NeuRA Magazine #22

Dementia Research

PREVALENCE OF DEMENTIA IN INDIGENOUS COMMUNITIES

Research led by Prof Tony Broe and Dr Kylie Radford has highlighted the high prevalence of dementia, particularly Alzheimer’s disease, in Aboriginal communities. We are working towards understanding the causes of cognitive decline and dementia, building capacity in dementia care and supporting Aboriginal family carers, and developing culturally appropriate strategies to promote healthy brain ageing.

The next decade will see a dramatic increase in the number and proportion of older people within the Aboriginal and Torres Strait Islander population. Close to 80% of these older people live in regional and urban parts of Australia (a third in our major cities). Recently, the Koori Growing Old Well Study (KGOWS) has shown that dementia prevalence in Aboriginal Australians across NSW is three times higher than the overall Australian population, at ages 60 years and older.

What is it that helps one person age successfully, and causes another to develop age-related diseases like dementia? Scientifically, we know too little about normal ageing and what factors influence some people, and not others, to develop diseases that affect the brain. Only by studying healthy elderly people, as well as those with problems, can we know what normal ageing looks like and learn more about staying healthy as we age. In collaboration with our Aboriginal community partners, our rigorous population- based approach allowed us to accurately assess the prevalence of dementia, not just those already ‘in the system’ and seeking treatment or care.

NeuRA’s Aboriginal health and ageing team, with collaborators, are now conducting a follow-up study (KGOWS-II) to determine the social and biomedical risk and protective factors for dementia across the lifespan. In 2016, NeuRA also initiated the Koori Active and Healthy Ageing Project. This research will develop effective, culturally appropriate, and accessible strategies to promote vitality and healthy brain ageing and prevent dementia in Aboriginal communities. This research is supported by NeuRA’s ongoing Koori Dementia Care Project, which aims to build capacity in dementia understanding and care with Aboriginal community controlled and mainstream service providers.

As one older Aboriginal participant observed: “Healthy ageing is your mind staying young”.

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Cortical activity during balance tasks in ageing and clinical groups using functional near-infrared spectroscopy

Prof Stephen Lord, Dr Jasmine Menant Walking is not automatic and requires attention and brain processing to maintain balance and prevent falling over. Brain structure and function deteriorate with ageing and neurodegenerative disorders, in turn impacting both cognitive and motor functions.   This series of studies will investigate: How do age and/or disease- associated declines in cognitive functions affect balance control? How is this further impacted by psychological, physiological and medical factors (eg. fear, pain, medications)? How does the brain control these balance tasks?     Approach The experiments involve experimental paradigms that challenge cognitive functions of interest (eg.visuo-spatial working memory, inhibitory function). I use functional near-infrared spectroscopy to study activation in superficial cortical regions of interest (eg. prefrontal cortex, supplementary motor area…). The studies involve young and older people as well as clinical groups (eg.Parkinson’s disease).   Studies Cortical activity during stepping and gait adaptability tasks Effects of age, posture and task condition on cortical activity during reaction time tasks Influence of balance challenge and concern about falling on brain activity during walking Influence of lower limb pain/discomfort on brain activity during stepping   This research will greatly improve our understanding of the interactions between brain capacity, functions and balance control across ageing and diseases, psychological, physiological and medical factors, allows to identify targets for rehabilitation. It will also help identifying whether exercise-based interventions improve neural efficiency for enhanced balance control.
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