Dementia Dispatch Issue 15, May 2017

From the Director

Janice Besch

In the three short months since my commencement in late February, I have learned a great deal about the Institute’s strategic potential to contribute to improved outcomes for people with dementia, their carers and families, through excellence in, and impact through, research. Having a personal story of my mother singly raising her three children while dealing with crippling rheumatism and osteoarthritis, I know the crooked paths our health and care system can take us down, as well as the hope for a cure and the disappointment that comes from many years without one.

My mother was in a wheelchair for the last thirty years or her life and lived in a nursing facility for 25 of those years. She remained a strong leader of our small family unit and a loving mother and grandmother throughout, and my discussions with people in this new role have led me to understand how fortunate we were. Dementia can be a cruel disease for some, presenting people with dementia with new and unplanned for challenges, and leaving their families and carers often at a loss at to what is the right thing to do. So I feel exceedingly fortunate that I am now in a position, with others, to contribute new understandings and new hope for people whose journey is undoubtedly more difficult than that of my own family.

The people I have met in this very committed community have been straight forward in stating their views. We need better outcomes, and we need them as a matter of urgency. There is a sense of realism around the possibility for a cure. It will take time. There is also a strong commitment to making changes now that will improve the lives of people with dementia, their families and carers beyond a cure.

The Institute was formed to oversight the Government’s investment of $200 million to boost dementia research over 5 years, and it is doing this in a considered way, seeking to invest in areas that are of greatest need and that therefore will make the greatest difference. We are mid-way on the 5 year journey, and it is my privilege to lead that period of the Institute’s current term where we ensure the funds that have been invested are delivering. Over this period, we will be checking in with our funded researchers and reporting on progress so that our stakeholders know of the excellent work underway.  We will continue to advance key initiatives that address gaps in research – from prevention to diagnosis, the search for a cure, living with dementia, and care. And we will be looking to build critical mass through developing a research community and capability that can take the current research effort through into the future.

Right now, we have two grants schemes under deliberation and one Call for Applications open.  The Boosting Dementia Research Leadership Fellowships will support mid-career researcher to transition to leadership positions in dementia research. The Implementation of Dementia Research into Clinical Practice and Care Grants seek to achieve the translation of research evidence into care environments to improve healthcare outcomes across various settings, from care in the home and general practice through to aged care facilities.  This scheme has been developed with the involvement of consumers and funding decisions will be made with representation from, and the advice of, consumer representatives. We hope to be announcing the results from both of these Calls by the end of June.  Our Targeted Call for Research into Dementia in Indigenous Australians is now open and further details are provided below. Together these three Schemes represent an investment of up to $66 million in dementia research – an investment that will undoubtedly make a huge difference over the coming years.

I look forward to working with you. It has been wonderful meeting so many of our stakeholders at National Lecture Tour events around the country and at other meetings and events. I welcome your ideas and I hope to see you at the Australian Dementia Forum in Melbourne in October.

Janice Besch

Save the Date: NNIDR Australian Dementia Forum 2017

15-18 October 2017
Melbourne Convention and Exhibition Centre
1 Convention Centre Pl, South Wharf VIC 3006

Australia is part of the region with the fastest growing incidence of Alzheimer’s Disease and other dementias. Over the last 10 years, the number of people globally with dementia has increased by 10 million. Right now, an Australian is diagnosed with dementia every six minutes. Given our own health challenges, our position in the world, and our capacity to lead research and health services innovation in our region, the need for us to provide quality research findings that deliver evidence-based clinical practice, from prevention to care and cure, to improve population outcomes is indisputable.

The 2017 Australian Dementia Forum will provide fertile ground for our researchers who are working to address the challenge of Alzheimer’s and other dementias to share information and explore collaborations relevant to the NNIDR Strategic Roadmap for Dementia Research. We will share knowledge and information about the activities that have been funded to date and begin future planning.

Forum speakers will include international keynote presenters, researchers that have received Boosting Dementia Research Initiative funding, key policy makers, and community and research leaders. The National Institute’s 75 ARC NHMRC Dementia Research Development Fellows are reaching the mid-point of their four year research program. Large collaborative research projects funded by the Institute are also well underway. The Forum is well placed to highlight and interrogate achievements to date. It is expected that new opportunities for partnership and potential new program directions will arise from discussion of this work.

Over the coming weeks, the Forum Planning Committee will develop a program that will encourage this dialogue across research teams; and that will respond to the major dementia research questions being explored. One or more round table strategy review and development sessions are also likely, and a call is being made to our Dementia Research Fellows for ideas for additional development sessions.

The Forum has been expanded to three and a half days, and will immediately precede Alzheimer’s Australia’s National Conference. The final day of the Forum will provide researchers, carers and service providers with a unique opportunity to mutually explore research translation opportunities. NNIDR, as a partnership between NHMRC and Alzheimer’s Australia, is uniquely positioned to provide this translation forum and platform.

