THE NATURAL HISTORY OF COGNITIVE IMPAIRMENT AND DEMENTIA IN A STROKE COHORT
Funder
National Health and Medical Research Council
Funding Amount
$290,747.00
Summary
In a current NHMRC-funded study, we have examined 200 stroke patients (and 100 control subjects) at 3 months after a stroke and one year later, and identified those who have impairment in memory and other cognitive functions. We have also studied these subjects in detail from a psychiatric perspective and performed brain scans on them using magentic resonance imaging. We find that many stroke patients have problems with their cognitive functioning which has a major impact on their lives. A large ....In a current NHMRC-funded study, we have examined 200 stroke patients (and 100 control subjects) at 3 months after a stroke and one year later, and identified those who have impairment in memory and other cognitive functions. We have also studied these subjects in detail from a psychiatric perspective and performed brain scans on them using magentic resonance imaging. We find that many stroke patients have problems with their cognitive functioning which has a major impact on their lives. A large number also become depressed. These consequences of stroke are not given sufficient importance by clinicians. The fact that stroke is a common problem in the elderly, and our society is aging, makes this a problem of major public health significance. In the new proposal, we plan to study these subjects up to 3 years with repeat neuropsychiatric assessments and brain scans to investigate the natural history of stroke-related cognitive impairment. We will determine whether further new cases of dementia develop in the period 1-3 years, what happens to the brain lesions picked up on brain scans, and how these deficiencies affect the patients' living status and their longevity. We will be able to determine the factors that lead to a good outcome, and suggest strategies that may be applicable to improve the functioning of these individuals.Read moreRead less
Vascular Mechanisms Of Neurodegeneration: Drivers And Determinants Of Dementia
Funder
National Health and Medical Research Council
Funding Amount
$6,421,722.00
Summary
The evidence is compelling: vascular burden is the greatest determinant of late life cognition. The volume of evidence linking vascular risk and dementia is conclusive. All late-onset dementia syndromes, especially Alzheimer’s disease, are driven or exacerbated by vascular brain burden. We aim to examine how vascular burden causes dementia. Understanding the mechanisms means that we can prevent and treat the global epidemic of dementia.
Vascular Cognitive Risk Score: Quantifying The Vascular Burden In Alzheimer's Disease
Funder
National Health and Medical Research Council
Funding Amount
$627,180.00
Summary
What causes dementia in a patient presenting to a clinic is often uncertain. While there are exciting potential treatments in the pipeline, we need to understand the cause of the disease in a specific patient to make correct treatment decisions. Stroke and other vascular diseases of the brain cause a significant proportion of dementia in the community. Using MRI scanning technology, this project will quantify this burden in a given patient by developing a ‘vascular cognitive risk' (VCR) score.
An Extended Follow-up Of Stroke Patients For Cognitive Impairment And Neuropsychiatric Disorders: Sydney Stroke Study
Funder
National Health and Medical Research Council
Funding Amount
$321,800.00
Summary
Vascular Dementia (VaD) is the second most common cause of dementia after Alzheimer's disease. In fact, it may be a preventable cause of dementia. Yet it has been relatively neglected by researchers until the last decade, which has seen an upsurge of interest in this disorder. There is no consensus on the criteria for dementia. The profile of early cognitive impairment due to vascular factors is still poorly understood, and the longitudinal course of VaD as defined by modern criteria has not bee ....Vascular Dementia (VaD) is the second most common cause of dementia after Alzheimer's disease. In fact, it may be a preventable cause of dementia. Yet it has been relatively neglected by researchers until the last decade, which has seen an upsurge of interest in this disorder. There is no consensus on the criteria for dementia. The profile of early cognitive impairment due to vascular factors is still poorly understood, and the longitudinal course of VaD as defined by modern criteria has not been studied. There have been few studies of the progressive changes in MRI in patients with cerebrovascular disease. The overlap of VaD and Alzheimer's disease (AD) remains a problem for taxonomists and clinicians. One approach to the study of VaD is to examine a high risk group of subjects longitudinally to determine the early features, the risk factors and progressive changes. With this in mind, we began studying a cohort of stroke patients who are at high risk of VaD, in 1997-1999, and are following them longitudinally. The follow-up is now in its third year, and three neuropsychological assessments and two MRI-MRS scans have been performed. We propose to extend the follow-up to 5 years, with repeat neuropsychiatric, neuropsychological and MRI-MRS investigations, and wherever possible to necropsy, to determine the nature of vascular pathology that underlies cognitive impairment. Our cohort of stroke patients is arguably the most comprehensively assessed such cohorts internationally, and presents an excellent opportunity for a long-term follow-up study.Read moreRead less
Using A National Level Multi-registry Analysis To Determine Whether Prescribed Anti-platelet Therapies Post-stroke Can Modify The Risk Of Cognitive Decline Or Dementia
Funder
National Health and Medical Research Council
Funding Amount
$446,302.00
Summary
Stroke survivors are at risk of dementia. Blood brain barrier damage after stroke may allow drugs in the bloodstream, which can be toxic to brain cells, to enter the brain. Clopidogrel, a drug commonly used after stroke, blocks a receptor essential for brain repair. After stroke, clopidogrel may access the brain and compromise repair processes, increasing the risk of dementia. We will link use of clopidogrel to the risk of dementia after stroke, using national Swedish health registry data.
Using Diffusion MRI For Understanding The Relationship Between Memory Decline And Corticothalamic Tracts
Funder
National Health and Medical Research Council
Funding Amount
$57,578.00
Summary
Stroke populations are at a risk of dementia. Structural changes have been demonstrated to precede cognitive changes, providing a potential for early diagnosis and intervention. Magnetic resonance imaging markers of structural connectivity are powerful predictors of dementia. As a longitudinal study, this proposal has the unique advantage that I will be able to detect changes in post-stroke brain networks in the 3 years after stroke. This raises the potential for future clinical application.
Is Stroke Neurodegenerative? A Longitudinal Study Of Changes In Brain Volume And Cognition Following Stroke
Funder
National Health and Medical Research Council
Funding Amount
$290,946.00
Summary
There is no direct evidence linking Alzheimer’s Disease (AD) and stroke. It is unknown whether stroke can trigger progressive dementia in the same way as AD. In a group of stroke patients, I will measure MRI brain volume and cognition in the 5 years after stroke. These findings will be critical for identification of those patients most at risk of dementia after stroke. This may allow future early intervention for these patients, via promising AD disease-modifying therapies.