Dementia Dispatch Issue 17, August 2017

Director’s Report 

Congratulations to all the new grant recipients announced in July, we welcome all new grant holders to the Dementia Institute membership. The new research will soon be underway across all the Dementia Institute’s Strategic Roadmap Priorities, with the project grants focusing in particular on implementation of research evidence into clinical care and practice.
There have been a number of other exciting developments at the Dementia Institute as we build towards ADF2017, the Dementia Institute’s annual research forum.

Congratulations are also extended to Professor Kaarin Anstey and her international collaborators for the July launch of the International Research Network on Dementia Prevention (IRNDP) in London. The IRNDP is a multinational network bringing together researchers who are working to reduce the risk of dementia across the world, and the launch provided the opportunity to bring together researchers and representatives of major research and government agencies to discuss next steps. For further information visit their website.

On the international front, the Dementia Institute has provided the 2016 research data for the WHO Global Dementia Observatory’s Domain 3: Research & Innovation, and will be working with other Australian agencies and jurisdictions over the coming months to fill data gaps.  The Observatory gathers and reports on government funding body expenditure on dementia research and development, and provides a direct indication of progress towards addressing the priorities expressed in the WHO Global Action Plan against Dementia.

Our partnership with the European Framework’s Joint Program on Neurodegeneration continues to produce dividends. The results of this year’s Call will be announced shortly and a new Call is in development for 2018. JPND connects Australian teams with collaborators in at least three other collaborating countries to progress research programs, delivering the Dementia Institute’s Strategic objective of building internationally significant, and large scale dementia research programs.

As many of you will know, the Dementia Institute is currently gathering stories on early outcomes and anticipated impact from all grant recipients, and is looking to place our work in context of dementia research supported by other agencies, industry and philanthropy. Thank you in advance for your contributions in this respect. Information will be aggregated to produce a comprehensive account of work progressed under our Initiative, and this will provide an excellent basis for strategy discussions vital at this stage of our work program. We believe the reports on outcomes and potential impacts will be valuable not only in Canberra, but also to researchers looking to establish new collaborations and universities wishing to incorporate dementia research as a priority area of focus in their research portfolios. The initial data set will be available at ADF 2017, to be held in Melbourne 15-17 October. Information from other sources will enrich the capacity for strategic insight into the dementia effort over time.

We hope you enjoy our new format Newsletter and please provide suggestions for new content moving forward. 

The Dementia Discovery Fund

The Dementia Discovery Fund logo

The Dementia Discovery Fund (DDF), launched October 2015, is an international investment fund that supports discovery and development of novel dementia treatments. Established through an initial $100 Million investment from the UK Government, Alzheimer’s Research UK and a number of leading pharmaceutical companies (Biogen, GlaxoSmithKline, Johnson & Johnson, Lilly, Pfizer and Takeda), the DDF is managed by the venture capital firm SV Life Sciences and overseen by a Scientific Advisory Board. The DDF works collaboratively with universities, academic institutes and the biotechnology and pharmaceutical industry internationally.

Moving beyond the amyloid hypothesis, the aim of the DDF is to identify novel dementia research projects and nurture these through the pre-clinical phase, enabling further development in clinical trials. The DDF has a key focus on four key scientific areas:

  • the biology of microglial cells in the central nervous system (CNS) and the importance of inflammation in dementia
  • the role of the energy-producing mitochondria structures in the cell
  • trafficking and membrane biology
  • the physiology and function of synapses

More widely, the DDF has prioritised increasing global interest and industry confidence in the value of dementia research.

To date, the DDF has invested in nine projects, most recently purchasing a 513,000-compound CNS-focussed small molecule library for collaborative high throughput screening, and providing $5m in backing for Cerevance, a new pharmaceutical company focused on CNS diseases. The DDF aims to invest in around 40 projects or companies over the next 15 years, with the goal of getting three to five new drugs to treat dementia into the clinic. 

For more information on the Dementia Discovery Fund go to: The Dementia Discovery Fund website.

Science Meets Policymakers

Eight NHMRC-ARC Dementia Research Development Fellows were granted a Registration Award from the Dementia Institute to attend the Science & Technology Australia Science Meets Policymakers event held at ANU this month. Dr Christopher Pettigrew, the Dementia Institute’s Deputy Director, and Dr Rebecca Haddock, the Dementia Institute’s Manager of Research Policy and Governance, joined the Fellows on the day.

