nutrients and dietary patterns and reduced risk of cognitive decline and AD. Certainly, individual foods, or nutritional components such as Omega 3 fatty acids, or B vitamins, may be associated with reducing dementia risk. They may have a specific role to play in counteracting biological processes in the body that can contribute to cognitive decline. But as consumers, we don’t eat just one type of food. So, it is important to look at the diet as a whole – the nutrients in different foods can interact, and this combination may bring additional health benefits. There have been some intervention studies to test the effect of dietary patterns in dementia prevention, such as the Mediterranean diet, and these show promising results. However, we need to do more intervention research! Researchers are working to better understand how specific dietary components can influence cognition, how these foods affect brain health when consumed together and how to tailor dietary advice to specific countries, cultures and settings. When we think about changing our diets and lifestyles, we know that “one size does not necessarily fit all”. It is important to understand the food cultures and available resources of different countries to provide tailored, needs-specific dietary advice and support.
If you could give yourself one piece of advice as an ECR, what would that be?
Network, network, network! It can be so daunting as an ECR to put yourself out there but is so important to build connections and network, as you never know where it might lead. Having a LinkedIn or Twitter profile can be useful to get yourself noticed!
What is the future of dementia research?
I think the future is bright for dementia prevention research. This research area is getting a lot of attention, both through research funding and public engagement. Recently, we have seen huge advancements in dementia prevention by identifying modifiable risk factors that can be targeted across the life course. I am excited to see what future research in this area will bring!
How can people get involved?
Read more about dementia prevention and what you can do to promote brain health. Charities, such as The Alzheimer’s Society, have some useful resources. You can also get involved in dementia-related research – Join Dementia Research is a service providing new opportunities for people to play their part in beating dementia, connecting researchers with people who want to participate in studies. It is free to sign up and you will be directly matched to a study that meets your criteria.
Dr Connor Richardson – Post-Doctoral Research Associate
What is your research area?
My main area of research is in the Epidemiology of dementia and cognitive impairment. I work on large population-based cohorts to investigate the risks of dementia in the population over time with the Cognitive Function and Ageing Studies (CFAS). My most recent work involves using newer machine learning techniques to investigate dementia neuropathology.
How did you get into this sphere?
I was interested in dementia from the final year of my undergraduate biomedical sciences degree, my favourite modules being Biology of Ageing and Neuroscience; however, I did not enjoy lab-based science.
During my MSc in Public Health Research, I knew I wanted my thesis to be on dementia and quantitative methods. I was supervised by Katie Brittan and Blossom Stephan, looking at cognitive reserve and dementia. I enjoyed the project, so went on to work with Bloss, Louise Robinson and Fiona Matthews on my PhD looking at Mild Cognitive Impairment (MCI). Since then, I have been the CFAS statistician as a post-doc with Fiona Matthews.
How has this area changed since you first became involved?
Although I have worked in the field for a relatively short time I have noticed several changes. As I was beginning my PhD, the DSM version V was being published, which completely re-classified the diagnosis of dementia and MCI into Major and Minor Neurocognitive disorder, which remains controversial.
Similarly, I just attended the Alzheimer’s Association, where a debate was being held to redefine Alzheimer’s diseases based on biomarkers without clinical symptoms.
Closer to my own work, there is currently a huge expansion of data science and machine learning moving into the space of traditional epidemiology and statistical modelling.
Overall I think dementia research is quite an exciting area of research as things can change pretty quickly, and changes can often be pretty controversial.
What are the key challenges?
It’s a relatively small field in comparison to other medical research. The key challenges for me are probably similar to most researchers at my level, balancing career development and publishing and gaining experience with day-to-day work.
I have found that when at events like conferences, the dementia research network is extremely friendly!
If you could give yourself one piece of advice as an ECR, what would that be?
I am guilty of putting too much pressure on myself to do too many things at once. I am often reminded to take a step back, take a breath and think about one thing at a time.
I’ve recently realised the importance of setting work aside for a short time and reflecting on where I want to be and how to get there.
What is the future of dementia research?
I think new technology is moving the field very quickly; for example, there is huge momentum behind using imaging from MRI and PET scanning combined with AI/ machine learning to diagnose dementia earlier and earlier, if this is necessarily a good thing seems to be a hot debate at the moment. Unfortunately, this seems to limit the attention being paid to modifiable population risk.
There is also more emphasis on researching dementia among low and middle-income countries and being much more inclusive of minority and underrepresented groups in dementia research.
How can people get involved?
I think the Alzheimer’s society does a huge amount of engaging people in dementia research; they have massive amounts of information and training to become dementia friends so people can learn what living with dementia means.
