Theme 1: Prevention

Focused on the underlying mechanisms and prevention of dementia

• Team 1: Clinical Genetics and Gene Discovery is led by Dr. Peter St. George-Hyslop, whose lab discovered 9+ new genes associated with Alzheimer’s disease.

• Team 2: Inflammation & Nerve Growth Factors is led by Dr. Claudio Cuello, who leads a research team working on the multidisciplinary aspects of brain repair and brain aging.

• Team 3: Protein Misfolding is led by Dr.  Neil Cashman, who oversees two labs dedicated to investigating why misfolded proteins cause disease in surrounding cells (such as Alzheimer’s and Parkinson’s).

• Team 4: Synapses & Metabolomics is led by Dr. Robert Bartha, who develops unique MRI methods to observe diseases of the human brain and body with the objective of producing new insights to improve patient care.

• Team 5: Lipid & Lipoprotein Metabolism is led by Dr. Cheryl Wellington, who focuses on genetic and environmental risk factors for dementia by examining lipid and lipoprotein metabolism in the brain.

• Team 6: Nutrition, Exercise and Lifestyle in Alzheimer’s Disease Prevention is led by Dr. Carol Greenwood, whose studies aim to identify nutrition strategies that support optimal cognitive function with aging. Specifically, Greenwood and her team study the relationships between lifelong dietary patterns, risk of cognitive decline with aging, and how diet-associated vascular and metabolic disorders affect this decline. Greenwood’s team is set to launch a clinical trial exploring the effects of diet and exercise on the brain’s structure and its cognitive performance. The study will include older adults who have subjective cognitive decline (i.e. self-reported perception of memory or cognition problems) and vascular risk factors. These groups have been targeted because they are at high risk for both Alzheimer’s disease and vascular dementias (and their combination), but are still performing cognitively within a normal range. Individuals within these groups can also experience lifestyle-associated risk factors (including obesity, high blood pressure and cholesterol, insulin resistance, and type 2 diabetes) which can each be managed through better lifestyle choices. Simply put, early diet and lifestyle interventions may be most effective within these groups. To learn more, click here.

Theme 2: Treatment

Aims to improve diagnosis and treatment of dementia

• Team 7: Vascular Illness and its Impact on Neurodegenerative Diseases. Led by Drs. Eric Smith and JoAnne McLaurin, this team includes 17 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 is evident as a symptomatic stroke that causes paralysis or speech loss. More subtly, it shows up as concentration or memory problems that result from extended periods of hypertension (i.e. abnormally high blood pressure), metabolic syndrome, or multiple subtle strokes that appear in functional imaging scans as deficits in the brain and its blood vessels. 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 plan clinical trials in people with early stage VCI. To learn more, click here.

• 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.

• Team 9: Developing New Biomarkers is led by Drs. Roger Dixon and Pierre Bellec. This team is an active and growing collection of Canadian investigators who contribute varied interests and complementary approaches to biomarker research in aging and neurodegenerative disease. We promote connectivity and integration across a spectrum of biomarker domains and expertise. The spectrum ranges across neuroimaging, neurobiology, neurocognitive and neuro-quantitative modalities. In addition to hypothesis-guided biomarker research, Team 9 features data-driven single-omics and multi-omics approaches to biomarker discovery and validation.  As such, Team 9 collaborative research coordinates and implements emerging technologies such as machine learning, data mining, connectomics, metabolomics, genomics, trajectory analyses, and precision subtype discovery.

• Team 10: Cognitive Intervention, Reserve and Brain Plasticity. Led by Dr. Sylvie Belleville, this team aims to better understand how cognitive reserve and brain plasticity protect against age-related neurodegenerative diseases, and to develop strategies to increase resilience. Specifically, they are creating and testing a cognitive training program that will support cognitive health in people with subjective cognitive decline (i.e. a self-reported perception of memory or cognition problems). The program combines training in memory and attention strategies with stimulating leisure activities (e.g. learning music, learning a second language, and playing active video games). Participants’ brain structure and function, cognition, and well-being will be measured immediately after training, and then again two years later to assess the long-term maintenance of benefits, as well as the protective effects the intervention has against age-related decline. For this study, the researchers are keen to recruit as many participants as possible with a lower level of formal education. Those individuals are known to have a higher risk of developing dementia, and are thus likely to benefit considerably from this type of intervention. In addition, the study will identify the best responders by examining whether individual characteristics – for instance, genotype, sex, or cognitive lifestyle – predict better effects.

• Team 11: Prevention and Treatment of Neuropsychiatric Symptoms is led by Drs. Nathan Herrmann, Krista Lanctôt, and Dallas Seitz. Nathan Herrmann’s primary contribution to dementia research is in the area of the treatment of behavioral disturbances and cognition. Krista Lanctôt studies how dementia influences emotions and moods, and how they may be better managed. Dallas Seitz’s research examines how older adults with psychiatric disorders use health services, evaluates the safety and effectiveness of treatments for geriatric mental health conditions, and carries out knowledge translation in geriatric mental health.