Understanding how policy is made and the intersection between evidence and policy development is vital for keeping Australia at the forefront of science and technology innovation. This event provided the opportunity for researchers, such as the Dementia Fellows, to make connections and to examine the intersection between the evidence base and policy making.  By enabling scientists and policy makers to engage in meaningful conversations, and come together, it ensures policy decisions are underpinned by good science.

The Dementia Fellows, and other delegates, heard from experts in policy formulation and senior policymakers about Australia’s vision for science and technology policy, and how to positively and meaningfully contribute to policy. The program included targeted workshops with national leaders in policy to brainstorm ideas and to contribute to shaping the landscape for important national issues.

The workshops focused on two issues: the 2030 Strategic Plan for the Australian Innovation, Science and Research System, and environmental information (data and analysis) and how it can be utilised by decision makers and policymakers. For the Dementia Fellows the event provided a unique opportunity to engage with policymakers and learn about the complexities involved in making and applying policy.

 

 

 

From bottom left: Dr Ashleigh Smith, Dr Genevieve Steiner, Dr Lisa Kalisch Ellett, Dr Olga Shimoni, Dr Tuan Nguyen, Dr Rebecca Haddock (Dementia Institute secretariat), Dr Yifat Glikmann-Johnston, Dr Sandra Garrido, and Dr Christopher Pettigrew (Dementia Institute secretariat). Not pictured Dr Fiona Kumfor.

National Ageing Research Institute LTD (NARI) Annual Symposium

The MARC Annual Symposium: “Future Directions in Ageing Research – What do the Leaders Think?” was held on 11 August 2017 at the Royal Melbourne Hospital, and attracted a crowd of 180 people.

This event provided attendees with an opportunity to hear from leaders in the fields of Dementia, Falls, Healthy Ageing, and End of Life and Palliative Care, who shared the latest research in their respective field, and insights into the future directions of ageing research in Australia.

Speakers included Professor Susan Kurrle (University of Sydney), Professor Anne-Marie Hill (Curtain University), Professor Andrea Maier (The University of Melbourne and Royal Melbourne Hospital), Professor Lorna Rosenwax (Curtin University), and Dr Frances Batchelor (National Ageing Research Institute).

Lorna Rosenwax spoke out about palliative care. Her main points included that end of life care services have been found to reduce hospitalisations, increase the number of people dying in their preferred place of death, generally at home, and that bereaved families leave feeling more satisfied with the End of Life Care services their relative received as their preferences were listened to and planned for.

Suu Kurrle said that while the prevalence of dementia in Australia is increasing, it is important to remember that ageing is not a determinant for receiving a diagnosis of dementia. As a society, we still don’t know enough about the causes of dementia and researchers are currently revisiting a number of past theories relating to the origins of the disease.

Andrea Maier discussed senescent cells which are a biomarker of ageing, and the accumulation of senescent cells in tissue can impair function and have an impact on the development of many age related diseases. Physical appearance can be indicative of excessive senescent cells in the body when a person is perceived to be older than they are, as characterised by things such as having more facial wrinkles and reduced elasticity in the skin.

Anne-Marie Hill reminded the delegates that falls remain a substantial socio-economic problem and that more research is needed for special groups (such as people with dementia and stroke), hospitals and residential care where falls are a large problem. Health promotion is needed urgently to reach older people aged 50 years and over directly to raise awareness of falls risk and falls prevention.

For more information on the MARC and to find out more about upcoming events, please visit the MARC website.

NHMRC Update

To date, the 2017 NHMRC grant application round has resulted in the commitment of more than $40 million to medical research projects aimed at improving the lives of Australians fighting dementia.

