Dementia is an umbrella term that describes a collection of symptoms related to degenerative changes in the brain.

Almost one in 10 Australians aged over 65 has dementia, and 250 Australians are diagnosed every day. People with dementia experience chronic, progressive declines in memory and thinking. The changes are difficult for not just the patient, but also devastating for their families  and friends.

Healthy Ageing and Development theme leader Professor Melanie Bahlo said the Institute, with its multidisciplinary approach, was well positioned to advance knowledge of dementia.

“Investigating the biological drivers of dementia and other common neurodegenerative disorders is key to developing rapid diagnostics, much-needed early intervention and targeted therapies. Most importantly, we hope to improve the quality of life for people with dementia,” she said.

Focus on early detection

Currently, there is no diagnostic test for dementia. By the time symptoms are noticed, most of the damage has already been done.

With a $15 million contribution from Colonial Foundation, the Colonial Foundation Healthy Ageing Centre was established – a joint project between the Institute and the Royal Melbourne Hospital (RMH).

An Australian first, the centre brings together clinicians, pathologists and researchers to develop technology for the early detection of neurodegenerative conditions that cause dementia in people as young as 40.

Institute proteomics laboratory head Associate Professor Andrew Webb, who co-leads the centre with RMH director of pathology Professor Frank Bowling, said the technology would use blood-borne signatures to detect early dementia.  

“We’re aiming to identify a diagnostic signature that would inform the development of a preventative treatment for dementia. The intention is for the test to be available through standard pathology services,” he said.

The five-year project will analyse the genomic and metabolomic information of 20,000 Victorians to create biological signatures of healthy ageing and dementia.

“The insights gained could lead to new therapies that halt or slow disease progression,” Associate Professor Webb said.

More accurate diagnosis

Clinical diagnosis remains a challenge in people presenting with cognitive or memory symptoms. Patients often see a number of specialists over many years before receiving a confirmed diagnosis, a great source of frustration for patients and their families.

Using the newly installed, state-of-the-art Simoa biomarker platform, Associate Professors Rosie Watson and Nawaf Yassi are developing a new diagnostic test that can distinguish between the various types of dementia from a simple blood sample.

Associate Professors Watson and Yassi are joint Institute laboratory heads, and clinicians at the RMH with expertise in neurology and geriatric medicine.

“Current methods of detecting dementia subtypes are expensive and require specialised expertise and facilities. We want to develop a fast and accurate diagnostic, at a fraction of the current cost, that is available in rural and regional centres, not just capital cities. It could also be used to monitor disease progression," said Associate Professor Watson.

The project will identify blood biomarkers for each dementia type, including Alzheimer’s disease, Lewy body dementia, post-stroke dementia and young-onset dementia.

“For the almost 500,000 Australians living with dementia, an early, accurate diagnosis means prompt access to the right treatment, relevant support services and often increased quality-of- life. This will be potentially transformative,” Associate Professor Watson said.

Protecting against Parkinson’s

More than 80,000 Australians are living with Parkinson’s disease, a neurodegenerative condition characterised by the death of neurons and inflammation in the brain.

Up to 40 per cent of people with Parkinson’s will experience some form of dementia. The Institute is establishing a multidisciplinary Parkinson’s Disease Research Centre to address the urgent need for diagnostic tests that can detect the disease early, and for new treatments.

By understanding why neurons die and the role of inflammation as a driver of disease, centre researchers hope to develop much-needed new drugs that slow or even stop disease progression.

In 2019, laboratory head Associate Professor Grant Dewson and colleagues revealed how Parkin – a protein linked to Parkinson’s disease – may protect neurons in the brain.

They showed Parkin, which is absent or faulty in half the cases of early onset Parkinson’s disease, ‘buys time’ for cells to repair internal damage that may otherwise kill them.

Professor David Komander is a world leader in the structure and function of Parkin and also ubiquitin, a critical protein that – if abnormal or improperly controlled – is linked to Parkinson’s disease.

“Ubiquitin signalling is a large, untapped opportunity for generating new medicines for conditions such as Parkinson’s disease,” Professor Komander said.

The Institute’s discoveries could underpin the development of new therapies that slow the progression of Parkinson’s disease, Associate Professor Dewson said.

“Drugs that, for example, mimic or promote the effect of Parkin may have the potential to reduce harmful cell death in the brain,” he said.