Podcast – AAIC 2023 – Day Two

Voice Over:

The Dementia Researcher podcast, talking careers, research, conference highlights, and so much more.

Adam Smith:

Hello and welcome to the second of our Alzheimer’s Association International Conference highlight shows. I’m Adam Smith and all this week I’m joined by different researchers each day who are going to share their best bits from the day’s events.

With 100s of talks and 1000s of posters, these shows are far from comprehensive. However, what we hope is to provide a snapshot of what’s going on for those who aren’t attending, and perhaps inspire those who are to check out something that they might have missed.

But that’s enough for me. Let’s meet today’s guests. I’m delighted to be joined by Sára Zsadányi and Dr. Aoife Cosgrave and Dr. Sonata Mačiulskytė. Hello, everybody.

Dr Aoife Cosgrave:

Hi.

Sára Zsadányi:

Hi.

Dr Sonata Mačiulskytė:

Hello.

Adam Smith:

Everybody looks so nervous for if you’re watching audio, if you’re listening on audio, everybody looks a bit nervous. It’ll be fine. Before we get going, let’s do some introductions and because Sára looks the least nervous of all, I’m going to go to Sára first. Why don’t you introduce yourself, Sára, tell us about yourself.

Sára Zsadányi:

Great. Well, I’m Sára Zsadányi, I am originally from New Zealand, but currently working in Spain at the San Palm Memory Unit. And my PhD, which I’m having my first-year review for on Friday, is looking at small vessel disease in Down syndrome and I’m mostly looking at neuroimaging for this at the moment.

Adam Smith:

Brilliant, thank you Sára. So, did you do your undergrad in New Zealand?

Sára Zsadányi:

Yes, I did. I did my undergrad, my master’s degree over there.

Adam Smith:

So that’s a bit of a jump to go from New Zealand to Spain. I’m assuming you could have done it in New Zealand. What inspired you to move all the way to Spain?

Sára Zsadányi:

I was very excited to move to Europe. It was partially motive by love, but I have stayed now for the research part of it.

Adam Smith:

Oh, well done. We did an ask your mentor podcast recently with Yvonne Couch who told us how she moved countries as well to her. She followed her PhD to follow a boy but didn’t regret it at all. She said it worked out perfectly. So, I hope following for love has done the same for you.

Sára Zsadányi:

Absolutely.

Adam Smith:

Anyway, I moved on so quickly there just in case. Aoife, why don’t you go next?

Dr Aoife Cosgrave:

Hi. So, I haven’t come from as far as New Zealand. So, you can hear by my accent that I’m Irish and I finished my PhD a few months ago. So, it was working between a lab in Dublin and a lab in London. And it was looking at Phytocannabinoid compounds derived from the cannabis plant to see if they had any anti-inflammatory effects in models of acute neuroinflammation.

But then towards the end of my PhD, I realized I preferred to talk about my research and other people’s research than doing the research. And I really wanted to stay in the neuroscience area, that field. And then a job with Alzheimer’s Research UK came up and I started working with them two, three months ago now. And I’m a science communication officer for Alzheimer’s Research UK. Yeah, so I’m getting the taste of it now and I’m being at a conference. But on the other side.

Adam Smith:

We should say that, shouldn’t we? That, Sára and Aoife, you’re both actually in Amsterdam right now at the conference.

Sára Zsadányi:

Yes.

Dr Aoife Cosgrave:

Yes, we are.

Adam Smith:

And you disappeared up to your rooms and escaped from the social stuff to very kindly join us this evening to share your highlights. So, Aoife, that’s a big change. Oh, I am interested to know though, you said did cannabinoids have that? Did they work? Are we waiting for the publication?

Dr Aoife Cosgrave:

Waiting for the publication, IP issues. And it was a screen of a few compounds and one in particular did show some nice effects.

Adam Smith:

Brilliant. So, we should keep an eye out for that paper then. Thank you very much. Sonata, thank you for very patiently waiting. Why don’t you introduce yourself?

Dr Sonata Mačiulskytė:

Okay. Hello, everybody. I have a little bit longer postdoctoral experience, not postdoctoral, but post PhD experience. I defended my PhD almost 10 years ago. I am staying in academia but I’m not doing research either. Actually, I’m from Lithuania, but I did my PhD in Finland. Differently than you both. So, I’m from social sciences so it’s a little bit different and the topics which I cover will be a little bit different.