On 31 July 2017, 45 grants were announced by the Minister for Health, the Hon Greg Hunt MP, including 32 Boosting Dementia Research Leadership Fellowships and 13 grants for Implementation of Dementia Research into Clinical Practice and Care. A full list of grantees can be found on the NHMRC website

Fellow Profile

In 2015 Dr Kate Smith was awarded a NHMRC-ARC Dementia Research Development Fellowship. This opportunity has enabled her to move to the  Centre for Aboriginal Medical and Dental Health   at the University of Western Australia to work closely with the centre Director, Professor Dawn Bessarab, and her team, who advocate the importance of culturally secure health care for Aboriginal Australians. With the funding Dr Smith has been able to appoint Lianne Gilchrist, a Yamatji woman and Occupational Therapist, as an research officer on the project.  The research project team set out to develop a quality of life tool for  older Aboriginal Australians including those with dementia and cognitive impairment, and an accompanying package of recommendations for service providers.  This tool will be used by service providers to enhance the quality of life of older Aboriginal people as required, by identifying the factors important to each person’s quality of life.

The first stage of the study has been successfully completed, with in-depth interviews with 21 Aboriginal participants based in Perth aged 47-89 years using a yarning approach. The Aboriginal worldview of quality of life and wellbeing has been explored, and the factors important to having a ‘good life’ identified.   After analysing the data the information is being taken back to yarning groups to develop the draft quality of life tool. In 2018 the researchers will begin investigating the validity of the draft tool, with the aim of having the final package completed and disseminated by 2019.

This work is being conducted with a number of co-investigators, and in partnership with Moorditj Koort Aboriginal Health and Wellness Centre, People Who Care, RISE network, and Hall and Prior, with the active involvement of a Nyoongar Advisory group and the research team recently published an invited paper; Well-being of older Aboriginal Australians: The importance of ‘keeping spirit strong’'AUSTRALASIAN JOURNAL ON AGEING, 36, 2, pp. 112-113. Smith K, Gilchrist L

from left Prof Dawn Bessarab, Dr Kate Smith, Lianne Gilchrist, Dr Paula Edgill (co-investigator)

Dementia Institute Fellows Report

NHMRC-ARC Dementia Research Development Fellow, Dr Scott Ayton, from the Florey Institute of Neuroscience and Mental Health recently received significant media attention for his breakthrough work into the association between high levels of iron in the brain and the progression of Alzhiemer's disease.  

For further information about Dr Ayton, visit the Dementia Institute's website.

For more information about the research visit the SBS website.
   
* Newly diagnosed dementia patients or those aged 65 who have noticed their memory declining can register to be involved in the study at 3D@florey.edu.au

Current Funding Rounds 

NNIDR/NHMRC

Applications for the Targeted Call for Research (TCR) into Dementia in Indigenous Australians are currently under review. Visit the NHMRC website for more information about this TCR. 

Australian

Mason Foundation research grants

Judith Jane Mason and Harold Stannet Williams Memorial Foundation, through the Equity Trustees, invites applications for its research grants. These aim to achieve enduring, positive impact in the areas of chronic fatigue syndrome and Alzheimer’s disease by funding medical research focused on the causes, prevention and management of these diseases. Proposals focused on fatigue and chronic neurological and inflammatory disorders are particularly encouraged, as are those that use the Canadian consensus criteria, the Fukada criteria or both. Visit the funder's web page for more information about this opportunity.   

International Funding Opportunities

BrightFocus Foundation

BrightFocus provides research funds for U.S. and international researchers pursuing high risk studies that illuminate areas for which there currently is little understanding, helping to bring to light crucial knowledge about Alzheimer’s disease, glaucoma, and macular degeneration. Our mission is to save mind and sight by funding innovative research worldwide and by promoting better health through education.

The maximum award value of the ADR Standard Award is US $300,000, payable over three years.  Interested post-doctoral researchers should apply for the ADR Postdoctoral Fellowship Awards, a two year award with a maximum value of US $100,000.  Visit the funder's web page for more information about this opportunity.   

Peer reviewed Alzheimer's research programme – convergence science research award

The US Department of Defense, under its peer reviewed Alzheimer's research programme, invites applications for its convergence science research award. This supports efforts to generate research resources and tools, or novel research efforts for professionals and practitioners in health sciences in the areas of traumatic brain injury and its consequences on Alzheimer’s disease and related dementias.Visit the funder's web page for more information about this opportunity.

