Tuesday, July 12, 2016

Advancing Knowledge in Dementia, But It’s Not What You Think

The Watchman has blown a horn like this in Ripon, UK, every day at 9 pm since 886 to indicate he is now patrolling the town to keep watch for thieves or invading armies.  

Although I formally retired on June 30, I gave talks last week in England at two interesting venues that are putting Alzheimer’s disease and other dementias in a new light. 

The first venue was the Interdem Summer Academy, held at Nottingham University.  Interdem is one of the cross-national organizations of scholars and students that have been established in part due to opportunities resulting from the open borders in Europe and encouragement of the European Union.  Yes, I was aware of the irony of visiting just after the BREXIT vote, and the vote was made more poignant by the exceptional quality of work I found going on among students and faculty, as well as their multi-national, multi-ethnic composition.

Interred, which sponsors a variety of activities including the Summer Academy, was established to promote psychosocial research on dementia that improves quality of life of persons with dementia and their carers (as caregivers are typically called in Britain).  Much of the research in Europe and North America on dementia is biomedical, but the scholars affiliated with Interdem use psychological and social techniques to improve quality of life now and perhaps even push back the onset of dementia and its inevitable course.  

The students at the academy were enthusiastic and creative.  Their studies look at a wide range of strategies that build on strengths that persons with dementia generally retain.  The types of efforts that students are undertaking range from examining benefits of an innovative arts program to investigating the effects of small-scale care homes in the Netherlands located on farms where residents can participate in activities that are familiar to them and meaningful.  Other studies emphasize use of technology to create more supportive environments.  These types of programs may be able to normalize daily life, despite cognitive decline, and help people remain active and engaged.  The Interdem Academy provides training to help students carry out their projects.

The second venue was at the School of Dementia Studies at Bradford University, a unique program headed by Murna Downs that brings together scholars and students from a variety of disciplines to focus on dementia.  Like at Interdem, the students I met were creative and passionate about their work.  The studies they were conducting as part of their training ranged from finding ways to avoid medication errors during transitions such as from home to the hospital or from a care home to the hospital to finding new ways to build support for caregivers in the South Asian population in the Bradford area. 

Students and faculty at Interdem and at Bradford share the belief that we have to act now to improve quality of life of persons with dementia and their caregivers.  This is in contrast to the stance widely taken in the USA that we have to put all our efforts into finding a cure.  As a result, there is little funding support for innovative, but distinctly non-biomedical approaches.  But as the young researchers I met emphasized, we have lots of tools now that we can apply to make an immediate difference.  To do otherwise would mean we write off all those people who currently suffer from dementia or will develop it in the coming years.  I believe the creativity I found in these two programs reflects greater acceptance in Europe of examining the science that leads to good care.  Similar investment of money and effort here could lead to innovative programs of our own.

Our trip involved a bit of travel, too, including a stop in Ripon where we had a nice pub dinner and saw the Watchman, as well as some hiking in the Yorkshire countryside.  We also wandered around Nottingham in search of Robin Hood, Maid Marian and comfortable shoes and were successful with the latter.