UWI research could lead to a greater understanding of the disease and early detection of a disorder that affects millions worldwide
The Express continues the series of articles which will be run every other Tuesday on research at The UWI, St Augustine.
Alzheimer’s Disease (AD) is the sixth leading cause of death in the USA and the numbers are rising locally and internationally. By 2030 the numbers of persons affected by the disease in the developed world is expected to double and then triple by 2050. For over a decade researchers at The University of the West Indies have been focusing on gaining a greater understanding of the disease and finding ways for early detection. The researchers have made significant strides in Alzheimer’s and dementia research in Trinidad and Tobago.
Although there is no cure for Alzheimer’s, a brain disease that affects millions and places tremendous demands on caregivers and family members, treatment is available and research, like the work being done at UWI, provides hope.
In 2003, Dr Nelleen Baboolal, a senior lecturer in Psychiatry Dr Gershwin Davis, a Senior Lecturer in Chemical Pathology and Prof Amanda McRae, Prof of Human Anatomy at the Faculty of Medical Sciences at the St Augustine Campus, began developing a three tiered project that could yield breakthrough results by examining not only the epidemiology of Dementia, but the associated risk factors; and biomarkers for the disease.
The project is certainly revolutionary, as it has the potential for developing a serum screening biomarker for the disease that could introduce a paradigm shift in the way we approach the health care maintenance of the elderly. This is due to the fact that this marker would provide a universal means to differentiate Alzheimer’s Disease (AD) from other dementias, as well as establish early detection of the disorder.
But what is a biomarker? A biomarker is a substance such as an antibody or protein which is usually present in either the cerebrospinal fluid or blood. The team explained in detail that according to the criteria of the Consensus Report of the Working Group on Molecular and Biochemical Markers of AD, an ideal biomarker should be: reliable; non-invasive; simple to perform; inexpensive; able to detect a fundamental feature of AD neuropathology; and validated in neuropathologically confirmed AD cases (to be precise —be able to detect AD early in its course and distinguish it from other dementias).
For these UWI researchers, the most exciting milestone occurred in 2008, after conducting a workshop entitled “Biomarkers for Dementia—Is there a role?” at the American Association of Clinical Chemistry Conference in Washington DC.
“This attracted the attention of a major UK-based diagnostic company. Subsequently collaboration developed between this company and UWI to further the development of a diagnostic biomarker for Alzheimer’s disease,” Dr Davis explained.
But this was not the only success for the team, the research also helped in initiating investigations about caregiver burden, the extent of dementia in nursing homes versus senior centres and in completing preliminary research on cognitive impairment in diabetics in Trinidad and Tobago.
“This is a collaborative effort not on a specific project but on the theme Alzheimer Disease and Dementia and Mild Cognitive Impairment (MCI). To that end we established and incorporated Dementia Awareness and Research of Trinidad and Tobago (DARTT), a nonprofit company in order to better pursue our research goals and to extend the awareness of Dementia to the general population,” he added during an interview in STAN magazine in 2010.
“This collaboration has benefited from the expertise of Prof Surujpal Teelucksingh of The University of the West Indies and Prof Robert Stewart of the Institute of Psychiatry, King’s College, London. Our collaborative efforts have generated several publications, book chapters, workshops and conference presentations at international conferences including the International Conference on Alzheimer Disease, Vas Cog, American Association of Clinical Chemistry Conference and Caribbean Health Research Conference.”
Education about the disease is integral to effective health care and over the years these UWI researchers, through the DARTT foundation, were able to heighten public awareness of Dementia and help to reduce the associated stigma by focusing on the caregivers and contributing to the literature.
In October they will host a workshop on ‘Targeting Dementia’ at The UWI Research Expo and information on the disease will be showcased at the UWI Research Expo exhibit at the JFK Auditorium from October 3rd-5th.
In 2013, Drs Baboolal and Davis were jointly successful in being awarded a TT$550,000 grant from the UWI- TT Research, Development and Impact (RDI) Fund to pursue a project entitled “Mitigating the Dementia Tsunami in Trinidad and Tobago”. This project seeks to determine the impact of dementia and its prevalence in persons aged 60 and above in Trinidad and Tobago. The study will also determine the associated cost and implications for the family and caregivers, health care system and economy of Trinidad and Tobago.
An important goal of this project is to raise national and international awareness and funding for development of local research evidenced policies, programmes and medical interventions targeted at defeating the disease of dementia in our region through obtaining accurate, factual information on the prevalence of dementia in our society. Other members of this multi-disciplinary research team include Prof McRae, Dr Stewart, Prof Karl Theodore and others from the HEU, and Dr Gladys Maestra (University Zulia, Maracaibo, Venezuela). This project is an example of the research the RDI Fund seeks to encourage on the UWI St Augustine Campus through its targeted funding programme: research projects that address a pressing developmental need, plan for impact throughout implementation, and enable knowledge mobilisation through active engagement with stakeholders.
The project is timely, to say the least, as a dramatic demographic change is occurring worldwide wherein the oldest segments of the population are increasing at the fastest rate.
By 2015 in Trinidad and Tobago, the age group under 15 years old will fall to 23.9 per cent, with the group over age 65 increasing to 7.5 per cent of the total population. Trinidad and Tobago’s population is following the world wide aging trend. What is looming for Trinidad and Tobago as its population ages? How will we cope with the dementia epidemic? Are we prepared and what measures will be adopted to meet the socioeconomic demands of dementia? These are some of the questions being addressed by the study.
Although the greatest risk factor is increasing age and most people with the disease are 65 years and older according to the Alzheimer’s Association, it isn’t just an elderly disease. In fact, up to five percent of people with the disease have early onset, which means that symptoms may appear in the forties and fifties and get progressively worse.
While in the early stages memory loss is mild, in the later stages the individual may lose the ability to communicate with others and the activities of daily living become all but impossible. In fact according to CNN medical correspondent, Dr Sanjay Gupta, safety becomes a major challenge as six out of ten of persons with AD will wander and become lost.
“As things stand now, people with dementia are largely ignored,” Gupta added.
In the news recently, two Dutch nurses who wanted to provide the best healthcare for their parents established a Dementia Village, in Hogeway; complete with barbers, chefs and grocers specifically trained to service this small community.
Worldwide the focus is on treatment, finding better ways to prevent the disease from developing and delaying its onset. Education is key not only to those affected but on a national scale particularly during Alzheimer’s month in September.
For more visit: www.sta.uwi.edu