Drug discovery call for proposals

The Alzheimer’s Society and Alzheimer’s Drug Discovery Foundation (United Kingdon) invite applications for their academic-led clinical studies in drug discovery funding under the ADDF programme to accelerate clinical trials. This supports clinical studies to measure the safety and tolerability of new drugs for Alzheimer’s or other forms of dementia, as well of proof of efficacy studies with biomarker or cognitive outcomes. The main focus is on repurposing studies, which seek to leverage the benefit of translated preclinical work and safety data. Proposals of potential therapies with novel mechanisms and no-prior indications are also welcome. For more information visit the funder's web page.

Health disparities and Alzheimer's disease (R01) NIH: National Institute on Aging, US

The National Institute on Aging, the National institute of Neurological Disorders and Stroke, and the National Institute of Nursing Research invite applications for their grants for research on health disparities and Alzheimer's disease and related disorders (R01). These support health-disparities research related to Alzheimer’s disease, including the study of biological, behavioural, sociocultural, and environmental factors that influence population level health differences.  Visit the funder's web page for more information about this opportunity   

What’s On

Australian Dementia Forum 2017

The Forum will bring together Australia’s dementia researchers who are working to address the challenge of Alzheimer’s disease and other dementias, providing fertile ground for accessing the latest research breakthroughs and exploring collaborations relevant to the NNIDR Strategic Roadmap for Dementia Research.

Forum speakers will include international and national keynote presenters, preeminent researchers, including from the Institute’s Dementia Research Team Grant holders and recipients of International dementia research funding, policy makers, and community and research leaders.

The Forum will also provide the 75 NHMRC-ARC Dementia Research Development Fellows, who are reaching the mid-point of their four year program of research, an exciting opportunity to highlight their achievements to date. It is expected that the convening of Special Interest Groups and other networking events will round out discussions and provide the catalyst for new collaborations across the dementia research community.

The Dementia Institute will also take the opportunity to share knowledge and information about its research activities, providing an initial overview of outcomes from the significant investment that the Boosting Dementia Research Initiative has made. We will also begin a conversation around future planning.

Useful References

Outcomes of Care from the in-hospital experience: New Study

The relationship between in-hospital location and outcomes of care in patients diagnosed with dementia and/or delirium diagnoses: analysis of patient journey Lua Perimal-Lewis1,4* , Clare Bradley1,4, Paul H. Hakendorf2, Craig Whitehead2,4, Louise Heuzenroeder3,4 and Maria Crotty2,4.

Background: The discrepancy between the number of admissions and the allocation of hospital beds means that many patients admitted to hospital can be placed in units or wards other than that which specialise in the patient’s primary health issue (home-ward). These patients are called ‘outlier’ patients. Risk factors and health system outcomes of hospital care for ‘outlier’ patients diagnosed with dementia and/or delirium are unknown. Therefore, the aim of this research was to examine patient journeys of people with dementia and/or delirium diagnoses, to identify risk factors for ‘inlier’ or ‘outlier’ status and patient or health system outcomes (consequences) of this status.

Methods: A retrospective, descriptive study compared patients who had dementia and/or delirium according to the proportion of time spent on the home ward i.e. ‘inliers’ or ‘outliers’. Data from the patient journey database at Flinders Medical Centre (FMC), a public hospital in South Australia from 2007 and 2014 were extracted and analysed. The analysis was carried out on the patient journeys of people with a dementia and/or delirium diagnosis.

Results: When 6367 inpatient journeys with dementia and/or delirium within FMC were examined, the Emergency Department (ED) Length of Stay (LOS) after being admitted as inpatient was  prolonged for ‘outlier’ patients compared to ‘inlier’ patients (OR: 1.068, 95% CI: 1.057–1.079, p = 0.000). However, the inpatient LOS for’outlier’ patients was only marginally shorter than that of the ‘inlier’ patients (OR: 0.998, 95% CI: 0.998–0.998, p = 0.000). The chances of dying within 48 h of admission increased for ‘outlier’ patients (OR: 1.973, 95% CI: 1.158–3.359, p = 0.012) and their Charlson co-morbidity Index was higher (OR: 1.059, 95% CI: 1.021–1.10, p = 0.002). Completion of discharge summaries within 2 days post-discharge for ‘outlier’ patients was compromised (OR: 1.754, 95% CI: 1.492–2.061, p = 0.000).Additionally, ‘outlier’ patients were more likely to be discharged to another hospital for other care types not offered at FMC (OR: 1.931, 95% CI: 1.559–2.391, p = 0.000).