So, what I’m doing now, to make a long story short, I’m serving as a vice director for academic affairs at my university and also, I’m still lecturing. I hold the position of associate professor. And with my team of teaching assistants, I am running courses on social policy and social gerontology. And I still dream about returning back to research one day.

Adam Smith:

But you have another job as well, don’t you? But did I miss it there? But you also work with Alzheimer Europe.

Dr Sonata Mačiulskytė:

It’s not a job, it’s volunteering. Yes, actually I’m a member of the PPI Panel, Patient Public Involvement Panel. And I’m also a chair of a newly established European dementia carers working group.

Adam Smith:

Fantastic. So, everybody is ultimately qualified. And what I love is that we’ve got people working, all three of you working in so many different fields that you’ve all probably attended different sessions today. Which is great because the last thing we want is you all to go to the same thing. Well let’s get on with the highlights.

So, Sára, I know you’ve been presenting this week. Why don’t you tell us, before we get onto everybody else’s highlights, tell us about your presentations, your posters.

Sára Zsadányi:

So, this is my first year, my very first conference and also my very first poster.

Adam Smith:

That’s brilliant though. Come on. To whom can remember actually presenting at the first conference they attended? Usually you go to a few, you get a feel for things. So, you’re in the first year of your PhD, you’ve just moved countries, and you’ve got two posters at the biggest conference. Well done. That’s amazing.

Sára Zsadányi:

Yes, I’m very blessed. So, I am presenting my own work, which is looking at microbleeds and Down syndrome, which is a neuroimaging manifestation of small vessel disease or cerebral amyloid angiopathy. So, I presented that yesterday, which was wonderful. Very great experience to have a lot of people who are actually leaders in the field come and ask me questions about my work.

And then on Wednesday, I am also going to be presenting a colleague’s work. She works with white matter hyperintensities, her name is Alejandra [inaudible 00:07:32]. And she has also been looking at neuroimaging or a neuroradiological manifestation of small vessel disease, which is white matter hyperintensities in Down syndrome. And I’m very excited to see if I will have some more people asking questions on Wednesday.

Adam Smith:

So, I’m going to put you on the spot and say, do you remember the poster numbers? So, we can encourage everybody who’s listening or walking to go away and check those out. Well, they can just go by your name as well.

Sára Zsadányi:

Yes, I have a very unique name. Well, my one yesterday was number 19, but I’m afraid I do not know Alejandra’s.

Adam Smith:

That’s all right. If you’re watching online, if you go to the platform and click on posters, it now allows you to search by surname or by first name. So, if you search S-A-R-A for Sára, and then Z-S-A-D-A-N-Y-I, you’ll find Sára’s posters. Or poster the first one, certainly, the other one’s for your colleague. So, what were the main findings from your poster?

Sára Zsadányi:

So, the main finding is that people with Down syndrome have a much higher prevalence of microbleeds. And we were also looking at some associations with different AD Alzheimer’s disease biomarkers. We were looking at some neuroimaging biomarkers, the white matter hyperintensities that I will be presenting on Wednesday, and hippocampal volumes.

And I was also looking at some CSF biomarkers and I was looking at a few cognitive tests as well. So, we saw a few associations between the microbleeds. So, with an increase of microbleeds, we had an increase in white matter hyperintensities, and we also had a decrease in the hippocampal volumes.

So, this was all very exciting for me, and I went on to do some regression analysis and found that many of the associations stuck around. But surprisingly the white matter hyperintensity is not so much. So, I’m going to be very interested in carrying on doing this work and also to look at the regions where microbleeds appear in Down syndrome.

Adam Smith:

Great. So, we’ll see more when you come back to AAIC next year. Or ADPD, which of course will be before AAIC. Any thoughts on what causes the microbleed? Why do people living with Down syndrome experience more microbleeds in the first place?

Sára Zsadányi:

Very good question. So, people with Down syndrome, from a very young age, start to accumulate amyloid because of the triplication of the APPG on chromosome 21. So, amyloid builds up in small vessels and we call this cerebral amyloid angiopathy. And when this happens, it causes the vessel walls to become a little bit weaker and a little bit of blood to come out into the brain.

