Cognitive health and dementia

Investigating cognitive health and decline

Explore our current research projects aimed at preventing cognitive decline, and supporting good cognitive health and development across the lifespan.

The Macquarie University Lifespan Health and Wellbeing Centre is conducting a range of projects investigating cognitive impairment and dementia risk.

Learn about these projects, including funding and collaborators.

Increasing social participation for older Australians with cognitive challenges

Full title: From isolation to inclusion: Increasing access to social participation for older Australians with mild cognitive impairment or early dementia and their supporters

Funded by: The Australian Association of Gerontology RM Gibson grant in partnership with the Dementia Australia Research Foundation

Older adults with mild cognitive impairment and early dementia often experience social isolation. Their supporters commonly experience social isolation too. Social isolation often leads to feelings of depression, anxiety, loneliness, poor wellbeing, and the development of dementia.

The study plans to:

• adapt an intervention to the unique barriers and facilitators of social participation in these populations in focus groups with people with cognitive impairment and supporters
• pilot test the intervention over three months to evaluate whether it increases social participation and wellbeing.

Learn more about creating social inclusion resources for people with cognitive impairment and carers.

AU-ARROW study: reducing dementia risk by protecting brain health

Full title: The AUstralian multidomain Approach to Reduce dementia Risk by prOtecting brain health With lifestyle intervention (AU-ARROW) study

Funded by: Medical Research Future Fund (MRFF) – International Clinical Trial Collaborations Scheme, US Alzheimer’s Association, Lions Alzheimer’s Foundation, WA Alzheimer’s Association

This study aims to validate the findings of the Finnish (FINGER) study, in an Australian population over a period of two years.

A total of 600 people aged between 55 and 79 – 300 in Sydney and 300 in Perth – will be recruited. Participants will be allocated randomly (and evenly) into two study groups:

• the health education and coaching group (HC)
• the structured, multidomain lifestyle (MIND diet, aerobic/resistance training exercise sessions and computerised brain training exercise subscriptions via the BrainHQ program) intervention group.

This study will add to the evidence that lifestyle modifications can impact in a significantly positive way on cognitive decline and dementia risk, across different countries and cultures.

This will help develop a framework of preventative steps that can help preserve brain function, and possibly also reduce the incidence or severity of other preventable health conditions such as type 2 diabetes, heart disease and high blood pressure.

Learn about the CoMBAT-AD group’s research.

Visit the Australian Alzheimer’s Research Foundation.

ADNeT: screening for trials and longitudinal research

Full title: The Australian Dementia Network (ADNeT): Screening for trials and longitudinal research on trials ready cohort (TRC)

Funded by: The National Health and Medical Research Council (NHMRC)

This study assesses the deposition of the tau protein and compares the results against Aβ PET scans performed in the same participant population: participants aged over 40, both with and without cognitive impairment or dementia.

It also assesses Aβ and tau in cerebrospinal fluid, investigate blood-based biomarkers and genetic risk factors of Alzheimer's Disease.

Visit the Australian Dementia Network.

ToTAL (Testosterone-Omega Three (DHA) - Amyloid Lowering) study

Full title: A 56-week Double-Blind, Randomised Study to Evaluate the Efficacy of Testosterone, With and Without DHA Supplementation on Cerebral Amyloid Load in Men with Subjective Memory Complaints (The ToTAL Study)

Funded by: Western Australian State Government, Lotterywest, Australian Alzheimer’s Research Foundation, CRC for Mental Health

This project studies the effects of testosterone and/or omega-3 fatty acids found in fish oil called DHA (Docosahexaenoic Acid). DHA is thought to protect brain cells from the damage caused by the accumulation of amyloid-βeta.

It is hoped that combining fish oil with testosterone will have stronger preventative (reduce accumulation and increase clearance of amyloid-βeta) effects in Alzheimer's Disease.

Learn about the CoMBAT-AD group’s research.

Cognitive decline and financial literacy

Funded by: National Seniors Australia

There are two risks with undiagnosed decline of cognitive functioning when managing large amounts of money at older age:

• people may have an undiagnosed decline and fail to recognise financial scams
• other people may believe that there is a decline where none exists and prematurely abdicate responsibility for management of their financial affairs, leaving themselves vulnerable to financial abuse.

In 2017 National Seniors Australia sponsored the first wave of data collection. In 2018 we followed participants' progress across self-rated cognition, and assessed cognition using tablet-based technology from Cambridge University.