A targeted call for papers will be made this month.  If you would like to be considered for the Program or would like to be involved as a sponsor or exhibitor, register your interest now: nnidr.admin@alzheimers.org.au

Dementia in Indigenous Australians targeted call now open

The Institute’s Targeted Call for Research (TCR) focussing on dementia in Aboriginal and Torres Strait Islander communities (referred to here as ‘Indigenous Australians’) is now open.

Dementia is an emerging health priority in Australian Aboriginal communities, but substantial gaps remain in our understanding of this issue, particularly for the large urban section of the population. In remote Aboriginal communities, high prevalence rates of dementia at relatively young ages have been reported. [i]

A relative lack of research directly focussed on Indigenous Australians living with dementia (and their families and carers), coupled with a lack of culturally appropriate diagnostic tools, has resulted in the poor recognition of dementia within Indigenous communities and among health care workers and service providers. This has had major implications for the provision of timely and culturally appropriate health services.

The Call for research projects addresses this important need and has been developed NNIDR with input from expert advisers from around Australia and from the NHMRC Principal Committee Indigenous Caucus. The Call expressly recognises the need to identify and fund research teams that have knowledge and experience of the challenges facing Indigenous communities, as well as strong working relationships with those communities they seek to involve in research (or the proven capacity to establish these critical research relationships quickly and well).

For more information and to apply, please visit:
https://www.nhmrc.gov.au/grants-funding/apply-funding/targeted-and-urgent-calls-research

Award for PhD Students: Research in Alzheimer’s/Dementia/Parkinson’s Disease

Neuroscience Research Australia is pleased to invite applications for the Helen & Emanuel Poteris Award for PhD students undertaking research in Alzheimer’s/Dementia/Parkinson’s Disease. This award is generously supported by the Combos family in honour of Helen and Emanuel Poteris.

The successful applicant of this award will use the grant to further their research program or career development, for example by supporting costs of research, conference attendance, or consumables.

Award background, criteria and application form can be found here:

https://lodestone.neura.edu.au/dl/The-Helen-and-Emanuel-Poteris-Award-Criteria-and-Application-2017.pdf
https://lodestone.neura.edu.au/dl/The-Helen-and-Emanuel-Poteris-Award-application-2017.doc

Applications should be submitted via email by 5pm, Wednesday 31 May 2017 to: Felicity Forsyth (f.forsyth@neura.edu.au).

NNIDR Fellows publish special issue – Journal of Molecular Neuroscience

Molecular Neuroscience

An excellent example of the work currently underway as a result of Australia’s Boosting Dementia Research Initiative can be found in the November 2016 issue of the Journal of Molecular Neuroscience[ii]. The issue is comprised of cutting-edge review articles written by individual Dementia Research Development Fellows and their colleagues. It provides a comprehensive peer-reviewed, state-of-the-art account of dementia and related neurodegenerative disorders ranging from clinical, brain imaging, molecular biological mechanisms, and potential therapeutic targets, and covers all major forms of dementia, including AD, vascular dementia, dementia with Lewy bodies, frontotemporal lobar degeneration, and Parkinson’s disease dementia.

Articles were chosen to discuss important proteins and other biological factors involved in dementia, including tau protein (Li et al. 2016), apolipoprotein E (ApoE ε4, Mahoney-Sanchez et al. 2016), BACE1 (Munro et al. 2016), presenilin (Greenough 2016), metals (McAllum and Finkelstein 2016), and gonadal hormone (Du and Hill 2016). In addition to neurons, the potential involvement of microglia in AD is discussed (Grubman et al. 2016). A second set of articles presented novel tools that can be used in dementia study, from clinically available magnetic resonance imaging (Yassi et al. 2016), the Cogstate Brief Battery (Lim et al. 2016), to a more under experimental development touchscreen platform for cognitive testing (Shepherd et al. 2016) and fluorescent nanoparticles to deliver drugs (Shimoni et al. 2016). Lastly, this issue also covers clinical findings relevant to dementia, including age-related prevalence of ApoE ε4 in AD (Heffernan et al. 2016), the potential to utilizing subjective cognitive decline for AD clinical trial (Buckley et al. 2016), and linkage between cognitive decline and alcohol abuse (Perry 2016).

Australia has a proud history of participation in dementia research (especially Alzheimer’s disease), with an Australian, Colin Masters, being one of the first to complete the sequence of beta-amyloid which is still the main therapeutic target for AD (Masters et al. 1985) and the first to clone the amyloid protein precursor gene (Kang et al. 1987). With the Boosting Dementia Research Initiative, we hope to maintain the leadership of Australia in dementia research.

We sincerely thank Dementia Research Development Fellows (Drs Erin McAllum, Mark Greenough, Simon James, Kathryn Munro, Amy Heffernan, Xin Du, Nawaf Yassi, Rachel Buckley, Yen Ying Lim, Emma Burrows, Christina Perry, Alexandra Grubman and Olga Shimoni) and their colleagues for their initiative in putting together this publication.

Living Well With Dementia: Clem Jones Centre for Ageing Dementia Research Public Dementia Forum

Clem Jones Centre for Ageing Dementia Research Public Dementia Forum

Congratulations are extended to QBI Director Professor Pankaj Sah and the Director of the Clem Jones Centre for Ageing Dementia Research (CJCADR), Professor Jürgen Götz, for their recent half-day public forum on the topic of dementia.