Adam Smith:

Fascinating. Well thank you so much for sharing that. So go check that poster out on the platform. Or you’ll also see Sára wandering around the conference if you’re there in person right now in a purple T-shirt. But we’re going to talk about that a little bit later. Thanks very much.

Okay, so let’s get on with today’s highlights. Of course, the big news, the first big news which I’m going to introduce when we can all have a little bit of a chat about, was the report from Eli Lilly about the trailblazer owls to clinical trial of donanemab and how effective this is in early symptoms of Alzheimer’s disease.

I’m going to read this just so I don’t make a mistake. The three main bullet points that they gave away on their press release was that the beneficial treatment effect continued to increase relative to placebo over the course of the trial, with the largest differences versus placebo seen at 18 months.

They went on to say that study participants at the earliest stage of the disease had the greater benefit with 60% slowing of decline compared to placebo. And significant benefits were also seen in advanced patients.

I don’t know if there were more details. Obviously, I have to confess, I haven’t watched all of this talk back, so I’m guessing that there’s more detail if you go back and watch this on what they mean by more advanced patients and at what point that kicked in. The third point that they made was nearly half, 47% of study participants at the earliest stage of the disease who received donanemab, had no clinical progression at one year.

And the big difference on this drug compared to the other ones that the FDA have approved, is that it’s the treatment time. So, you only take this until amyloid is cleared and then you stop taking it. Whereas the other ones, that I think you continue to take it is my understanding of this.

And 52% of people who took this drug only actually participated for a year. So, I’m guessing that it had cleared the amyloid within a year, 72% within 18 months, which of course means that this is potentially significantly cheaper and of course doesn’t have the same pressure.

Aoife, you were there in person for some of this. Why don’t you tell us what were the nuances? I’ve given you the headlines that came out of the press release. What have you got to add to that?

Dr Aoife Cosgrave:

First off, it was just really exciting. I don’t think I’d ever been in a hall of that size before. And then when the first slide came up of all of the first top line data, everyone started applauding, which was very exciting. And what you said there about the coming off of the treatment, I think that’s really, really interesting.

And so, they were monitoring the people, they continued to do so. And it was about, I think it was 47 weeks, people were able to come off because they had such a lowering of amyloid. They came off of donanemab and then they were monitored again, and it was 76 weeks later from beginning of the trial that they were still but now off of the drug. So about 26 weeks later, still had lowering.

But then what’s going to be really interesting is to monitor these people long-term and see does amyloid creeps back up again? How often will these people need to be monitored to see will doses change? Or will you go back on the drug? But like you said, it could be cheaper for people then, doses could be changed.

I think it does really highlight the importance of being able to measure. And we saw so much about biomarkers over the last two days, that if you were able to cheaply, actually measure these people that should go hand in hand with it.

Adam Smith:

That’s the tricky thing is that’s what makes some of these things so controversial is because whilst I think there’s general agreement that amyloid has no place there and having no amyloid is better than having it, you can also have it but not necessarily have Alzheimer’s. So, deciding when to treat is the tricky part, I guess, and seeing that clinically impactful differences.

But I mean the results are amazing. I was interested in the bit about it, so 47% of study participants received no clinical progress. Does anybody have any sense of how that compares to other drugs? I mean 47%, because I don’t know if that meant that the other 53% did carry on or they just didn’t get as good an effect. And how does 47% effectiveness compare to? Is that good?

I mean it’s great for this disease when there’s nothing at all, nothing else out there, but how does that compare to other treatments? Is that a good start? I don’t really get a sense clearly … I’m not making much sense, am I? But you know what I mean. Clearly, it’s good, but how good is it compared to other treatments for other diseases?

Dr Aoife Cosgrave:

I don’t know the answer exactly to that question, but I think when we see further trials that compare. So, these are comparing a new drug against a placebo arm, be fascinating to see the lecanemab the donanemab comparing the new drugs comparing to these ones. That will give us a better-

Adam Smith:

We’re not going to be too far away from each other, are you? Particularly if regulators want to decide which one is the most cost-effective, they’re going to start to compare. So, Sára and Sonata, have you got any thoughts on this?

