DEMENTIA NEWS

EDITION 16, 2013 - SEPTEMBER 23

UNDERSTAND PARTICIPATE

DISCUSS

EDITORIAL

Hello Dementia News readers,

I hope that you have managed to get to an event or two during Dementia Awareness Week. I was lucky enough to attend the 8th National Dementia Research Forum over the weekend where I met many Australian researchers, consumers and carers working in the dementia field. I will be bringing you a special edition of Dementia News next fortnight that will focus on new research presented at the Forum, including what is on the horizon for dementia research and that all important question of finding a cure.

I also wanted to draw your attention to the Alzheimer’s Disease International World Alzheimer’s Report released last Friday which shows that globally, the number of dependent older people will soar from 101 million in 2010 to 277 million in 2050 and that nearly half of these people will be living with dementia. The report calls on governments around the world to implement national dementia action plans to better support informal carers of people with the chronic disease. Lead author on the report, Professor Martin Prince said “dementia needs to be a public health priority and adequate planning needs to be in place so that people with dementia can live well.” See our media release and full report by clicking here.

I had a plethora of new research articles to choose from for this edition. In the ‘understand’ section, I have summarised a study recently published in the highly regarded journal Nature. It reports how playing a specially developed video game may enhance brain function in older age. Another article focuses on a new study reporting on a commonly used diabetes drug which may have potential as an Alzheimer’s disease treatment. Finally, multiple media outlets reported last week that cleanliness could be linked to Alzheimer’s disease. After reading the research paper, this statement seemed like a bit of a stretch. I asked Dr Molly Fox, lead researcher on the study, to write an article especially for Dementia News about her research. Dr Fox has assured me that we don’t need to stop having showers just yet.

Another paper which made global headlines over the past fortnight was an opinion piece by Australian and British researchers asking whether we are overdiagnosing dementia. I thought this would make an interesting article for our discuss section.

I welcome any comments or feedback on the articles or topics you might like to see discussed.

I hope you enjoy this issue,

Dementia News editor,

Ian McDonald

Did you know: Alzheimer’s disease was named after Dr Alois Alzheimer who, in 1906, first described a ’peculiar’ disease in the brain of Auguste Deter who had died at aged 55.

1 Dementia News

Playing a video game has improved multitasking abilities in adults between 60-85 years of age. The game, called NeuroRacer, was developed by researchers from the University of California, who published their findings in the journal Nature. The game requires participants to race a car around a track while road signs appear. Participants need to look out for a specific sign, while ignoring all the rest, and press a button when it appears (i.e. multitasking).

174 participants aged between 20-79 took part in the initial phase of this study. None had issues with vision or brain function, and none were considered “gamers.” Results showed that participants’ ability to multitask declined with age (see graph). A second trial asked a separate group of older adults (aged 65-80) to play the game. Participants were split into three groups: • Those who just played the racing game (with no

signs popping up).

• Those who just watched for signs (with no racing involved).

• Those who played the racing game and watched for signs at the same time (multitasking).

Each participant could practice the game for up to one hour a day, three times a week for four weeks (12 hours in total). On return, one month later, participants in the multitasking group had similar results to those of the 20 year olds in the initial study (see graph). Even six months later, without extra training, these levels did not rapidly decline.

Lead researcher Dr Adam Gazzaley said “we consider the older brain to be ‘plastic’ – meaning it has an ability to reshape itself in response to a certain stimulus. If we can target these areas, we may be able to improve brain performance throughout older life.”

For more information click on the links below:Media link: Sky NewsVideo link: University of CaliforniaJournal link: Nature

MULTITASKING DIFFICULTIES IN AGEING ADULTS – VIDEO GAMES TO THE RESCUE

UNDERSTAND NEW RESEARCH

Dementia News 2

EXISTING DIABETES DRUG MAY REVERSE ALZHEIMER’S DISEASE SYMPTOMSA common Type 2 diabetes drugs (Liraglutide) has reversed the effects of Alzheimer’s disease in mice. These results were published in the Journal of Neuropharmacology by researchers in the UK. The mice, all in late-stage Alzheimer’s disease, were given a daily dose of Liraglutide over ten 10 weeks. The researchers found that the usual signs of Alzheimer’s disease pathology, such as toxic plaques, were reduced with treatment. The same mice also performed better on object recognition and spatial memory tests.