Learn more about National Seniors Australia’s work.

Do older Australians make optimal decisions when entering aged care?

Full title: Do older Australians and their carers make optimal payment decisions when entering residential aged care? A survey and assessment

Funded by: Ecstra Foundation unconditional grant

Financial decision-making within Australian aged care is marred by complexity. Payment decisions when entering residential care have consumption and wealth implications for older people, and can influence the financial sustainability of providers.

This project has explored how older Australians and their informal carers make accommodation payment decisions. A sample of approximately 600 carers who helped older Australians with their payment decisions was recruited and an online survey was conducted.

Two discussion papers have been released:

• one assessing the role of carer financial literacy when making payment decisions
• one assessing resident, informal carer and provider-level factors that may influence payment decisions.

Sydney memory and ageing study 2

Funded by: The National Health and Medical Research Council (NHMRC)

Following the success of the original Memory and Ageing Study (MAS), MAS2 will recruit a new cohort that is a generation older with different life experiences.

The aims of the study are to:

• chart the generational change in the physical, psychological, social, and cognitive/brain health in Australians aged between 70 and 90 years
• examine the effects of living through the pandemic on mental health
• determine changes in risk factors for cardio- and cerebrovascular disease and cognitive decline, and their relative contributions to cognitive decline
• determine changes in use of health services and pathways to care, and factors associated with health care.

View the study at UNSW’s Centre for Healthy Brain Ageing (CHeBA).

Screening and risk reduction for dementia in primary care

Funded by: Medical Research Future Fund Investigator Grant

This project aims to evaluate the effectiveness and cost-effectiveness of an online tool implemented in primary care to reduce risk for dementia compared to treatment as usual in a randomised controlled trial.

This tool will help to better identify individuals at risk and engage patients in preventative medicine approaches that offer the potential to result in wide scale risk reduction for cognitive decline.

Learn more about the tool.

Ageing Well Tool in general practice

Funded by: Medical Research Future Fund Emerging Leadership Fellowship and The Ian Potter Foundation grant

The Ageing Well Tool has been developed to measure common mental disorders and risk factors for dementia and poor wellbeing, including depression, anxiety, alcohol overconsumption, and cardiovascular risk in older adults in primary care.

Following screening, GPs/practice nurses may plan some evidence-based risk reduction strategies with patients as needed.

Learn more about the Ageing Well Tool.

Social participation in people with mild cognitive impairment

Full title: Barriers and enablers to social participation in people with mild cognitive impairment/early dementia and their supporters

Funded by: Macquarie University ECR Enabling Scheme

Older adults with mild cognitive impairment/early dementia and their supporters often experience social isolation.

Social isolation is associated with increased depression, anxiety, loneliness, and the development and progression of cognitive impairment. Yet there is limited understanding of barriers and enablers to social participation, and ways to address isolation in these populations.

The study aims to identify these barriers and facilitators in both consumers and supporters using a survey and focus groups. The findings will be used to develop interventions to reduce isolation.

Tailored intervention for reducing falls after stroke trial (FAST)

Funded by: The National Health and Medical Research Council (NHMRC)

Stroke is the second biggest cause of death and the third most common cause of disability worldwide.

Falls are a major contributor to disability after stroke. Stroke survivors are twice as likely to fall as the general older population and more likely to fall repeatedly. The consequences of falls for stroke survivors severely jeopardise their long-term health and wellbeing.

The Falls After Stroke Trial (FAST) aims to test the effect of a home-based, tailored intervention (habit-forming exercise and safety training) to reduce falls.

Learn more about the FAST study.

Effectiveness of Hi-Walk in long-term community stroke rehabilitation

Full title: Effectiveness of very high dosage mobility boosters (Hi-Walk) in long-term community stroke rehabilitation

Funded by: National Stroke Foundation EMCR Seed Grant

Many people experience mobility limitations more than six months after stroke, with minimal (or no) ongoing therapy to support their mobility goals – impacting not only mobility, but also wellbeing.

The Hi-Walk trial aims to transform the long-term mobility training of people after stroke by providing the first evidence of the impact of a mobility booster program for people in the community.

Hi-Walk will support people with resources they can access to take control of their own mobility goals at their current level of mobility.

The program is individualised and incorporates a self-management approach designed to prolong benefits beyond the program.