Theme 2: Treatment

Aims to improve diagnosis and treatment of dementia

 

  • Team 6: Sleep and Dementia is working to better understand how poor sleep and circadian rhythms contribute to dementia, and how effective sleep and circadian rhythm-based interventions can build brain resilience and prevent cognitive impairment and decline. Led by Drs. Thanh Dang-Vu and Andrew Lim, the team is using wearable devices to measure sleep in hundreds of older adults, and relating this data to cognition, brains scans, and other dementia biomarkers. This will help the team to understand key mechanisms linking sleep to dementia. The team is also testing if interventions to improve sleep and sleep physiology can improve cognition and prevent (or perhaps even reverse) dementia-related brain changes. Leading to new approaches to leverage sleep and circadian rhythms, this work has the potential to impact the health of millions of Canadians at risk for, or living with, Alzheimer’s disease and related dementias.

 

  • Team 7: Vascular Illness and its Impact on Neurodegenerative Diseases is led by Drs. Eric Smith and Bojana Stefanovic. This team includes 18 basic and clinical researchers who are working together to translate discoveries about vascular disease into therapeutic treatments for vascular cognitive impairment (VCI). In some cases, VCI may be caused by a symptomatic stroke that causes paralysis or speech loss. More subtly, it shows up as concentration or memory problems that result from damage to the brain from extended periods of hypertension (i.e. abnormally high blood pressure), metabolic syndrome, or multiple subtle strokes. Specifically, the team is: (1) developing a new understanding of the disease process of VCI in animal models of vascular risk and vascular disease (including testing new therapies); (2) defining brain images and blood biomarkers of the earliest VCI changes in human beings; and (3) using this information to conduct a clinical trial of a new therapy called remote ischemic conditioning in people with early stage VCI.

 

  • Team 8: Lewy Bodies, Aging, and Dementia is led by Dr. Richard Camicioli, who focuses on the diagnosis and treatment of dementia and Parkinson’s disease. This team includes movement disorder programs from across the country, as well as cognitive programs that care for people living with Lewy body disorders (LBD). The diversity of these programs ensures that the full range of people living with LBD are recruited to participate in the research projects undertaken. The role that differences (heterogeneity) plays in diagnosis and prognosis in LBD is being examined using fluid biomarkers, genetic markers, clinical assessments (including non-motor symptoms, cognitive, and gait measures), and neuro-imaging. In addition, the impact that cognitive resilience, reserve, frailty, and co-morbidity have on an individual’s observable characteristics, diagnosis, and prognosis is being examined. Current projects are in-progress based on collaborations with Team 7 (Vascular); Team 9 (Biomarker); Team 12 (Mobility, Exercise, and Cognition); Team 13 (Frontotemporal Dementia); and Team 14 (Multi-morbidity). Given the sex differences in LBD – compared with other dementias – a central consideration in our analyses is women, gender, and sex through the CCNA’s WGSD program.

 

  • Team 9: Biomarkers in Aging and Neurodegeneration is led by Drs. Roger A. Dixon and M. Natasha Rajah. This team is an active collection of over 30 Canadian investigators who contribute varied interests and complementary approaches to biomarker research in aging and neurodegenerative disease. We promote synergies and collaboration across a spectrum of biomarker domains and expertise. This spectrum includes neuroimaging, neurobiology, neurocognitive and neuroinformatics modalities. Accordingly, Team 9 endorses a range of approaches to biomarker discovery and validation, including hypothesis-guided, interaction/network-targeting, data-driven, and multi-omics designs. A leading aim of Team 9 is to foster collaborative research that implements emerging technologies such as machine learning, data mining, connectomics, metabol/lipidomics, genomics, trajectory analyses, heterogeneity, and precision subtype discovery. We support enhanced consideration of sex and gender, as well as research that features diverse aging-related risk and protection influences on brain health, resilience and dementia..

 

  • Team 10: Cognitive Intervention, Reserve and Brain Plasticity is led by Drs. Sylvie Belleville and Nicole Anderson. This team aims to advance knowledge about how cognitive reserve and brain plasticity prevent or delay age-related neurodegenerative diseases, to develop training programs to increase resilience, and to bring them to the community in order to make them accessible to all segments of the population. Specifically, team members are contributing to a deeper understanding of the mechanisms by which some people are more resistant than others to the effects of aging, as well as the individual characteristics that make some people more responsive to cognitive training. They have created a program that combines training in memory and attention strategies with stimulating leisure activities (e.g., learning music, learning a second language, watching documentaries, and playing active video games). Participants’ brain structures and functions, cognition, and well-being are being measured immediately before and after training, and then again 2 years later to assess the long-term maintenance of benefits. Moreover, the team is developing strategies to make cognitive training programs accessible to most Canadians by finding ways to distribute them to the community and using new technologies (such as virtual reality or online platforms) to distribute those programs to remote communities. Finally, they are piloting some multi-domain cognitive programs (including cognitive training, leisure activities, physical exercise, and nutrition advice) that can be customized to meet individual needs.

 

  • Team 11: Prevention and Treatment of Neuropsychiatric Symptoms is led by Drs. Nathan Herrmann, Krista Lanctôt, and Dallas Seitz. Working in collaboration with researchers across Canada, they have created the first long-term care (LTC) research consortium, comprised of 20 facilities and spanning 7 provinces. This research consortium has been used to examine educational, pharmacological, and non-pharmacological interventions aimed at preventing and treating neuropsychiatric symptoms (NPS) and minimizing their severity, duration, and impact among residents with dementia in LTC settings. In the CCNA’s second phase, the team aims to identify novel drugs for the treatment of NPS among LTC residents; create an online dementia education course for family doctors (with a focus on identifying, diagnosing, and managing NPS); and continue funding pilot projects in LTC and outpatients with NPS, with greater emphasis on preventing disability.

 

  • Team 12: Mobility, Exercise, and Cognition is led by Drs. Manuel Montero-Odasso and Louis Bherer. The MEC team focuses on the relationship between physical activity, motor performance, and cognitive decline related to aging and neurodegeneration. Throughout the aging process, motor and cognitive decline often interact because of the common brain networks they share. Aging-associated or disease-driven changes damage these brain networks. This, in turn, affects motor learning and control, memory, executive function, and gait and balance. More importantly, motor and cognitive decline are key risk factors for dementia, falls, fractures, and future aging-related disabilities. Specifically, the MEC team is studying the interaction and expression of cognitive and motor decline during the course of neurodegenerative diseases. Their findings will then be translated into innovative exercise-based interventions. To date, MEC has had several notable accomplishments, including the SYNERGIC Trial (SYNchronizing Exercises and Remedies in GaIt and Cognition). This trial is a flagship multi-site and multi-domain interventional study aimed at testing the efficacy of combining multimodal physical exercise with cognitive training and vitamin D supplementation to improve cognition in people with mild cognitive impairment (MCI), a pre-dementia state. This cutting edge trial will help to identify if multi-domain interventions can postpone the progression from MCI to dementia.

 

  • Team 13: Frontotemporal Dementia is led by Drs. Elizabeth Finger and Simon Ducharme. This team examines the factors that cause dementia, with a particular focus on atypical and young onset dementia. Specifically, team members explore new laboratory and imaging techniques to help identify and distinguish the various types of dementia at their earliest stage. Further interests include investigating new techniques to treat different types of dementias at different stages.
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