Plastic model of a brain, interior view
30 September 2019
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A team of researchers from the Royal Melbourne Hospital, the Florey Institute of Neuroscience and Mental Health, the Walter and Eliza Hall Institute of Medical Research and Massachusetts General Hospital (United States) are working to understand factors that contribute to dementia. 

The Healthy Brain Project is following middle-aged adults, aged 40-70 years old, with a family history of dementia over a long period of time to determine what combinations of genetic and environmental factors put people at risk of dementia, and what factors are protective against it.

So far, 6845 Australians have signed up to the study, which involves an initial online survey and a saliva sample for genetic testing. The survey is repeated every year. Participants can also choose to sign up to various sub-studies.

Alzheimer’s disease is caused by the build-up of amyloid plaques and tau “tangles” in the brain – these proteins are key diagnostic markers of Alzheimer’s disease. Both tau and amyloid can block messages between brain cells, causing cognitive impairment.

The Royal Melbourne Hospital’s Associate Professor Nawaf Yassi, one of the lead researchers on the Healthy Brain Project, says that while we know that amyloid and tau are critical factors in Alzheimer’s disease, there is much that is not yet clear.

“There have been drugs developed that have been very effective in clearing amyloid from the brain, but they haven’t yet been shown to affect people’s memory and cognition” A/Prof Yassi said.

“One of the reasons is that they have potentially been trialled too late in the disease process, when people are already displaying symptoms. There’s very strong evidence now that the abnormal proteins that lead to Alzheimer’s disease first start accumulating up to 30 years before symptoms begin, so the problem is if we try to intervene when people have symptoms, often it’s too late.”

“This is why The Healthy Brain Project is interested in the very early stages of Alzheimer’s disease - if we can understand the disease very early and then try to intervene very early, we have the best chance of reducing the impact of dementia later in life.”

Researchers around the world have also started to investigate the impact of other factors on Alzheimer’s disease. A/Prof Yassi said that while amyloid and tau accumulation are crucial markers of Alzheimer’s disease, the Healthy Brain Project is also seeking to study other crucial risk factors such as genes, diabetes, sleep, mood, high blood pressure, and other cardiovascular risk factors.

“There are clearly other risk factors we have to target. This may include other proteins, such as the protein that’s involved in the development of Parkinson’s disease, or diseases of the blood vessels, sleep disorders, mood, exercise, diet and environmental risk factors.” A/Prof Yassi said.

One of the Healthy Brain Project sub-studies is the biomarker study, which invites people who have completed the initial Healthy Brain Project online survey to complete tests in person at the Hospital. These tests include memory assessments, blood tests, MRI scans and lumbar punctures, and an at-home sleep study.

“While the online platform can give us the earliest indication of what’s happening with memory, the biomarker cohort will help us really understand the biological changes at the very early stages to see how they are changing very early in the disease process,” A/Prof Yassi said.

The Healthy Brain Project is looking to recruit 200 participants for the biomarker sub-study, and A/Prof Yassi said the interest so far has been “incredible”.

“We have had some very generous participants come from Perth, from Queensland – all over Australia – for our biomarker study and it’s incredible the level of engagement our participants have,” A/Prof Yassi said.

“People are just altruistic at heart and they really want to help out – it’s just amazing.”

The researchers are aiming for 10,000 participants overall, based around Australia, to participate in the Healthy Brain Project. If you are aged between 40-70 years of age, with a family history of dementia and a stable internet connection, join now at https://www.healthybrainproject.org.au/.

The Healthy Brain Project is generously supported through funding from the National Health and Medical Research Council, the Australian Research Council, the Alzheimer’s Association International Research Grant Program, the Dementia Australia Research Foundation, the Yulgilbar Alzheimer’s Research Program, the Charleston Conference on Alzheimer’s disease, The National Heart Foundation of Australia, the University of Melbourne, and the Bethlehem Griffiths Research Foundation.

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