Category Archives: Interviews

Interview with a Dementia Researcher: Rory Boyle, Cognitive Neuroscience Researcher

What areas of research are you currently pursuing?

My PhD research is focused on using machine learning to identify markers of cognitive ageing. Currently, I am working on a project which uses machine learning and MRI scans to create a model of normal or healthy brain ageing. This model can be used to estimate how well, or poorly, a person’s brain is ageing and this estimation is termed the brain-predicted age difference, or brainPAD.

It has already been shown that people who have high brainPAD scores (which means their brains are ‘older’ relative to their actual age) have a higher risk of early mortality and tend to perform worse on measures of physical functioning (such as grip strength, lung function, walking speed).

However, we don’t yet know whether brainPAD can be used as a measure of cognitive ageing. If people with high brainPAD scores are shown to perform worse on tests of cognitive function, then brainPAD could potentially be used as a way of identifying such people at a very early stage, before cognitive decline is noticed using standard cognitive tests.

The next project in my PhD will look at developing an objective measure of cognitive reserve. Some people whose brains have the hallmarks of Alzheimer’s disease or other dementias seem to be able to maintain normal cognitive function. This has led researchers to try and understand why some people might have a buffer or some form of protection against certain neurodegenerative diseases. One theory is that people who are able to tolerate such neurodegeneration have high levels of what is called ‘cognitive reserve’.

Cognitive reserve refers to an individual’s ability to use their brain irrespective of their brains’ structural health. It is proposed that life experiences, such as education, occupational attainment, engagement in social, leisure, and mentally stimulating activities, and physical activity contribute to cognitive reserve.

However, currently, cognitive reserve is typically measured by questionnaires and interviews which measure these same factors (education, occupational attainment, etc.). This means that we might not have the most accurate measures, as people might not fully remember all the details of their education or social activities and their answers might be affected by response bias!

My goal is to use neuroimaging to develop an objective and standardised measure of cognitive reserve so that people with low cognitive reserve can be identified. This would allow for interventions to be directed at these people and it would also help in studies evaluating strategies to improve cognitive reserve.

What are the big questions or theories currently being debated in your subfield?

There are a couple of big questions which people are trying to answer in relation to cognitive reserve. Can cognitive reserve be objectively measured, and if so, how? What is the neural basis of cognitive reserve? Hopefully my project will help to shed some light on these questions.

What is a common misconception related to dementia that you often encounter?

One common misconception is that there nothing we can do to reduce our risk of dementia. Given our knowledge of cognitive reserve, one way we could reduce our risk of dementia is by increasing cognitive reserve! There is more and more evidence that taking part in mentally stimulating activities, being socially active, and regularly exercising can lower the risk of dementia. More generally, there is evidence that having a healthy diet, particularly a Mediterranean diet, not smoking, and cutting down on alcohol can also reduce the risk of dementia.

What recommendations would you give to people wanting to reduce their risk of Alzheimer’s disease?

Like a lot of things, the best recommendations for reducing risk of Alzheimer’s disease or other dementias are to live a healthy and active life. Specifically, try to exercise three times a week, particularly aerobic exercise like brisk walking, swimming, cycling. As well as that, try to stick to a Mediterranean diet, which is rich in fruits and vegetables, whole grains, beans and nuts, olive oil and fish.

Be socially active, join a group or club. In Ireland, we have a really great initiative called Men’s Sheds were men can meet up and work together on hobbies and meaningful projects. This is a great example of how people can keep socially engaged. As well as that, take part in mentally stimulating activities like puzzles and Sudoku. If you have access to a PC, there are now thousands of free online courses on websites like Coursera or EdX. By signing up for these, you can challenge yourself and learn something new, all while keeping your brain stimulated!

How can non-scientists contribute to the fight against Alzheimer’s?

Non-scientists could help in the fight against Alzheimer’s by taking part in research. Research studies are always on the lookout for participants. People without Alzheimer’s disease are always needed as well to form control groups. Have a look online or at any nearby universities!

On top of that, there are now even easier ways to take part in research. For example, downloading and playing the SeaHero Quest app allows researchers to collect valuable information about how the brain navigates in space, which is a key skill that declines early on in dementia.

When do you believe a viable Alzheimer’s treatment will be available?

I’m not sure, but I am hopeful that with all of the new techniques we will be able to identify people likely to develop Alzheimer’s or other dementias, earlier than ever before. This will allow for any interventions that can help with Alzheimer’s to be implemented at the early stages of the disease, where interventions are likely to be most specific. It will also help researchers test and monitor the effects of new interventions and treatments.

Is there any other information you’d like to add?

My PhD research is funded by the Irish Research Council, in partnership with Altoida AG. I am very grateful for the support of both of these organisations. Altoida AG has developed an app that uses computerised and gamefied tests of cognitive performance to evaluate perceptual and memory function in older adults. This app may ultimately allow for early screening of mild cognitive impairment and identification of people who are at risk of developing Alzheimer’s disease. We have tested this app on a number of older adults here in Trinity College, and hopefully we will have some interesting data from these tests in the next year!