Dementia News asked lead researcher Professor Christian Holscher from Lancaster University why he chose this drug? “I decided to test Liraglutide, because it is a highly successful treatment for Type 2 diabetes and diabetes is a risk factor for Alzheimer’s disease. Therefore, the hypothesis was that this drug may prevent and reduce the symptoms of Alzheimer’s disease and this turned out to be correct.”

Due to the successful results in mice, clinical trials have begun in humans. Professor Holscher said “we have begun a large phase 2 clinical trial, which means we will get a reliable result. A separate study analysed the brain tissue of people with Alzheimer’s disease who had been treated with Liraglutide, and showed clear improvements. We are therefore hopeful that this clinical trial will show a positive result. A clinical trial in people with Parkinson’s disease is also planned.” We wish Professor Holscher luck with this exciting research and will give you updates as they come in.

For more information click on the links below:Media link: MirrorJournal link: Neuropharmacology

Liraglutide is an injectable drug used to treat Type 2 diabetes. It stimulates insulin production in diabetics. Research also shows it can pass through the blood brain barrier and have a protective effect on brain cells.

CLEAN LIVING AND ALZHEIMER’S DISEASEDuring the second week of September, a new study comparing rates of Alzheimer’s disease in different countries resulted in media outlets around the world claiming headlines such as ‘Could good hygiene cause Alzheimer’s disease?’ Dementia News asked the study’s author Dr Molly Fox from the University of Cambridge to comment on this issue. We thank her for writing this article.

Our study revealed that the incidence of Alzheimer’s disease was higher in countries where a greater percentage of the population have access to clean drinking water and lower in countries that had more infectious disease over the past century. These results have been published in the recent edition of Evolution, Medicine and Public Health, where we tested the “hygiene hypothesis” for Alzheimer’s disease. Do people who live in highly urbanised, sanitised (clean) and relatively pathogen free environments have a greater risk of Alzheimer’s disease?

In ‘clean’ urbanised environments, people are seldom exposed to animals, faeces, and mud and have have access to toilets, plumbing, antibiotics, decontaminated water, and other public health measures. As a result, they are at a much lower risk of dangerous sporadic infections. However, an undesirable side effect is that they are not exposed to the beneficial microbes that can help the immune system develop.

One conclusion is that people who are less exposed to microbes may not be able to control inflammation, which for some people, might lead to excessive inflammation. People with Alzheimer’s disease can exhibit excessive inflammation and this is what inspired us to test whether Alzheimer’s disease has a similar global distribution to autoimmune diseases and allergies for example - and we found that indeed it does.

We caution that these results do not imply that people shouldn’t wash their hands or bathe. Rather, they suggest that the ‘larger’ environments in which we live may be too clean, not our bodies specifically. Washing your hands protects against dangerous infections and protects others against the spread of dangerous infectious agents and is always recommended.

For more information click on the links below:Media link: NHSJournal link: EMPH

Inflammation is the body’s attempt at protection against infection, disease and tissue damage, and an important part of the immune response. While usually beneficial, it can become harmful if excessive inflammation occurs.

3 Dementia News

A recent opinion paper in the British Medical Journal by the University of Sydney’s Professor David Le Couteur has raised questions about new criteria that have introduced diagnostic categories for ‘pre-clinical dementia’, and the potential downsides of policy measures intended to encourage GPs and other health professionals to diagnose dementia earlier.

Dementia News spoke with Professor Le Couteur, who said “one of the main issues of diagnosing people with pre-dementia is that it does not always mean dementia. The belief is pre-dementia leads to mild cognitive impairment (or MCI) which leads to dementia - but this is rarely the case.” The paper has been welcomed by many doctors who agree that there is limited evidence to back up the use of dementia screening procedures in clinical practise.

Alzheimer’s Australia agrees with Professor Le Couteur that pre-clinical dementia and MCI often does not progress to dementia, and that any efforts to increase diagnosis of pre-dementia, particularly in pre-symptomatic stages, would not be appropriate for the general population. However, as Alzheimer’s Australia National Research Manager, Dr Chris Hatherly, explains, it is important in considering this issue to distinguish between the concepts of early and timely diagnosis and between dementia screening and assessment.

