Professor Ballard and collaborators are currently undertaking a systematic review of person-centred care interventions and training manuals for use with people with dementia in care homes. The protocol is available for download here
As the age of the population increases, dementia is becoming increasingly frequent in western countries. Already there are more than 700,000 people with dementia in the UK and the number is likely to double in the next 30 years. Our group is adopting a variety of scientific approaches to understand the basis of key symptoms in people with dementia, to determine the mechanisms underlying dementia and to develop new treatments, with a particular emphasis on non-Alzheimer’s dementia such as those related to stroke, Parkinson’s Disease and Downs Syndrome.
Post Stroke Dementia
25% of people have dementia after a stroke with many others developing dementia over the following 5 to 10 years. In addition, many individuals experience more subtle impairments of their higher brain functions (such as planning skills and speed of processing information) and are at very high risk of subsequently developing dementia. Our work has highlighted the importance of very small strokes in the deep parts of the brain in this process (called microvascular disease), investigated key genetic factors that influence this process, established new methods for measuring these changes in the brain very accurately and identified a pattern of brain atrophy specific to post-stroke dementia.
A substantial proportion of people who have impairments of their higher brain function after a stroke experience an improvement over the following two years. We are currently investigating the mechanisms of this improvement to try and identify novel treatment approaches for preventing dementia in these individuals.
Downs Syndrome Dementia
There are approximately 20,000 people in the UK with Down’s Syndrome, who almost invariably develop changes in the brain very similar to Alzheimers Disease as they get older. We have identified a risk gene associated with a much earlier onset of dementia and are currently studying the importance of this gene and the way in which it accelerates changes of Alzheimer’s Disease.
Dementia with Lewy bodies and Parkinson’s Disease Dementia
It is only become evident in the last 15 years that dementia with Lewy bodies (DLB) is a common form of dementia accounting for about 20% of people with late onset dementia. We have clarified the clinical symptom profile experienced by these individuals, which includes visual hallucinations, symptoms of Parkinson’s Disease and fluctuation in the level of impairment as well as extreme sensitivity to certain types of sedative medication.
From studies using donated human brain tissue we have found the main chemical changes in the brain that relate to some of these key symptoms, and found chemical changes that influence the speed of cognitive decline. Our current work includes studies to establish an experimental model of DLB so that we can investigate the mechanisms underlying the condition, studies to look at the potential importance of stem cells already present in the brain in slowing down these changes and further mechanistic studies relational functional MRI brain imaging to chemical changes in the brain.