Early Intervention For Amnestic Mild Cognitive Impairment : A Randomised Trial Of Memory Management
Funder
National Health and Medical Research Council
Funding Amount
$577,556.00
Summary
It is increasingly recognised that Alzheimer’s disease can emerge slowly over years and persons presenting with memory impairment, or mild cognitive impairment (MCI), are at increased risk of developing Alzheimer’s disease. Following diagnosis of MCI, active management through symptomatic drug treatment remains equivocal, therefore, memory impairment continues to be troublesome and patients and families are seeking interventions that offer improvement in quality of life. Cognitive interventions ....It is increasingly recognised that Alzheimer’s disease can emerge slowly over years and persons presenting with memory impairment, or mild cognitive impairment (MCI), are at increased risk of developing Alzheimer’s disease. Following diagnosis of MCI, active management through symptomatic drug treatment remains equivocal, therefore, memory impairment continues to be troublesome and patients and families are seeking interventions that offer improvement in quality of life. Cognitive interventions are low cost and, where effective, can provide a stand-alone intervention or add value to the pharmacological approach. The primary aim of this study is to evaluate whether an early intervention program of memory training is effective in improving use of memory strategies in everyday life, and whether this has psychological and emotional benefits for individuals with MCI and their families. We will evaluate through a randomised controlled trial the efficacy of a memory-group program which will involve the family and patient, rather than just the person with MCI, in developing increased awareness of memory issues and specific strategies to prevent memory failures. Over successive cohorts recruited from memory clinics, families will be randomly assigned to either an immediate intervention or a delayed intervention (waiting-list control) group. We will also recruit a sample of healthy older adults who will be similarly randomised into early and late intervention groups. Healthy older adults will provide a means of establishing whether any improvements in the MCI groups are (i) to the same extent as healthy older adults and (ii) to normative levels. Evaluation will be at pre- and post-intervention and at six months follow-up on tests of memory, questionnaires of knowledge and use of memory strategies in everyday life, and appraisal of level of wellbeing. Information about memory and systematic training in compensatory memory skills are expected to significantly improve the capacity of patients and families to cope with everyday memory difficulties. Through active participation in the management of memory impairment, it is expected that the level of wellbeing will increase, for both patient and families.Read moreRead less
The Role Of Metabolic And Inflammatory Factors In Cognitive Decline And Cerebrovascular Pathology In The Elderly
Funder
National Health and Medical Research Council
Funding Amount
$945,987.00
Summary
Metabolic factors and measures of inflammation in the body have recently been shown to influence mental function and increase the risk of developing age-related disorders such as Alzheimer’s disease. The influence metabolic factors and inflammation have on function of the ageing brain is likely to be determined by complex interplay between many factors, such as physical health, lifestyle, nutrition and our genes. By studying these factors and how they relate to one another in large groups of eld ....Metabolic factors and measures of inflammation in the body have recently been shown to influence mental function and increase the risk of developing age-related disorders such as Alzheimer’s disease. The influence metabolic factors and inflammation have on function of the ageing brain is likely to be determined by complex interplay between many factors, such as physical health, lifestyle, nutrition and our genes. By studying these factors and how they relate to one another in large groups of elderly individuals, we will be able to determine the role these factors play in brain ageing. In addition we will be able to determine an ‘at risk’ profile for elderly individuals for accelerated ageing effects. Identification of this profile is important as it will allow the development of interventions which may prevent or delay the onset of cognitive decline in late life. We plan to study the impact of metabolic and inflammatory factors on brain ageing and in two groups of elderly individuals both of which are currently being studied in detail by our research team. By using these existing groups we will minimize the costs associated with our research, but maximize the research benefit and the benefit to society. Our groups include a large community sample of elderly individuals aged 70-90 years and a large group of elderly twins aged over 65 years. Our use of twins for the study is particularly important as it will help us separate genetic and environmental influences on the measures. We will measure multiple metabolic and inflammatory factors in the body and determine their relationship to detailed tests of cognitive function and to cerebrovascular pathology on brain magnetic resonance imaging. We will look at how these factors relate to one another and which factors are most strongly associated with accelerated ageing. We will be able to follow subjects in each group over a 2 year interval to see which factors most strongly predict change in cognitive function and cerebrovascular pathology over time. Our research is unique in its inclusion of multiple factors which may affect brain ageing, its ability to look in detail at the contribution of genetic influences on metabolic and inflammatory factors, and in our planned follow-up of these individuals.Read moreRead less
Investigation Of Neural Mechanisms Of 670 And 830nm Laser Acupuncture In Pain Relief, Using Rat
Funder
