The NEIL programme brings together a core group of Irish researchers to focus on the development of a completely new programme of research for multi-level interventions to delay and/or prevent dementia. Here is a sample of NEIL research studies aimed not only at the identification of optimum methods for enhancing cognitive function, but also at the identification of markers of cognitive decline.
Memory Research Unit
We have developed the infrastructure for a Memory Research Unit, where we will use a comprehensive assessment protocol to collect detailed data on memory and related cognitive processes, and a range of factors that may impact on these processes as we age. This rich database will allow us to conduct extensive research, to investigate a range of hypotheses related to cognitive ageing. We are currently recruiting research volunteers to participate in assessment sessions at this Unit.
RelAte - Benefit of relationship based mealtime intervention in socially isolated older adults
Aim: To determine the benefit of a relationship-based nutritional intervention in older people living alone.
Methods: One hundred older people living alone will be recruited through local community services. Participants will be randomized to either a) a relationship-based mealtime intervention delivered by a trained volunteer for approx 180 minutes, once a week for 8 weeks. Participants will also be given dietary advice and will be made aware of local community based meal-provision services where they can avail of low-cost meals to be consumed in a social setting. Or b) a control intervention where participants will be given dietary advice and will be made aware of local community based meal-provision services where they can avail of low-cost meals to be consumed in a social setting.
Endpoints: Participants in the intervention and control groups will be assessed at baseline, immediately post-intervention (8 weeks) and at 12-week and 26-week follow up for changes in: quality of life; cognitive function; social connection; mood; BMI; walking speed.
Expected Outcomes: Short-term and sustained benefit for the relational nutritional intervention, nutritional advice and information on local social meal service provision over nutritional advice and information on local social meal service provision alone.
Funding Agency: Home Instead Inc.
ACAD - Automated Cognitive Assessment Delivery
We have developed an automated, repeatable, computerised, cognitive assessment tool, suitable for online delivery on personal computers and mobile devices. Testing of this assessment tool is currently underway.
Alzheimer's Disease (AD) is an ever-increasing public health concern among the ageing population and is the most common form of dementia affecting more than 15 million individuals worldwide and around 5 million Europeans. Even modest therapeutic advances that delay disease onset and progression could significantly reduce the global burden of the disease and the level of care required by patients. There is therefore an imperative to develop new treatments for AD that have disease modifying effects. This double-blind placebo controlled study will test the efficacy and safety of nilvadipine in 500 subjects with mild to moderate AD over a treatment period of 18 months. Nilvadipine is safe and well tolerated in AD patients and clinical studies with this medication have shown stabilization of cognitive decline and reduced incidence of AD, pointing to both symptomatic and disease modifying benefits. If this trial is successful, nilvadipine would represent an advance in the treatment of AD patients and would have a major impact on the health and social care costs incurred in Europe by this neurodegenerative disorder.
For more information, see http://www.nilvad.eu/
De-Stress: Cognitive function, caregiver stress and cortisol: Mechanisms and implications for prevention of adverse health consequences in spouse dementia caregivers
Background: The increased incidence of dementia with advancing age, together with demographic ageing, gives rise to an exponential increase in the need for dementia care. Much of this care is provided by informal caregivers, frequently spouses, who are usually aged over 60. There is considerable evidence that dementia caregiving leads to a number of negative health outcomes including anxiety, depression, physical illness, hospital admissions and even premature death. Caring for a progressively dementing spouse is a prototypic chronic stressor. Chronic psychosocial stress has been implicated in age related cognitive decline. Elevated cortisol levels indicate stress and may be a risk factor for cognitive decline. Despite an extensive literature on the effects of age, chronic stress, anxiety and depression on cognitive function, research examining cognitive function in caregivers and in particular caregivers of people with dementia, is sparse.
Aims: The main aim of this study is to clarify the relationship between cognitive function and the stress associated with caring for a spouse with dementia. Dementia caregivers may be a population at risk for cognitive impairment and possibly dementia. Ireland's heavy reliance on informal caregiving in dementia will only remain feasible if the determinants of the health of caregivers and understood and optimised. The ultimate goal of this study is to inform policy, future research and the development of targeted interventions in order to improve caregiver health and make care in the community a viable option, not only for the individual with dementia, but also for their caregiver.
Funding Agency: Medical Research Charities Group and Health Research Board
The Goal: Improve cognitive health behaviours in older adults.
