Prince George part of major dementia study

A Prince George doctor will head a research site as part of the largest Canadian study on dementia.

The two-year, $8.4 million study will address gaps in knowledge around how the various forms of the disease manifest together rather than in isolation.

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"We really know very little about the mixed forms," said Jacqueline Pettersen, a principal investigator who will run one of 30 sites in the country.

"This unique study is looking at not only at pure forms of dementia - things like Alzheimer's, vascular dementia, lewy body dementia, frontotemporal dementia - but also the overlap between those entities because in reality we tend to see more mixed forms of the disease rather than pure form."

The Canadian Consortium on Neurodegeneration in Aging (CCNA) announced the study to mark World Alzheimer's Day on Wednesday.

The Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) will involve 1,600 participants with memory problems between the ages of 50 and 90.

It will be funded from a $31.5 million grant that created CCNA in 2014.

While easier to investigate, the pure forms are not as reflective of the population. A person who shows features from different dementias can lead to misdiagnosis and confusion - so the study could help offer doctors better ways to assess patients.

"We're hoping that the knowledge will enable us to diagnose patients sooner, help to enhance quality of life for patients and their families and then ultimately to lead to treatments and prevention of dementia," said Pettersen, a cognitive neurologist who has taught at the Northern Medical Program the last eight years.

That approach won't be entirely new to Pettersen, who is nearing the end of a shared study with the University of British Columbia looking at mixed Alzheimer's and vascular dementia on a much smaller scale.

For COMPASS-ND, she hopes to follow at least 20 patients from Prince George and the region and said she'll likely start enrolling people this fall. Doctors will collect clinical information from study participants, like memory assessments, brain scans, blood samples and more. Most studies focus on large urban centres, rather than smaller or more northern towns.

"Traditionally this group of patients has been under-represented or not represented at all in these types of trials," she said.

"Just as looking at mixed-dementias gives you more of a real-world sense as to how dementia presents."

"I think it's also true that by including the smaller centres you really get more of a real-world appreciation of how dementia can present in all its forms," Pettersen added.

While current research hasn't made any conclusions that connect location with the disease, it's a potential factor.

"For most diseases - and dementia is no exception - it's likely a combination of genetic susceptibility in conjunction with environmental contributors," Pettersen said.

Pettersen has done some work looking at the role of nutrition in cognition. For example, early studies suggest a correlation between lower levels of vitamin D and aspects of cognition that are relatively impaired.

Pettersen will also take a secondary role as a leader on the Frontotemporal Dementia research team, looking at a disease that typically appears earlier in life - under age 60 - and is revealed in behavioural rather than cognitive changes.

Researchers will also consider gender, given women are more likely to develop Alzheimer's disease, while men are more likely to develop vascular dementia.

"Women are twice as likely as men to have Alzheimer's and dementia and twice as likely to care for a loved one with the disease," said Lynn Posluns, president of the Women's Brain Health Initiative in a statement.

"This important study can advance our understanding of why women experience dementia differently and lead to effective treatments that meet women's needs and halt the process."

Lifestyle modifications continue to be the best approach for prevention or slowing development, Pettersen noted. That includes nutrition, exercise for both the body and brain and social interaction.

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