Early vs Timely diagnosis of dementiaWith advances in biomarker technologies (see Dementia News 26 August 2013 - page 5), researchers can now detect the presence of Alzheimer’s disease as much as 20 years before first symptoms appear. However, the tests that are used to do so are expensive and invasive (e.g. special PET brain scans and lumbar puncture tests), and at present are only used in research settings. With new technology, ‘early’ diagnosis of dementia is now considered to mean a research-only diagnosis and before symptoms have actually appeared.

A timely diagnosis, in contrast, means a diagnosis of dementia at a time when it is both appropriate and useful for the person concerned. For some, this will be a diagnosis as early as possible after the onset of symptoms; providing an explanation of ‘what’s going on?’ and at a time where they will be able to put in place appropriate legal, financial and advance care arrangements, to try the available symptomatic medications, or to engage in the lifestyle changes that may possibly help to slow the progression of their symptoms. For others, a timely diagnosis will be at a much later stage in the disease, and for a few, it is possible that they may prefer not to be diagnosed at all.

Unfortunately, only an estimated 50% of people with dementia in Australia are ever diagnosed and those who are, have to wait an average of 3.1 years from the first symptoms to a confirmed diagnosis. So most people don’t receive a timely diagnosis, and the push for better screening and assessment by Alzheimer’s Australia and many health professionals is all about trying to improve this situation.

Screening vs assessmentThe other important distinction is between screening – usually one or more quick tests used to indicate the likelihood that someone may or may not have a disease – and assessment – a much more rigorous process used to diagnose or clear a person with certainty. Screening is used very successfully with conditions such as heart disease, some cancers and HIV-AIDs to ensure that assessment and treatment can be targeted to those who have the early, often pre-symptomatic, stages of these diseases.

Unlike cancer or heart disease, there is currently no way to screen people for pre-clinical dementia. Instead, the only screening measures available are questionnaires such as the Mini-Mental Status Examination that can be used to detect symptoms of the disease. By the time symptoms are present, most people will have progressed beyond pre-dementia, and will be in a position where a timely diagnosis will soon be appropriate.

According to Dr Hatherly “dementia is being underdiagnosed rather than overdiagnosed, and while we don’t want to alarm people by pushing for assessment of pre-dementia, we certainly need to do a better job of providing appropriate assessment, timely diagnosis and high quality medical managing and care for the 321,000 people who are living with dementia in Australia today.”

For more information click on the links belowMedia link: Medical observerJournal link: BMJ

IS DEMENTIA BEING OVERDIAGNOSED?

DISCUSS THE SCIENCE

Mild cognitive impairment is the onset of brain function impairment beyond those expected, based on the age and education of the individual, but which are not significant enough to interfere with daily activities – see the Fight Dementia website here for more information.

4 Dementia News

PARTICIPATE TO LEARN MORE

AUSTRALIAN ROTARY HEALTH PHD SCHOLARSHIPS OPENAustralian Rotary Health currently has the following PhD scholarships available for candidates working on Alzheimer’s disease.

South Australia - 1 scholarship available. New South Wales - 2 scholarships available. • The first scholarship specifically relates to “the

improvement of quality of life of people with dementia by investigating the impact of modifications to the built environment in residential aged care/acute care settings.”

• The second scholarship focuses on “research to improve the quality of life of people with dementia in residential or community settings.”

This scholarship is offered under our Funding Partner Program which is a three way financial commitment between a Rotary Club or District ($11,000pa), Australian Rotary Health (7,000pa), and the administering University or Research Institute ($11,000pa). The annual value of this scholarship is therefore $29,000pa for a maximum of 3.5 years.

The application form and guidelines can be downloaded from our website - click here. If you have any questions, please contact. Michelle NicholasResearch Administration ManagerAustralian Rotary Health E: MichelleNicholas@australianrotaryhealth.org.auP: (02) 8833 8308

Applications close Friday 13th December 2013.

AADRF PHD SCHOLARSHIPS OPENDementia affects the minds so we want our best minds working on it. The Alzheimer’s Australia Dementia Research Foundation (AADRF) have scholarships available worth up to $30,000 for prospective or current PhD students working in the field of dementia research.Scholarships available are:• 1 * Alzheimer’s Australia Dementia Research

Foundation Consumer Dementia Research Network PhD Scholarship on Dementia Specific Respite (valued at $30,000 per year for three years).

