One year in: Update on major Alzheimer’s study ‘PISA’
QIMR Berghofer Medical Research Institute is trying to crack one of medicine’s most challenging mysteries: can we detect who is going to develop dementia and what warning signs do we need to look out for?
Professor Michael Breakspear, Dr Christine Guo and Professor Nick Martin are now partway through the five-year Prospective Imaging Study of Ageing (PISA) project. They have already registered about 60 participants to complete the initial sequence of testing.
Participants in the study are currently taking part in cognitive and genetic tests, magnetic resonance imaging (MRI) and positron emission tomography (PET) imaging to help pinpoint the markers that might be indicators of developing the disease.
The study includes a new imaging module, which tests the memories of participants as they view a series of news clippings. Previously, traditional approaches required participants to memorise and recall very abstract pieces of information or isolated words and faces.
‘The results from the news viewing experiments are really encouraging,’ Dr Guo said.
‘We’ve found the rich emotional and natural flavour of the news clips evokes the memory processes more robustly than traditional tasks used to study memory in the MRI scanner.
‘Our hope is this will allow us to more effectively capture the subtle memory deficits of someone who is in the very earliest stages of Alzheimer’s disease,’ she said.
Bronwyn Ferrier, 65, is a participant in the study and has completed the first round of MRI and PET scans, plus the memory and cognitive skills tests last year.
‘I did really well at the news snippets testing in the MRI session. I scored quite high on that, having high recall, probably because I’m a bit of a news buff,’ Bronwyn said.
Bronwyn describes other elements of the testing involved: recalling names of a spoken list of 20 objects; reading names of colours written in a different colour; and finishing sentences with one word that has no relevance to the sentence, to determine how responsive the brain is to swapping thought processes.
‘At first, I was really concerned with getting the right answer, but then they explained that it’s all personal testing and that my own baseline results will be used to see if there’s any degeneration in about five years’ time,’ Bronwyn said.
The overall objective of the five-year study is to develop an algorithm that will enable early detection of Alzheimer’s disease—identifying people who are at a higher risk of developing the disease while they are still young and healthy.
‘While the burden of dementia in Australia occurs late in life, it’s likely that the underlying brain disease starts decades prior to the first symptoms,’ Professor Breakspear said.
Bronwyn, living on the Gold Coast, remembers that she really had to deliberate before signing up to participate in the Brisbane-based study.
‘Then I thought, they need healthy people to get involved in medical research, and I’ve had close contact with my husband’s mother having Alzheimer’s, which was a very difficult time. So I feel proud to do my little bit.’
Alzheimer’s disease remains an enormous burden on Australian society, with devastating consequences for everyone involved—those living with it, as well as their families and carers. There is nothing more heart breaking than a loved one forgetting who you are, how you fit into their life and the memories you created together.
‘With growing effort being made in preventative programs, early intervention will allow us to identify at-risk individuals and start working with them sooner to delay the disease,’ Dr Guo said.
‘We want to develop ways to identify those people at the very earliest stage of the disease, before permanent and often irreversible damage to the brain takes place,’ Professor Breakspear said.
1 May 2018.