Online dementia tool
Assessing dementia risk from home.
How would you know if you are at risk of developing dementia? And even if you did know you are at risk, what do you do about it?
Dementia is a group of brain disorders caused by damaged nerve cells in the brain. It can affect our memory, thinking and ability to interact socially. But dementia is experienced differently across individuals, depending on which areas of the brain are damaged.
Getting a diagnosis can be complicated—partly because the disease progresses over decades. It can take months to receive a definitive answer.
According to the World Health Organization, more than 55 million people in the world are living with dementia. The cases are increasing by 10 million new cases per year. And the impacts extend beyond the patient to their families, caregivers and communities.
Research into the disease is shifting towards prevention.
Professor Kaarin Anstey from the UNSW Sydney School of Psychology and Neuroscience Research Australia (NeuRA) led the development of the assessment tool CogDrisk, which can effectively identify dementia risk.
“It's a multi-causal disease,” Prof Anstey said.
"There's lots of information about the risk factors for dementia in the academic literature. But there's a gap between just knowing the risks and actually being able to assess whether or not you have the risk, and then knowing what to do about it. CogDrisk was developed to address this."
- Professor Kaarin Anstey, UNSW Sydney - School of Psychology and Neuroscience Research Australia (NeuRA)
“But there are some modifiable risk factors. Most people want to know what their risk factors are and want to do something about them once they know.”
CogDrisk is an online 20-minute assessment for dementia risk that generates a personalised report. Being online means patients from all walks of life can access it. They can then use their personalised report to discuss their dementia risk factors with their GP.
The tool helps patients centre their care and helps clinicians develop individual risk reduction plans and interventions.
Challenges & opportunities
Dementia is the seventh leading cause of death worldwide. And the burden of care is only set to increase from the global societal cost of nearly 2 trillion $AUD in 2019.
Due to an ageing population, the number of Australians diagnosed with dementia is expected to increase to more than 530,000 next year and nearly double that by 2056.
There is no current medical cure for dementia. Unsuccessful clinical trials for treatment led to urgent calls for dementia prevention.
“Prevention is now recognised by the World Health Organization as one of the key areas of research,” Prof Anstey said.
International and national plans around the disease include risk reduction—where individuals know their risk factors, so they can actively choose healthy ways to look after their brain and body.
Prof Anstey hopes that CogDrisk makes it easier for GPs and patients alike to access information on reducing the risk of dementia.
She said last year, more than 10,000 Australian GPs attended training on CogDrisk by HealthEd—the nation’s largest provider of GP training.
The online tool includes resources in different languages.
“Not only are there lots of risk factors, but dementia itself is very complex, and GPs are very busy. So we're trying to develop ways of making it easier for the public and GPs to get the right information."
- Professor Kaarin Anstey
Forward focused
Risk assessment tools are often developed based on a single cohort. This means it fits a particular dataset and population, which doesn’t work well when applied to other populations.
The CogDrisk team used statistical methods to combine risk factors cited in the existing literature from across the globe.
There are many studies on risk factors for dementia—but these aren’t always consistent. The systematic review that CogDrisk is based upon covers all the different risk factors.
This includes, “those which were robust, and those which were modifiable and could be assessed through a self-report instrument,” Prof Anstey said.
Some of the key modifiable risk factors that increase risk include insufficient physical activity, mid-life obesity and high blood pressure, smoking and poor diet.
“Good access to health care is important,” Prof Anstey said. “People need to manage cardiovascular risk factors in middle age, exercise, eat healthily, don’t smoke, treat depression and stay socially and cognitively engaged.”
She said statistical analyses of CogDrisk show that it's a robust and generalisable tool.
“It works across different countries and different data sets. And it's also quite comprehensive, it includes a lot of the newer risk factors that weren't previously included.”
Her research now involves implementing CogDrisk to enable people to know their risk of dementia and take practical steps to reduce it. “We are also seeking to uncover novel causes of cognitive resilience—to understand why some people do not develop memory loss and cognitive decline, despite having genetic and lifestyle risk factors for cognitive decline. This may lead us to new interventions to promote cognitive health in ageing.”
"As we age, risk reduction is incredibly important because there is currently no cure for dementia. Modifiable risk factors have effects that are independent from genetic risks. Following guidelines and strategies that promote optimal brain health can delay the onset of cognitive decline and potentially reduce risk of dementia."
- Professor Kaarin Anstey