Dr Sonata Mačiulskytė:

No, except that it’s great news.

Adam Smith:

I think we can agree on that.

Sára Zsadányi:

It’s very good to see that I’ve come into this field at such a good time where all the science is doing exactly what it needs to be doing, working towards a cure.

Adam Smith:

Yep. I think that’s the general consensus, isn’t it? That this is good news. I think the challenge now, and we’ve seen this, I think there was a paper, an opinion piece in the, I want to say The Lancet, but it could have been Alzheimer’s dementia. I know John Shot and Nick Fox published a piece today from UCL talking about the practical implications now.

I mean because it goes with this treatment there, it’s great, but we’ve potentially got to start using it. And how do we implement something like that? We’ve got lessons from other diseases. We know that these therapies are delivered in other places, but we’ve got to learn from that and work how we upscale that, which I know AR UK is also campaigning for right now. You published your report last year and I see you are working with the Royal College of Psychiatrists for a series of workshops on that challenge.

Dr Aoife Cosgrave:

Yes, and we have a speaker at the conference on Wednesday. So, Susan Mitchell, our head of policy, is going to be talking on a panel about system preparedness. But a couple of others, the names I’m not familiar with yet. But yeah, that’s one to look out for on Wednesday. So how these healthcare systems can get ready in different countries for these new drugs.

Adam Smith:

Brilliant. Well, that’s the big headline takeaway. Congratulations to Eli Lilly for getting through that. And so now let’s move on and get some of your highlights. Sonata, why don’t you go first, tell us what you enjoyed most today?

Dr Sonata Mačiulskytė:

As far as I’m biased with the public patient involvement. So, I joined the session on public and patient involvement in dementia research and I enjoyed it. So, there were six presentations. They can be grouped into three groups, I would say. So, one group was presenting national and very new patient public panels.

So, there was a Project Netherlands, a Dutch Project abroad, which also launched BPI panel just a year ago. And the presenter explained all the process, how they recruited panelists, and how successful they assess this process as successful. So, they still have 55 panelists.

And also, what is important about maybe to say about this session that it may be very different from the rest of the scientific sessions, from the other scientific sessions. Because each of these presentations were followed by people from these members of PPIs. So, it was very powerful, I would say.

Adam Smith:

So, this is the patient and public involvement global prospective session that Helen Bundy Medsger chaired. And I think the session you’re talking about is Tanya Dereiki, who’s at Amsterdam UMC. So, I didn’t realize though because I didn’t attend this session. So, after each of the kind of reasons for doing PPI, a patient or somebody living with a disease, spoke after each of them.

Dr Sonata Mačiulskytė:

Or they were in-person participating, like Chris Roberts for example. For this aboard project, there also was a panel member who presented actually what they are doing there and how they find the results, how they find their impact on the project implementation, on the process of all research.

And it could also be videos, short, very informative. But they all in general were like a part of panelists who expressed their thoughts, their experience in participating. And the importance of understanding and acknowledging their role in participation in these panels.

Adam Smith:

That is great to see. Because I think, I mean historically I don’t think AAIC had many people living with dementia or carers actually take to the stage. I mean they might have done at the start to kind of set the scene, or maybe at their closing parts or some of the fundraising. But to actually have people, multiple people in individual session I think might be the first time that that’s done.

And whilst PPI is going up the agenda, particularly at this conference, I don’t think there’s been one that’s been given such a profile and such a platform on the big stage, which is brilliant. I think Anna Diaz from Alzheimer Europe was at that one. And Ira Leroy from GBHI Trinity. Dianne Gove is also from Alzheimer Europe. And Chris Roberts of course who’s a friend of the show, has been on here a few times before, gave a great tour.

I have to say I did skip in and jumped just to watch Chris’s bit. So, if you haven’t seen that yet, do have a look. Although I’m a little bit sad to see that on the online platform, the people living with dementia who actually spoke, their names aren’t mentioned anywhere in there and they should be, I think. So go fix that.

Well, is there anything else to add to that, Sonata, from that session? What were your main kind of takeaways? Other than clearly PPI is important.

