4 February 2020
Associate Professor Genevieve Steiner, NHMRC-ARC Dementia Research Development Fellow, Director of Research, and Neurocognition Laboratory Lead at NICM Health Research Institute spoke with Fx Medicine for their latest podcast (opens in a new window) on Sunday discussing herbal interventions and cognitive decline in dementia.
Associate Professor Steiner explains in the podcast that dementia is a complex syndrome, comprised of more than 100 different diseases, for which it is necessary to undertake a broad range of tests to firstly exclude other causes of cognitive and brain dysfunction that might contribute to the problem.
Diagnosis in Australia can take several months, and in some cases, years, at times experiencing challenges with varying access to expensive technology depending, on the geographical area. Accurate diagnosis is crucial to ensure the correct treatment is used.
Age is the biggest risk factor for dementia, and together with chronic conditions and an ageing population, many Australian’s will be at risk of developing dementia.
Whilst research has advanced at a rapid pace, there has been a history of a large number of failed attempts at drugs to treat dementia.
Associate Professor Steiner considers part of the reason is that a patient is captured too late in the disease progression, and needs significantly earlier intervention well before the disease is diagnosed before pathology has built up in the brain.
In addition, the treatments that are used generally only target one single therapeutic target or aspect of the disease, rather than the whole.
With dementia considered not a normal part of ageing, Associate Professor Steiner says it’s important to understand the causes of dementia and how people can modify their risk.
“We're looking at well over a third percent of risk being modifiable in Australia. Genetics and age are non-modifiable, but across the lifespan, you've got up to 35 per cent risk that's modifiable. Factors such as obesity and cardiovascular disease in mid-life put us at higher risk of dementia,” said Associate Professor Steiner.
Earlier intervention before any form of clinical manifestation develops means researchers are looking at biomarkers, such as from the blood, brain, cerebrospinal fluid, urine, and faeces to determine early markers of dementia, in addition to investigations related to inflammation which is seen as a contributing factor in the pathophysiology of dementia.
There are excellent resources building up in the world such as the use of longitudinal studies, capturing data including imaging and blood markers, from people through their 40s and 50’s and so on which is extremely useful.
Associate Professor Steiner and her team at NICM HRI are testing new treatment strategies for cognitive decline with a focus on herbal medicine.
“We measure all our classical clinical outcomes for the trials to see if memory and thinking are improved. Then we measure brain function and run pharmacokinetics analyses. We look at the plasma concentration of different metabolites of these herbal medicines in the blood, and we can correlate that with the changes we're seeing in the brain function and the changes we're seeing in the clinical outcomes of memory and thinking. That gives us information that any changes we’re seeing are associated with the intervention that's being delivered, rather than some other cause," said Associate Professor Steiner.
>> Listen to the podcast(opens in a new window)