The Dementia Prevention Research Clinics

The Dementia Prevention Research Clinics are an exciting new opportunity for people with MCI to join a longitudinal study which holds promise for future research findings.

The Dementia Prevention Research Clinics: Recruiting participants with Mild Cognitive Impairment for promising research

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What to expect at the Dementia Prevention Research Clinic (DPRC)

BRNZ_DPRC blood taking

The Dementia Prevention Research Clinics are an exciting new opportunity for people with mild cognitive impairment (MCI) to join a longitudinal study which holds promise for future research findings. 

The initial DPRC in Auckland was established in 2015 in association with the Centre for Brain Research at the University of Auckland.  The processes and systems put in place, which have been developed with the input of the national network, will act as a template for two more Dementia Prevention Research Clinics in Christchurch and Dunedin. These two clinics will be launched at a later date in association with BRNZ’s research partners throughout New Zealand. 

New Zealand’s population is ageing, with a rapidly increasing number of people with Alzheimer's Disease (AD) or a related dementia. In 2011, the prevalence of dementia in New Zealand was over 48,000, with projected prevalence of almost 150,000 by 2050. AD progressively affects thinking abilities producing profound functional impairment, loss of independence and significant health care needs. 

The physical and emotional strains placed on individuals and family/whānau are immense. People who develop AD or other dementias typically go through an intermediate stage known as MCI, but not all people with MCI will go on to develop dementia.  Why some people progress and others do not is far from understood.  

A key aim of the Dementia Prevention Research Clinics is to identify biomarkers that predict which individuals with MCI will progress to dementia in a New Zealand sample, and to identify factors that influence rate of progression.  A biomarker is something that can be measured, which indicates the presence or absence of a disease state in a person.  

In our study scientists and clinicians will look for biomarkers from proteonomic, metabolic and genetic analyses of blood samples, from structural and functional brain scans, clinical measures of patterns of thinking abilities, and lifestyle factors including exercise, diet, cognitive activity and social functioning, or combinations of these.

Identifying a biomarker “signature” (a distinct pattern across different types of biomarkers) for development of AD would hugely improve our ability to provide and test targeted interventions to delay progression of MCI.  

A second aim of the Dementia Prevention Research Clinics is to develop and test novel intervention packages to delay progression from MCI to AD in preliminary clinical trials.  These trials may involve novel drugs, cognitive, social and physical interventions, either alone or in a combination. Clinic participants will be invited to participate in these intervention trials, as they are developed.

We are joining an international endeavor to find ways to prevent, or slow, the development of dementia: If we could delay dementia onset by 5 years, this would reduce dementia prevalence by 50%.

A research parnership between scientists, clinicians and New Zealanders with memory problems 

The Dementia Prevention Research Clinics provide New Zealanders with a unique opportunity to become a partner in the research process and to be involved in cutting edge national and international research into the huge challenge of dementia prevention.  

“It is critical this research is carried out in New Zealand, with our own unique population of peoples, in our unique environments.  These research participants and their families will be our partners. They are the centre of our work. They are ordinary New Zealanders from every walk of life.  We will ensure that their experience of engaging in our research is positive and worthwhile,” explains National Director of the DPRC network, Associate Professor Lynette Tippett.

On a typical visit to the Dementia Prevention Research Clinic 

• When participants and their families attend the Dementia Prevention Research Clinic, this may involve 3-4 sessions.

• They undergo a detailed characterisation of their functioning, general health and lifestyle, including diet and exercise.

• Blood samples are collected and MRI scans are conducted on many participants. This data provides valuable information to neuroscientists attempting to identify biomarkers and clinical markers of disease. 

• The clinicians at Dementia Prevention Research Clinic not only collect information, they listen to the experiences and needs of care-givers and family members/whānau. 

• Feedback is provided to participants and their families/whānau.

• Clinic participants are monitored longitudinally. They may be invited to participate in a broad range of preliminary clinical trials by researchers at Brain Research New Zealand. 

The Dementia Prevention Research Clinics have highly skilled staff with many years of clinical and research experience, and a clinical review committee comprising some of New Zealand foremost experts in the field.

 

Researcher inquiries

Associate Prof Lynette Tippett: National Director 

Telephone: +64 9 923 8551

Email: l.tippett@auckland.ac.nz

 

Participant inquiries (for the Auckland DPRC)    

Christine Brennan: DPRC Clinical Research Nurse 

Telephone: 09 923 7884

Email: brainresearch@auckland.ac.nz

 

DPRC Neuropsychologist: Dr Christina Ilse

[Right] DPRC Neuropsychologist: Dr Christina Ilse
[Right] DPRC Neuropsychologist: Dr Christina Ilse

“My main role at the DPRC is to complete neuropsychological assessments with participants referred to the clinic. A neuropsychological assessment is a detailed investigation of memory and thinking abilities (attention, concentration, language, planning, problem-solving etc.).

“Results can give us information about areas of strength and difficulty, and can assist with diagnosis. For example Mild Cognitive Impairment, Alzheimer’s disease, etc.” says Dr Ilse.

Why do you love what you do/what makes you happy doing this role?

“I have spent more than 10 years assessing, and diagnosing, dementia (including Alzheimer’s disease). It is a devastating diagnosis to give to the affected person and their family, especially because we currently have no effective treatment available.

“I feel very privileged to have the opportunity to work in the DPRC where the main aim is to identify possible treatments, factors which can slow disease progression, and improve or continue quality of life, for affected people and their loved ones,” says Dr Ilse.