The Idea: Develop and evaluate a series of online films that provide practical information, grounded in science, on maintaining cognitive health.
The Problem: The stigma of dementia prevents open discussion, and the false belief that nothing can be done for people with dementia and their families. A lack of understanding and all too frequent misinformation mean that people often misconstrue the memory loss of Alzheimer's Disease as 'normal' for older people and don't bring family members for assessment. In addition, people mistakenly accept that cognitive decline is an inevitable consequence of normal ageing and fail to seek medical opinion. Providing cognitive health advice and by providing clear scientific information that shows the difference between normal and abnormal memory functioning, and making people aware that memory problems can be a consequence of other diseases or disorders that require medical attention. The films will encourage people to be proactive and take responsibility for their cognitive health, make important lifestyle changes that reduce risk factors, learn strategies that support declining abilities, seek medical advice in order to facilitate early intervention and diagnosis and advance directives.
The Audience: The public generally and adults aged 50+ specifically.
The Approach: NEIL will use it's scientific expertise in the field of cognitive ageing and dementia to collate and coordinate beneficial information from a wide range of cognitive ageing research programs and translate it into useable, interpretable and engaging health and well-being short films, that can be delivered directly to the public online or via workshops facilitated by a cognitive coach. This educational content will enable and empower Irish citizens in a way that will promote active and healthy ageing and raise awareness that cognitive decline with age is not inevitable. The scientific content will be shaped by user-input and reframed so that all content is both engaging (to enable education and sharing) and accurate (delivering impact and inspiring action). The films will be produced by 360Productions and will use an attention-grabbing combination of clever cutting-edge graphics and sharp scripts. Each film will deliver a key message in one entertaining bite-sized chunk. The Cognitive Coaching film modules are designed to deliver the projects key aims: to make the science of brain ageing known to the wider population, so that they retain key knowledge, and develop the understanding that will allow them to use their new knowledge to take practical steps to improve their lifestyles, and the lifestyles of those they care for - leading ultimately to less stigma, less distress, earlier diagnosis, not just of dementia, but also of other conditions that impair cognitive function and will ultimately lead to a healthier Irish population.
Funding Agency: GENIO
Alertness Training for Focussed Living (ATFL)
In collaboration with TRIL (Technology Research for Independent Living) we have developed a home-based intervention for older people to help increase alertness, with a view to improving daily life activities. A randomised controlled trial of this intervention is currently underway. This self-administered, home-based system has the potential for considerable scaleable impact, as it may help older people to avoid errors and achieve their goals.
GSK/TCIN Research Consortium on Neurodegeneration
As part of the GSK/TCIN collaborative research programme addressing cognitive decline in the elderly, we have conducted a randomised controlled clinical trial exploring the acute and chronic effects of the existing Alzheimer's disease (AD) symptomatic treatment compound donepezil on cognitive electrophysiological (EEG/ERP) endpoints and olfactory discrimination in normal elderly individuals. The overall goal of the study is to identify sensitive EEG/ERP biomarkers that can then be used to accelerate the development of novel pharmacodynamic compounds in the future.
Neurophysiological Markers of Cognitive Decline Associated with Normal Ageing
Research funded by the Irish Research Council of Science, Engineering and Technology (IRCSET) addresses specific aspects of the cognitive decline associated with normal ageing. This project seeks to identify and explore both cognitive and neurophysiological markers among normal elderly which will aid in the prevention and prognosis of such cognitive decline. The first step in this research programme involves employing novel indices of brain function such as the concurrent use of pupillometry and electroencephalography (EEG), and investigating how these co-vary both with each other and with performance on standardised measures of cognitive function. This will inform the identification of separable biomarkers indicative of decreased attentional integrity and cognitive-behavioural arousal in the elderly, and the subsequent exploration of whether these specific deficits are amenable to remediation via a specifically-devised programme of cognitive training.
Possible Markers of Early Cognitive Decline
This NEIL study is a collaboration between Professor Ian Robertson and Professor Marina Lynch (cellular neuroscientist) examining blood samples for cellular markers of inflammation. If successful, it could offer a major opening for early screening and hence early prevention.
Web-based Working Memory Training
We have developed a web-based working memory training programme, which is currently being tested in a randomised controlled trial study. This intervention shows considerable promise as a cognitive enhancement tool and is well position for large-scale roll out.