National Health and Medical Research Council
Funding Amount
$326,207.00
Summary
Background Chronic pain is common and costs $10 billion dollars per year in Australia. Drug therapies are widely used but serious side effects limit use. Patients actively seek non-drug treatments and laser acupuncture is one of the most commonly sought therapies for chronic pain, however, how it works is not well understood. Our previous work Researchers propose that laser acupuncture reduces pain by direct effects on nerves, altering how pain signals are transmitted to the brain. To investigat ....Background Chronic pain is common and costs $10 billion dollars per year in Australia. Drug therapies are widely used but serious side effects limit use. Patients actively seek non-drug treatments and laser acupuncture is one of the most commonly sought therapies for chronic pain, however, how it works is not well understood. Our previous work Researchers propose that laser acupuncture reduces pain by direct effects on nerves, altering how pain signals are transmitted to the brain. To investigate this we (CI A and CI B) previously undertook a study of infrared laser on nerve cell cultures. This followed on from a positive clinical study with the same laser wavelength in the treatment of neck pain, undertaken by CI B. We established that laser temporarily interrupts the nerve transport system, which is made up of a series of minute tubes, called microtubules. These act as a “monorail” system for transport of mitochondria, which provide energy for all nerve functions. We propose that temporary interruption of this system, called fast axonal transport, disrupts the conduction of pain signals along the nerve, resulting in pain relief. Important unanswered questions The mechanism by which 830nm laser acupuncture relieves pain clinically remains poorly understood. For its acceptance into mainstream clinical practice it is important to determine the effect of laser on the peripheral nerves and in particular the pain carrying fibres. We know from an earlier study that a single exposure causes significant but reversible changes in pain fibres including axonal microtubule disruption, decrease in mitochondrial membrane potential and block of fast axonal flow. These events would result in conduction failure. The question is whether the repeated irradiations, comparable to those delivered clinically result in the same changes. This would provide a scientific basis for understanding the clinical effectiveness of laser acupuncture. We also do not know if 670nm laser acupuncture would act in the same way. There is evidence that this may be more effective so that this remains another important unanswered question. Further, there is no evidence regarding which wavelength would be cost and time effective as it is desirable to deliver lower dose. We need to determine the most effective dose and wavelength so that clinical trials could be carried out as was done for the trials by CIB (Chow and Barnsley, 2006).Read moreRead less
Evaluation Of Combination Nutritional Supplement Therapies In The Prevention Of Alzheimers Disease In
Funder
National Health and Medical Research Council
Funding Amount
$484,675.00
Summary
Age-related diseases are becoming a major concern as the world’s population grows older due to advances in medical technology, health and nutrition. Dementia accounts for a large proportion of agerelated diseases and is characterised clinically by deterioration in memory and cognitive processing. AD is the most common form of cerebral degeneration leading to dementia. Currently over 200,000 Australians suffer from dementia, with AD, accounting for 50-70% of all cases. At this rate, the number of ....Age-related diseases are becoming a major concern as the world’s population grows older due to advances in medical technology, health and nutrition. Dementia accounts for a large proportion of agerelated diseases and is characterised clinically by deterioration in memory and cognitive processing. AD is the most common form of cerebral degeneration leading to dementia. Currently over 200,000 Australians suffer from dementia, with AD, accounting for 50-70% of all cases. At this rate, the number of people in Australia with dementia will increase to 730,000 by the year 2050. Thus, there is an urgent need for effective preventative treatments for this devastating disease, as dementia will soon be the major cause of disability in Australia. As a result, the social and economic consequences of this disease present a significant challenge to society, and it is imperative that strategies to prevent or delay the onset of AD are developed. If complimentary and alternative medicine (CAM) therapies could be developed to prevent or delay the onset for Alzheimer’s disease, the impact on disease burden could be substantial. However, these CAM therapies need to be critically evaluated for their mechanisms, efficacy and safety before human clinical trial are undertaken. The proposed research plan will evaluate the efficacy of the nutritional supplements of polyphenols (EGCG from green tea and curcumin), omega-3 essential fatty acids (docosahexaenoic acid) and lipoic acid to determine whether these treatments in combination offer preventative therapies for AD. The findings from the current study will provide important information concerning the effects of combination supplements in preventing cognitive deficits and AD pathology in a transgenic mouse model. Combination treatments may reduce cognitive deficits (memory and learning), oxidative stress and AD pathology, thereby providing an important insight into possible CAM preventative treatment strategies for AD. The development of effective preventative strategies for the treatment of AD is critical if we are to reduce the number of people that are expected to develop AD over the next 50 years, due to the rapidly aging population. The outcomes of this research may provide disease modifying therapies for the prevention of AD.Read moreRead less