 

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Rory Boyle is a PhD candidate in the Whelan Lab in Trinity College Dublin. He graduated with a BSc in Psychology from Dublin City University in 2014, and an MSc in Brain Sciences from the University of Glasgow in 2016. His BSc research project compared the effects of aerobic exercise and caffeine consumption on measures of mood and cognitive performance. His MSc research project used EEG to investigate the age-related differences in the visual processing of faces. Specifically, his project examined whether there were differences in the information content of brain activity during the visual processing of faces.

 

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Interview with a Dementia Researcher: Dr. Aida Suarez Gonzalez, Clinical Neuropsychologist

What areas of research are you currently pursuing?

I am a clinical neuroscientist with a strong translational focus. I have a passion for non-pharmacological interventions and evidence-based services to help people to live well with dementia.

What are the big questions or theories currently being debated in your field?

The development of new multicomponent functional interventions in dementia (such as disease education, counselling, goal-setting, goal-oriented cognitive rehabilitation, coping strategies training, etc.) is a hot topic. These interventions have the potential to increase autonomy, quality of life, and mental health in patients and families.

Another big concept is the need to develop more suitable methods to produce high quality evidence in support of non-pharmacological interventions. The traditional methods used in classic drug trials do not always makes sense when applied to non-pharmacological approaches.

I am also interested in the introduction of a new generation of purpose-built assistive technologies (such as specific communication aids, adapted e-readers, memory aids, etc.). These tools are revolutionizing the way we provide support, so people can remain independent for longer. IDEAL and GREAT are two examples of programs that support the concept of living well with dementia.

What is a common misconception related to dementia that you often encounter?

There are two big misunderstandings that particularly trouble me because they produce undesirable consequences when a diagnosis of dementia is provided.

First, we always highlight that dementia is not a natural part of aging, that it is a disease. However, we usually forget to add that this is a very common disease in old age and that we, as longer-living societies, have lived with age-related diseases for centuries (and hey, here we are after all).

I don’t mean we should belittle the seriousness of dementia, but rather encourage more acceptance and reconciliation with life and trust in the resilience of what we human beings are capable of. I think this way of thinking moves the focus from the frustration of the current absence of a treatment to reflecting on what we can do to live well with the disease. And of course this way of seeing things is not incompatible with increasing research efforts towards finding a cure.

Secondly, calling the dementias “dementias” contributes the stigma and misunderstanding of the disease. In many societies across the world, the word dementia means losing yourself, your reasoning, judgement, understanding and contact with reality. And this is not true. This is a false and unfair misconception that every day strips millions of people around the world from their social roles and right to decide about their lives, and exposes them to patronization.

Of course, advanced stages of the disease do impair your thinking skills severely, but this is not the case in the early and even moderate stages (that can last for many years) and it also depends a lot on the dementia subtype that you have. With the right support, many people with progressive cognitive impairment can lead fairly independent lives for a long time.

Look for example at the UK Network of Dementia Voices, which is a community of 100 groups of people living with dementia that seeks to magnify their own views, make their voices being heard and pressure the public administration to include their advice in matters that affect them.

The same applies to the 3 Nations Dementia Working Group, who are a powerful group of people living with dementia transforming the way we perceive dementia and progressive cognitive impairment by making an extraordinary contribution to society through education and raising awareness. They do public speaking, provide input to public policy bodies and bring value, advice and information about what is like the experience of living with dementia. They have dementiayes, and also they are inspiring, powerful and they are transforming the world.

What recommendations would you give to people wanting to reduce their risk of Alzheimer’s disease?

There is quite a lot of scientific consensus around the main preventive measures: healthy diet, good control of vascular risk factors such as cholesterol, diabetes and hypertension, regular physical exercise, remaining mentally active, and maintaining strong and good quality social bonds and social networks.

How can non-scientists contribute to the fight against Alzheimer’s?

The lay public can make a powerful contribution by trying to educate themselves about dementia, understanding better the changes experienced by a person with the disease, and committing to contribute towards a more dementia-friendly society.

For example, if you run a fruit shop in a neighborhood with an aged population, it’s very likely that some of your clients may be living with memory problems. You can seek information to educate yourself to understand better what that means and place a sign in your shop window explaining that this is a “memory problems friendly shop” and that people can come and speak to you about how to better support them to continue doing their shopping safely and independently.

When do you believe a viable Alzheimer’s treatment will be available?

I wish I had a response for that and I wish that response was “soon.” However, it is possible that we still have to live with Alzheimer’s in our lives for a long time, so I would encourage researchers and policy-makers to double efforts on finding a treatment, but also on helping us having good, purposeful, meaningful and fulfilling lives even if carrying a diagnosis of Alzheimer’s. There is a lot of life beyond the diagnosis, let’s also embrace that and make the best of it.

Is there any other information you’d like to add?

I would like to encourage other scientists to join a movement for change that focuses more on people and less on the disease, at least in the case of the diseases for which a cure has not been found yet. We hardly have any relevant tools to use in clinical studies to measure the impact of non-pharmacological interventions on people’s real lives and this needs to change. Current methods in this area are so quantitatively constrained and disease-oriented that allow little flexibility and, their resulting scientific outputs are usually difficult to translate into clinically practice.

 

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Dr. Aida Suarez Gonzalez is a clinical neuropsychologist at University College London’s Dementia Research Centre. She earned her Masters degrees in Gerontology and Clinical Neuropsychology, as well as her PhD in Neuropsychology, from the University of Salmanca in Spain.

 

 

 

 

 

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