The forum covered living well with dementia (including a consumer perspective from John Quinn – pictured) and provided updates on the Clem Jones Centre’s research discoveries. The Clem Jones Centre for Ageing Dementia Research (CJCADR), housed within the Queensland Brain Institute at The University of Queensland, is one of Australia’s largest research centres dedicated to the prevention and treatment of dementia.  Jürgen is a world leader in conducting cutting-edge research in Alzheimer’s disease, is the inaugural Director of the Centre and is also a member of the NNIDR Expert Advisory Panel. CJCADR is driven by the insight that fundamental, basic research is required to provide a solution to the ageing crisis as diseases including Alzheimer's pose an increasing challenge to our society. The Centre currently has 10 laboratories of researchers. 

 

NNIDR 2017 Public Lecture Tour in review

Henry Brodaty

Thank you to everyone who attended the NNIDR Public Lecture Tour over March and April 2017 across eight Australian capital cities. The tour attracted over 1000 registrations and featured 2016 Ryman Prize winner Henry Brodaty (image left) who was also joined by Harry Johns (image right), President and CEO – USA Alzheimer’s Association in Sydney and Canberra.

Primarily targeted to address the information needs of people in the community who need to know more about the challenge of dementia for Australia, the tour provided a great interactive opportunity for the general community and consumers to attain the latest information on the scale of the problem in Australian and world terms and what governments and researchers across the world are doing to address it. 

Henry spoke to the hope for a cure, the lifestyle changes that can assist in slowing down progression of the disease, and he explained in lay terms why the journey towards a cure has been difficult.  He was delighted to answer questions from the audience in each location.  In Sydney, Canberra and Melbourne Harry Johns talked about how the United States Government came to legislate for the creation, implementation and ongoing monitoring of a national dementia strategy, providing important comparisons for Australia.

Sincere thanks are extended to Henry and Harry, to all of the people who told their personal stories as people living with dementia, and to Alzheimer’s Australia, the Wicking Trust and the Centre for Healthy Brain Ageing, University of New South Wales, for making this community outreach event possible. The talks by Professor Brodaty and Harry Johns are now available on the NNIDR website (www.nnidr.gov.au).

Fellow Profile

Dr Christina Perry, NHMRC-ARC Dementia Research Development Fellow, Florey Institute of Neuroscience

Dr Christina Perry

Dr Christina Perry is an NHMRC-ARC Dementia Research Development Fellow at the Florey Institute of Neuroscience. Christina obtained her PhD in 2012 from the University of New South Wales, after which she moved to Melbourne to work as a postdoctoral researcher in the Behavioural Neuroscience division at Florey Institute of Neuroscience and Mental Health. Her primary research interest is addiction, particularly in why relapse is such a pervasive problem for substance use disorder. Christina states that alcohol use disorders are prominent in Australia, and are associated with characteristic cognitive impairment and in some cases dementia. During her fellowship she will be investigating how chronic alcohol use interacts with the normal cognitive changes that occur with ageing and the link to dementia. 

To date Christina has used a highly translatable animal model of cognitive testing to systematically assay the cognitive domains affected or spared by chronic alcohol. The pattern of deficits that emerged clearly reflected that observed in human alcoholics.  She is now pursuing the neural mechanism behind these deficits, as well as investigating whether they can be recovered through voluntary exercise.

  • Perry CJ, Lawrence AJ (2017). Addiction, cognitive decline and therapy: seeking ways to escape a vicious cycle .Genes Brain Behav. 16(1): 205-218.
  • Perry CJ (2016). Cognitive decline and recovery in alcohol abuse. J Mol Neurosci. 60(3):383-389.
  • Perry CJ, Reed F, Zbukvic IC, Kim JH & Lawrence AJ (2016). The metabotropic glutamate 5 receptor is necessary for extinction of cocaine associated cues. Br J Pharmacol. 173(6): 1085-94

Christina hopes that the findings from her research will encourage clinicians to include interventions that boost cognitive performance (such as physical exercise) alongside behavioural therapy. We wish Christina all the best during her Fellowship.

Implementation Science Advice from the Global Alliance for Chronic Diseases

GACD

Implementation science studies commonly focus on the external validity of their findings, i.e. whether they can be generalised across different settings and individuals. This can be achieved by examining context and the various factors that impact the effectiveness of an intervention in a specific setting. Implementation research therefore requires a systems thinking approach. Context can account for a number of barriers and facilitators that determine the success of implementing a particular intervention. Implementation also commonly requires the study of behaviour change among individuals or organisations and therefore a deeper understanding of the social, economic, institutional or cultural factors that shape this behaviour. 

There are a number of resources available, a small selection has been provided by the Global Alliance for Chronic Diseases for guidance:

Share your story 

If you have a story to share on dementia, whether its research or personal experience, please contact nnidr.admin@alzheimers.org.au or phone 02 6217 9172. Your story may be published in the next newsletter, or used as vignettes in Institute-related communication materials, or created into a feature story and pitched to the media.