Conclusion: An examination of the patient journeys at FMC has determined that the health system outcomes for patients with dementia and/or delirium who are admitted outside of their home-ward are affected by in-hospital location despite the homogenous nature of the study population.

Keywords: Dementia and/or delirium, Health care delivery, Public hospitals, Patient journey, Outcome and process assessment (healthcare), Ward outliers

Clinical Trials in Australia

'Clinical Trials in Australia: the economic profile and competitive position of the sector' is the first comprehensive overview of the entire clinical trials landscape in Australia.

Produced in collaboration with L.E.K Consulting and funded by the Australian Government under the Industry Growth Centre Initiative, this report includes input from a range of sector participants and stakeholders. Whilst previous reports on the activity and economic profile of clinical trials have focused on sub-segments of the sector, MTPConnect's report provides a holistic and comprehensive overview of clinical trials in Australia, including investigative and observational trials, trials conducted in public and private settings, and trials sponsored by both industry and non-industry sponsors.

The report highlights the significant contribution that the conduct of clinical trials makes to the Australian economy, evaluates Australia's strong competitive position in the world market, and details priorities for future growth.

Key findings of the report include:

  • The Australian clinical trials sector is large and growing. Approximately 1,360 new clinical trials were commenced in Australia in 2015, and this figure has been growing at roughly 5% per year since 2010, outpacing the US, the UK, and the overall global average growth rate.
  • Investment in active clinical trials accounted for roughly $1.1 billion in gross expenditure in 2015. This includes approximately $930 million invested by industry sponsors, the large majority of which are international medical device, biotechnology and pharmaceutical companies that have chosen to invest in Australia.
  • The Australian clinical trials sector supported at least 6,900 high skilled jobs in 2015, the large majority requiring tertiary education levels.

Download the full report

Patent Analytics Report: Alzheimer ’s Disease

July 2017,

The report aims to capture the current patent landscape of treatments and diagnosis of Alzheimer’s disease since 2000. This is achieved through the analysis of data from patent families associated with Alzheimer’s disease in general.

Through the extraction and analysis of data associated with patent documents, it is possible to measure aspects of inventive activity such as scope, intensity, collaboration and impact. These metrics can be developed across technology sectors and by various units of measurement, such as individuals (inventors), institutions (applicants), regions and countries.

This report analyses data from patents filed through the PCT route in order to focus the study on the most globally relevant patent information relating to the diagnosis and treatment of Alzheimer’s disease. It has a particular focus on pharmaceuticals (chemical), biologics, genetic engineering and other medical treatments. It uses the scale and intensity of patent activity to provide an overview of inventions in the area of Alzheimer’s disease diagnosis and treatments through the lens of intellectual property (IP).

Read the full report.

Book Review: The Politics of Evidence: From Evidence-Based Policy to the Good Governance of Evidence by Justin Parkhurst 

This books provides a detailed synthesis of the debates surrounding evidence-based policy (EBP) as well as a governance framework for managing EBP. This is a comprehensive overview of the advantages and limitations of this approach that offers constructive insight into ensuring the judicious and careful use of evidence, writes Andrew Karvonen.

This review originally appeared on LSE Review of Books and is published under a CC BY-NC-ND 2.0 UK license.

In this book, Justin Parkhurst contributes to current EBP debates with a detailed synthesis of the main arguments for and against this approach, followed by a comprehensive governance framework to manage the use of evidence in policymaking. Parkhurst, an associate professor of Social Policy at the London School of Economics and Political Science, builds upon scholarship from public policy, policy studies, and related fields to trace the journey of EBP from its origins in clinical medicine to its current vaunted status as the “gold standard” of policymaking more generally. He systematically engages with the arguments of both promoters and detractors of EBP and proposes a constructive framework to address the main critiques, while also aiming to improve governance processes through the judicious and careful use of evidence.

Read the full review.

Call for papers

Have you published a research paper on dementia lately? Have you just had a paper accepted for publication? Let us know and we’ll include a link to it in our next issue! Simply send a link to your paper to nnidr.admin@alzheimers.org.au

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 Dementia Institute-related communication materials, or created into a feature story and pitched to the media.