Calgary's Dementia Research: Brain Aging, Cognitive Clinic, and Exercise, Slides of Geriatrics

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Dementia Research Activities

in Calgary

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Objectives

• At the end of the learning session,

participants will be:

• Able to describe the Healthy Brain initiative of the Faculty of Medicine
• Informed of the rationale of a number of on- going studies that might be of interest to patients seen in Seniors Health and how to refer patients for consideration
• Will not be discussing industry-sponsored trials or other studies (e.g., PHAC Dementia Systematic Review on Incidence and Prevalence)

Healthy Brain Aging

• Being led by Dr. Samuel Weiss/ Hotchkiss Brain Institute but also involves Libin Cardiovascular Institute, Brenda Strafford Centre on Aging, Seaman Family MR Research Centre, and others
• Combine activity in three research areas - aging, cognition, and cerebral blood flow – and five endowed Chairs (Alzheimer’s disease, geriatric medicine, Parkinson’s disease, stroke, vascular dementia)

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Cognitive Assessment Clinic

• Historically was the site and/or source (of

patients) for clinical cognitive research

• Site specific
• Multi-site studies
  • A Canadian COhort study of cognitive impairment and Related Dementias (ACCORD)
  • Consortium to Investigate Vascular Cognitive Impairment (CIVIC)
  • Canadian Outcomes Study in Dementia (COSID)
  • C5R drug trials (source of patients/ HMRC)
  • Others (next slide)

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Early versus Late Onset Dementia Study

• Principal Investigator: Eric Smith
• Co-investigators: Drs. Theresa Green, David Hogan, Dawn Pearson, and Pamela Roach
• Funded by C5R/ approved by CHREB
• Primary purpose
  • Identify the needs of people with early onset dementia (< 65 years of age) - Inform age-specific quality of life measures - Inform development of support strategies for patients and caregivers
• Compare with late onset dementia

Early Onset

• Estimated 70,000 people under the age of

65 in Canada with a dementia (2,200 in

Calgary)

• More likely employed outside home, have

dependent children, significant financial

burdens and more physically fit/ active

• Caregivers more likely working outside

home

• Need to better define their particular needs

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Study Methods

• Data abstracted from charts/ registry
• Individual and focus groups
  • 40-60 minutes (done concurrently); interview guide (broad and focused questions)
  • Using TRW/? telephone
  • Focus groups later – 6-8 per group
    • Realize might be challenge with dementia groups if at moderate or severe stage
• 8-10 EOD and LOD dyads
  • Stop if see strong repetition/ redundancy

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Effects of Regular Exercise on Cerebrovascular Reserve in Older Adults: Role in the Prevention of Age-Related Cognitive Decline

Principal Investigator: Dr. Marc Poulin

Co-Investigators: Dr. Gail Eskes (Dalhousie University), Dr. Christine Friedenreich, Dr. Michael Hill, Dr. Eric Smith, Dr. David Hogan and Dr. Stewart Longman

Collaborators: Dr. Todd Anderson, Dr. Richard Leigh, Dr. Wayne Giles

Trainees: Dr. Margaret Davenport (HSFC PDF), Dr. Genevieve Arsenault (AIHS PDF), Amanda Tyndall (PhD student)

Prior Work

• Cross-sectional study – 42 women (mean age
• Compared fit/ active versus sedentary
• Lower mean arterial pressure and higher cerebrovascular conductance during exercise and hypercapnic challenges
• Improved cognitive performance in fitter subjects
  • Neurobiol Aging 2010, 31:2047-

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EXERCISE TRAINING INTERVENTION CEREBROVASCULAROUTCOMES COGNITIVEOUTCOMES Aerobic exercisetraining 3x / week for six months

Resting CBF, CVC,CVR, MAP Cerebrovascular Reserve CBF, CVC, CVR, MAP responses to CO 2 and exercise

Overall Cognition Executive function Complex attention Verbal & visual memory^ Processing speed Visual-spatial processing Verbal reasoning

INDIVIDUAL CHARACTERISTICS(COVARIATES) Education^ Age Socio-economic statusOvarian hormones Free testosterone BMI Blood pressure

SUMMARY (^) Current Directions

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Aim to enroll 250 participants (125 men/ 125 women); staggered – starting in November 2009 and ending in July 2012; complete data collection by December 2013. Current number: 146 participants (89 female, 57 male) The study is supported by the Canadian Institutes of Health Research (CIHR) of $673,925 + an industry partner (Polar Electro) who has provided some equipment (in kind).

Outline

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• Age 55-
• 3 – 6 month phases (total 18 months)
• At 0, 6, 12 & 18 months:
  • Aerobic capacity (VO2 max testing)
  • CBF and cerebrovascular reserve
  • Cognition
  • Blood sampling

Study Overview

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Research Registry for Persons with Memory Symptoms

Setting

• Cognitive Neurosciences Clinic.
• Psychiatry clinics at PLC (Dr. Z. Ismail).
• Participation by other memory

clinics/specialists welcome.

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Research Registry for Persons with Memory Symptoms

Design

• Standardized forms for H+P and

diagnosis.

• Prospective written consent.
• Funding from donation to Hotchkiss Brain

Institute.

• Ethics approved.