• Team 12: Mobility, Exercise, and Cognition Led by Drs. Manuel Montero-Odasso and Louis Bherer, the MEC team focuses on the relationship between physical activity, motor performance, and cognitive decline in aging and neurodegeneration. During aging, motor and cognitive decline often interact because of the common brain networks they share. Aging-associated, or disease-driven changes in these networks therefore have consequences for motor learning and control, memory, executive functions, gait, and balance in older adults. More importantly, motor and cognitive decline are key risk factors for dementia, falls, fractures, and future 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 have had several notable accomplishments, particularly with regards to their CIHR/CCNA SYNERGIC Trial (SYNchronizing Exercises and Remedies in GaIt and Cognition). The SYNERGIC Trial is being conducted by their cross-Canada research team, and aims to identify the effects of a combination of physical, motor, and cognitive exercises on cognitive and motor decline. To learn more, visit http://synergictrial.com/.

• Team 13: Frontotemporal Dementia is led by Dr. Robin Hsiung, who examines the factors that cause dementia, and explores new lab and imaging techniques to help identify and distinguish the various types of dementia at the earliest stage. Another focus of his research is using clinical trials to learn new techniques to treat different types of dementias at different stages.

Theme 3: Quality of Life

• Team 14: How Multi-Morbidity Modifies the Risk of Dementia and the Patterns of Disease Expression is led by Dr. Melissa Andrew, who researches the impact multi-morbidities have on dementia. In particular, she looks at the impact frailty and vulnerability have on speeding up dementia’s onset and progression, and how dementia can be better managed and treated.

• Team 15: Gerontechnology & Dementia is led by Dr. Alex Mihailidis, who focuses on incorporating technology into the lived experiences of people with Alzheimer’s disease. Learning needs and characteristics of people living with dementia enables the creation of technological supports to help improve the quality of day-to-day experiences.

• Team 16: Driving & Dementia is led by Drs. Gary Naglie and Mark Rapoport, and Elaine Stasiulis is the program’s research associate. Working with a cross-Canada research team, they are developing a Driving Cessation and Dementia Toolkit for use in community settings by individuals, their families, and loved ones. Currently, the team is evaluating the toolkit with Alzheimer Society partners, with the larger goal of integrating elements into existing programming and services in 2017. The team is also developing a tailored, group-based intervention that will provide decision-making support to drivers with dementia and care partners, as well as support for coping and adaptation once the individual stops driving. Team collaborations include working with CCNA’s Team 15 to objectively measure the real-world impact of driving cessation interventions through developing a GPS-based algorithm that will identify patterns in mobility. The team is including rural and care partner perspectives on driving cessation within the intervention’s design by working with CCNA Teams 18 and 20. Collaborating with the Women, Gender, Sex and Dementia cross-cutting platform, the team is integrating knowledge about sex and gender into driving cessation. To learn more about the team’s recent findings, click here.

• Team 17: Interventions at the Sensory and Cognitive Interface. Led by Drs. Natalie Phillips and Walter Wittich, the team’s research focuses on the simultaneous presence of two (or more) sensory conditions that older adults with dementia frequently have. In particular, the team studies the interaction between sensory loss and cognitive function – i.e. the challenges this presents for cognitive assessment and early detection, as well as the implications for quality of life (including communication and interaction with others). Their research approaches include analyzing large databases (e.g., the CCNA’s signature study COMPASS-ND, the Canadian Longitudinal Study on Aging, and the Canadian Institute for Health Information), as well as experimental studies, experimental interventions, and qualitative interviews.

• Team 18: Effectiveness of Caregiver Intervention. Led by Drs. Joel Sadavoy and Mary Chiu, this team aims to better understand how social factors bear on the thoughts and behaviors of family members who juggle employment and caregiving for someone with Alzheimer’s disease and related dementia. Specifically, this team’s research focuses on the effectiveness and scalability of psychotherapeutic and skills training interventions to meet the unique needs of this group – from nurturing the stability of the family unit to the productivity of the labor market. For this, the team is carrying out: (1) A national survey and in-depth interviews to identify the unique characteristics and challenges faced by working dementia caregivers; (2) A clinical effectiveness and impact study of the Reitman Centre Working CARERS Program (which is a small group psychotherapy and skills training intervention developed to address the needs of working dementia caregivers); and (3) A study of the adaptability and feasibility of the implementation and scaling of the Reitman Centre Working CARERS Program in rural settings throughout Canada.

• Team 19: Integrating Dementia Patient Care into the Health Care System is led by Drs. Howard Bergman and Isabelle Vedel. Howard Bergman was the author of the Quebec Alzheimer Plan, From Prevention to End of Life Care, tabled in 2009. He and Isabelle Vedel are now working with the Quebec Ministry of Health in implementing this plan. Isabelle Vedel focuses on the implementation, evaluation, and organization of health care services for older people. To learn more about this work, please visit the Team 19 webpage.

• Team 20: Issues in dementia care for rural and Indigenous populations is led by Drs. Debra Morgan, Kristen Jacklin, and Carrie Bourassa. Debra Morgan leads the Rural Dementia Action Research team (RaDAR), and is the Director of the Rural and Remote Memory Clinic based at the University of Saskatchewan. Using a community-based research approach, Dr. Morgan works directly with stakeholders to translate best practices for dementia care – particularly quality of life of individuals and their families – to rural settings. Their recent baseline study report can be accessed here. Kristen Jacklin’s team is responding to dementia research priorities identified by Indigenous communities in Ontario through participatory and action-oriented research approaches. Specifically, Dr. Jacklin is developing evidence-based dementia care tools. Carrie Bourassa’s focus is on Aboriginal end of life care. To learn more about their CCNA activities and related projects on issues of aging and dementia in Indigenous populations, click here.