What do you hope will be the outcome of your collaborative team effort at the clinic?


“First and foremost, I hope that our collaborative team effort at the clinic will support our participants by making positive, lasting and caring relationships with them and their families. I also hope that we can enrol a large number of participants in the study so that we can achieve our aims of investigating factors, which contribute to the development and progression of cognitive decline in people who have Mild Cognitive Impairment,” says Dr Ilse.


What do you hope will be the research outcome of the DPRC in five years time?

“I hope that the individual studies, which participants will be invited to, will identify a range of factors which can be modified to prevent or slow disease progression, and improve quality of life for affected people and their families.


“Of course I also sincerely hope that we will be able to run this clinic indefinitely because I believe that dementia research is absolutely critical when one considers the statistics: it is projected that 140,000 people will be living with dementia, stroke, or both by 2026.


“We have no disease modifying treatment at this point for Alzheimer’s disease, so working on this via the Dementia Prevention Research Clinic is of critical importance,” says Dr Ilse.

DPRC Clinical Research Nurse: Christine Brennan

[Right] DPRC Clinical Research Nurse: Christine Brennan
[Right] DPRC Clinical Research Nurse: Christine Brennan

What does your role involve on a daily basis at the Dementia Prevention Research Clinic at the University of Auckland?

I'm the Research Nurse for both the Stroke Clinic and the Dementia Prevention Research Clinics located at the University of Auckland. I'm responsible for liaising with participants and coordinating appointments, results, and blood sample collection

Why do you love what you do/what makes you happy doing this role?

I enjoy being in this role because I get to work with people who are willing to contribute their time to research, and also with extremely experienced physicians and scientists. There is such a sense of contribution.

What is it that makes you excited about being involved in the DPRC and Brain Research New Zealand?

Being part of the first longitudinal study on Dementia Prevention, the clinic may learn about what causes these changes in dementia and also the interventions the measures that we can use to treat it.

To prospective participants in the clinic, what would you like them to know before making contact with you?

We don’t bite. We're here to make a difference and if you are kind enough to contribute to our research we will look after you as best we can.

 

Brain Research New Zealand Tissue Bank Research Fellow: Dr Erin Cawston

[Left] DPRC Tissue Bank Research Fellow: Dr Erin Cawston
[Left] DPRC Tissue Bank Research Fellow: Dr Erin Cawston

“My role is as the BRNZ DPRC Tissue Bank Research Fellow and I am responsible for establishing collection and processing controls of the highest standards. I am also in charge of developing new research initiatives and research projects for biomarker studies using samples collected from DPRC study participants.

“I watched my grandfather slowly decline with Alzheimer’s disease over 5-10 years. So I always hoped I would be able to use my knowledge to help in the fight against such a horrible disease not only for the individuals who suffer from it but also their families and communities. It is in my new role of BRNZ DPRC Tissue Bank Research Fellow that I have the opportunity to marry my two research passions blood diagnostics and molecular pathology in the fight against Dementia.

“I love what I do as it is an opportunity to marry my two research passions blood diagnostics and molecular pathology in the fight against Dementia,” says Dr Cawston.

What do you hope will be the outcome of your collaborative team effort at the clinic?

“Being part of this collaborative team has been such an honour and we are like a family. Everyone in the team has worked tirelessly to consider all aspects of this study and how this may affect the participant and their families at all levels. I hope the participants feel like they are not only helping future generations but also part of a special family,” says Dr Cawston.

What do you hope will be the research outcome of the DPRC in five years time?

“This is a hard question. But I would hope that the DPRC would be on its way to identifying specific biomarker signatures for the different stages of cognitive decline,” says Dr Cawston.
 

Our experts: Dementia Prevention Research Clinics

New Zealand Director

Associate Professor Lynette Tippett

Auckland DPRC

Associate Prof Lynette Tippett: Auckland DPRC Co-Director

Dr Phil Wood: Auckland DPRC Co-Director

Dr Gary Cheung: Psychiatrist

Dr Kiri Brickell: Neurologist

Dr Christina Ilse: Neuropsychologist 

Christine Brennan: Clinical Research Nurse

Dr April Clugston: Old Age Psychiatrist

Christchurch DPRC (opening date tbc)

Professor John Dalrymple-Alford: Christchurch DPRC Director

Dunedin DPRC (opening date tbc)

Dr Nicholas Cutfield: Dunedin DPRC Director

Dementia in New Zealand: A national problem

  • In 2014, our best estimates indicated that more than 50,000 New Zealanders had dementia. This has increased from an estimated 40,000 people in 2008.
  • The majority (60%) of people with dementia are female – moer than 30,000 NZ women had dementia in 2014 compared to more than 20,000 NZ men.  This is due to women living longer than men on average, and due to the prevalence rate of dementia being higher for women than men in age groups over 75 years.  
  • By 2050, almost 150,000 New Zealanders will have dementia – over 2.6% of the population, and more than triple current numbers.
  • Of the total, 59% will be female and 41% male.  Annual incidence (onset) of dementia will also more than triple in new cases by the year 2050. 
  • The total financial cost of dementia in the Asia Pacific region for 2015 was estimated to be US$1.2 billion. (Dementia in the Asia Pacific Region).
  • The World Alzheimer Report 2011 revealed that in countries like New Zealand, only 60% of cases are diagnosed/documented. This means that there are potentially a further 40% of people with dementia in New Zealand that have not yet been diagnosed – making the numbers above significantly higher.

Source: Alzheimer’s New Zealand

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