New national strategy to tackle dementia
Researchers in London, Ontario have been awarded $1.345 million over five years through the second phase of the Canadian Consortium on Neurodegeneration in Aging (CCNA), announced today as part of Canada’s first national dementia strategy. CCNA is a collaborative research program tackling the challenge of dementia and other neurodegenerative illnesses.
A Dementia Strategy for Canada: Together We Aspire focuses on preventing dementia, advancing therapies and finding a cure, as well as improving quality of life for people living with dementia and caregivers.
Clinician researchers from across the country working together
Dr. Manuel Montero-Odasso, Scientist at Lawson Health Research Institute, is world renowned for his findings on the relationship between cognition and mobility in the elderly, and gait as a predictor of frailty and dementia. He leads the Mobility, Exercise and Cognition (MEC) Team in London, comprised of top researchers in the areas of mobility, exercise and brain health.
“Evidence from other countries with dementia strategies shows that coordinated, targeted efforts at the national level improves results for all aspects of dementia care and also for research,” says Dr. Montero-Odasso, also a geriatrician and Director of the Gait and Brain Lab at Parkwood Institute, a part of St. Joseph’s Health Care London.
CCNA was purpose-built to synergize dementia research within the Canadian context. Phase I saw the creation of infrastructure fostering collaboration amongst Canadian researchers, and there are now 20 teams built around important research topics.
“This kind of effective national collaboration by scientists and clinicians from many disciplines gives the CCNA a cutting edge in research, prevention, treatment and management of all forms of dementia,” explains Dr. Montero-ODasso. “We created a national network of researchers form west to east coast with a high level of expertise to deliver lifestyle interventions to improve cognition and slow down progression to dementia. I feel privileged working with such excellent investigators and leading this important endeavour locally.”
Preventing dementia through lifestyle changes
The MEC team has several projects in the works, but the majority of the new funding is to complete the SYNERGIC Trial, SYNchronizing Exercises and Remedies on Gait and Cognition.
This first-in-the-world clinical study is testing a triple intervention aimed at treating Mild Cognitive Impairment (MCI) and delaying the onset of dementia. The SYNERGIC Trial incorporates physical exercises and cognitive training, along with vitamin D supplementation to determine the best treatment for improving mobility and cognition.
“We are looking at how interventions will work together and targeting cognitive decline at its earliest stage – individuals with MIC,” explains Dr. Montero-Odasso. “Both physical and cognitive exercises have shown promising effects for maintaining cognition, while vitamin D deficiency is associated with cognitive decline.”
A professor at Western University’s Schulich Medicine & Dentistry, Dr. Montero-Odasso partners with researchers from across the city including Dr. Rob Bartha, imaging scientist at Schulich Medicine & Dentistry and Robarts Research Institute at Western University, and Dr. Kevin Schoemaker who leads the Laboratory for Brain and Heart Health.
Study participants in the SYNERGIC Trial are asked to complete an individualized and progressive routine of exercises and cognitive training three times a week for six months, with one final assessment at 12 months. The main site for the study is Parkwood Institute with the physical exercises taking place at the Labatt Health Sciences Building on the Western campus.
To date, 138 research patients has been recruited across multiple sites in Canada.
One participant’s experience
One day, Peter Saracino saw an advertisement about a research study. They were looking for participants who were a minimum age of 60 and had minor cognitive impairment. He felt he fit the bill and he was interested in this kind of research.
“I have family members who suffered from forms of dementia and Parkinson’s Disease. I really understand how hard it hits and I liked that this study was about prevention,” explains Peter.
Going into it, Peter thought he was in pretty good shape. He has two dogs and walks them regularly. “But by going to the gym and doing the exercises and faster-paced walking, I realized that I wasn’t in as good shape as I thought. My diet was under control but I was still taking blood pressure medication. I didn’t have much energy.”
After 10 weeks in the study, he feels better than he has for over a decade. “I can garden for longer. I took two notches off my belt. I no longer take my blood pressure medication. I actually feel younger.”
He remembered that last year he slipped and fell four times, which was very unusual for him. Part of his cognitive impairment is that he had trouble with balance, and that has improved for him as well.
Peter feels that “this is exactly the kind of research that the government should be investing in – an ounce of prevention is worth a pound of cure. This kind of research leads to keeping people independent and healthier as they get older. People are happier. They feel like doing more. There is no downside to improving someone’s health through lifestyle changes, and in fact it is cost effective and helps ease the burden on the health care system.”
Individuals over 60 years old with mild cognitive impairment without dementia are eligible for this clinical trial. Those interested in participating are encouraged to contact a Lawson research coordinator at 519-685-4292 ext. 42179.
Looking forward
“Our preliminary analysis from SYNERGIC is giving us a strong indication that a multimodal approach, combining physical exercise, cognitive training and supplementation, has a synergistic effect. It seems the whole is greater than the sum of its parts,” says Dr. Montero-Odasso.
A major goal for the work of the MEC team in London is to translate their research findings into clinical guidelines that can be used at the front line of care. “Practitioners understand the overall importance of exercise and cognitive vitality, but we are missing more specific guidelines on what kind and how much will work for different patients. Basically, what is an effective lifestyle prescription.”
Dr. Montero-Odasso adds that “as our population ages, a comprehensive strategy is vital to ensure the growing number of those living with dementia receive the care and support they deserve. Over half a million Canadians are currently living with dementia. By 2031, this number is expected to nearly double.” More than one third of dementia cases might be preventable.
CCNA Phase II
In CCNA’s Phase II, researchers are working on analyzing the overall health of every patient in a large clinical cohort study, COMPASS-ND. This information will be used to enhance understanding of how changes in the brain affect dementia severity and ways to reduce and prevent this through lifestyle changes. Lawson is the leading recruitment site for COMPASS-ND and the London team will be instrumental in the larger lifestyle interventions moving forward.
CCNA is funded by the Government of Canada, Canadian Institutes of Health Research (CIHR) and other funding partners. CIHR is providing $31.6 million, and partners—including provincial agencies and non-profit organizations—are providing an additional $14.4 million for a total investment of $46 million over five years. The research on dementia prevention, diagnosis, treatment and care as part of Phase II of the CCNA will support the national strategy.
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