• 5 * Alzheimer’s Australia Dementia Research Foundation PhD Scholarships (valued at $30,000 per year for three years).

• 6 * Top-up PhD Scholarships for students currently receiving a PhD Scholarship from an alternative funding source ($7,500 per annum for up to 2 years ).

For more information visit the website - click here.

Or contact Dr Mary Gray, Manager Alzheimers Australia Dementia Research FoundationE: mary.gray@alzheimers.org.auP: (02) 6278 8910

Applications close Friday 18th October 2013

Dementia News 5

MEETING THE TRANSPORT NEEDS OF PEOPLE WITH DEMENTIAAlzheimer’s Australia NSW is gathering information from people through interviews and an online survey. Interviewees will recieve a $50 gift voucher as a thankyou and people who complete the online survey will go in the draw for a $100 gift voucher.

So, if you are a person with dementia or have been a carer of someone with dementia in the past three years, they would like to hear about your transport needs and experiences.

They would like to talk to you about issues such as:• Where the person with dementia needs to travel and

their travel arrangement

• How difficult is it to organise transport?

• What would make it easier for the person with dementia and the carer to find suitable travel for the person with dementia.

You can complete the online survey by clicking on the link here.

If you are interested in being interviewed please contact:Deborah CorrigallE: deborah.corrigall@alzheimers.org.auP: (02) 8875 4621

NANA NO HATS: CORRILEE’S NANALICIOUS RECIPES - AVAILABLE NOWThe CorriLee Foundation has released a fantastic new cookbook, Nana No Hats, which contains a collection of nanalicious recipes which will bring back many childhood memories from yesteryear.

Edited by Alzheimer’s Australia National President, Ita Buttrose, it’s more than a cookbook - it’s a 108-page treasure trove of family recipes, memories and reflections on a wonderful life, lived by a wonderful woman.

“Corrie has perfected the recipes over the course of her life and says that moderation is the key to enjoying these treats.” Proceeds from the sales will go to directly into Australian dementia research via the Alzheimer’s Australia Dementia Research Foundation - a cause close to the heart of the Lee family.

The book retails at $39.95 and is available online www.corrileefoundation.org or instore at Dymocks

6 Dementia News

CONTACT

This newsletter was funded by the Australian Government as well as the Dementia Collaborative Research Centre: Carers and Consumers © Alzheimer’s Australia as represented by the Dementia Collaborative Research Centre: Carers and Consumers, 2011DISCLAIMER:The views expressed in this work are the views of its author/s and not necessarily those of the Australian Government.

Any questions or comments are welcome.To subscribe/unsubscribe or if you have any information you would like to see included in future editions please contact:E: dementia.news@alzheimers.org.au P: (02) 6278 8916

NATIONAL DEMENTIAHELPLINE1800 100 500

UNDERSTANDING SLEEP IN CARERS OF PEOPLE WITH DEMENTIAAlicia Allan, a PhD candidate from QUT is conducting research on sleep in people with dementia and their carers out in the community.

She is seeking participants for this research so the research team can better understand some of the causes of sleep difficulties in those who provide care to people with dementia.

The study is aiming to capture the amount of sleep disturbance carers experience as a result of their care role, and also investigate some of the factors, such as activity and light exposure, that might be associated with disturbed sleep in people with dementia and carers who live at home in the community. The research is conducted in-home, is observational only and doesn’t require any change in daily routines or behaviour.

Participants can live anywhere in Australia.

Find out more information via the web link:www.carrsq.qut.edu.au/sleep and download the information sheet by clicking here.

Contact Alicia Allan for more informationE: alicia.allan@qut.edu.auP: 0447 325 479

CARERS IN SYDNEY WANTED FOR A DOCUMENTARY ON DEMENTIALillian Radulova is currently producing a documentary on dementia for her final year university project.

She is looking for someone who is currently caring for a loved one with dementia and is happy to share their personal story of the illness on camera.

It’ll go towards the documentary she is making on where we are at with dementia care and research and where the future is heading. If interested please contact Lillian directly.E: radulova.lillian@gmail.com P: 0432843643