Evidence that dementia can be successfully stalled

A University of Sydney academic is part of a team whose research could profoundly change the way we look at and treat dementia.

Professor Ian Hickie of the University's Brain and Mind Research Institute has, with his colleagues, gathered evidence that dementia can be successfully stalled, and possibly even reversed. In an editorial published this week in the prestigious British Journal of Psychiatry, they challenge the idea that dementia is an inevitably progressive neurodegenerative disease.

"In questioning the traditional wisdom that adult brain cells once damaged or lost can never be replaced, emerging evidence challenges the clinical pessimism often associated with dementia and points to a variety of ways of improving impairment and reducing risk of further deterioration," said the paper's lead author Dr David Burke, a psychogeriatrician at St Vincent's Hospital.

As with all other organs of the body, growth processes in the brain are dependent on blood supply. Generating new brain cells (neurogenesis) and new connections (neural plasticity) may therefore be impaired by vascular risk factors including high blood pressure, high cholesterol, smoking, diabetes, obesity, carotid stenosis, heart attack and stroke.

The researchers have shown that a variety of proactive measure can be adopted relating to diet, physical activity, cognitive activity, genes, psychological functioning and social functioning to combat these vascular risk factors and thereby treat or prevent acquired cognitive impairment and dementia.

"Taken together, these exciting findings open the door to new directions in the active management of people with late-life depression, cognitive impairment or dementia," said Professor Hickie.

"Prevention should focus on lifelong education, social engagement, healthy eating, exercise, and reduction of vascular risk factors. Active treatment also needs to move rapidly to incorporate these new medical, lifestyle, social and educational perspectives."

The paper, which incorporates research findings from the Brain & Mind Research Institute, The Black Dog Institute and various international studies, also highlights the need for advances in the neurosciences to be translated into clinical research and then clinical practice through close collaboration between neuroscientists and clinicians.