Dr Sonata Mačiulskytė:

The notes which I made for myself that the PPI involvement is very important for increasing participation in research, in increasing engagement and trust actually in researchers, in research of people from target groups and from general public. So, it’s very important.

And also, what was mentioned by Chris, by the way, is that it’s beneficial for both. Their participation to the researchers and the input and insights they give, but also for those people to communicate with each other. They helped each other. And a very important message, which he said that actually when he was invited to participate in research, he actually had a lot of doubts. But when he started, he felt that he returned his confidence, he started to feel valued again. And that is very important.

Adam Smith:

And I think all too often we’ve thought of PPI as being something that’s exclusively important to qualitative researchers or clinical researchers, because they have to do study recruitment and having PPI will help study recruitment. And I think we’re moving away from that now to think about where the public and people with lived experience can contribute to that fundamental science space as well.

Not just things about preventing falls or improving hydration in care homes. Watch this space for a podcast on that topic coming next month. So, I think it’s great and I really hope that that room wasn’t just full of all the care researchers that are attending an AAIC, that some of the basic scientists went and watched that as well.

So, if you are listening to this now and you’re at the AAIC or you’re just watching online, please do take a moment to go watch the patient and public involvement dementia research, global perspectives’ session. Because it’s a great way, if nothing else, to remind you why this is important and why you go into the lab each day. And to have that direct line of sight between your work and the people that will benefit, I think is really important.

And so don’t just kind of keep your head down in the lab, do look up once in a while and see the people that are living with dementia because I think it can be incredibly motivating. Thank you, Sonata. And that’s me off my high horse preaching of the values of PPI. Aoife, why don’t I come to you next? What have you seen today that you enjoyed?

Dr Aoife Cosgrave:

I think donanemab was such a big thing, but there was also so much other stuff happening at the conference. And I went to a neuroinflammation and neurodegeneration research session. And there were a few different speakers, and I think what kind of kept cropped up time and time again was just that treating your inflammation would be really important alongside as a co-treatment with some of these disease modifying drugs.

And one area that I wasn’t very familiar with, but I just found it very interesting, is looking at fibrin or fibrin and it’s a protein that’s involved in coagulation cascades, blood clotting, in case I need to be corrected. But they’ve shown that this fibrin protein can build up around amyloid plaques like there’s a deposition of it. But this group are looking at immunotherapy to not target fibrin’s role in coagulation, but that it also activates its microglial receptor. And so, they’re looking at that pathway. I’m just kind of looking at my notes here.

Adam Smith:

That sounds like a smart solution to it. I think there’s a general agreement that the amyloid and anti-amyloid therapies alone aren’t going to solve this. Particularly if you stop and the amyloid comes back. But if you can put some immunotherapy on that as well. Although, because that means we need to understand the fundamental cause of what’s bringing them there in the first place.

Dr Aoife Cosgrave:

Yeah, exactly. And the idea is that you could neutralize fibrin as a selective target for regulating particular microglia function.

Adam Smith:

Is that in mouse models yet?

Dr Aoife Cosgrave:

So, this is actually one to look out for because it’s in phase one healthy volunteers to start with.

Adam Smith:

Wow.

Dr Aoife Cosgrave:

It’s called, I have the note, it’s a Therini Bio, the researcher’s name is Katerina Akassoglou. I’m definitely butchering the surname.

But another interesting thing is that it’s this blood brain barrier and you have blood leaks that could activate microglia. So, they’re thinking that you could use this, it might increase efficacy and maybe decrease area pathology potentially.

Adam Smith:

Yeah, so it could be like an ant-side effect treatment for something else that’s going on.

Dr Aoife Cosgrave:

Yeah. Possibly.

Adam Smith:

As a bonus.

Dr Aoife Cosgrave:

This is all speculative and potential down the line, but they’ve definitely got the first stage.

Adam Smith:

Clearly progressed-

Dr Aoife Cosgrave:

Phase one.

Adam Smith:

If that’s onto phase one. So, I guess they’re only just starting that phase one trial. There’s no results from that yet.

Dr Aoife Cosgrave:

No.

Adam Smith:

No. Okay. So definitely want to keep an eye on it.

Dr Aoife Cosgrave:

Yeah.

Adam Smith:

Thank you, Aoife. Sára?

Sára Zsadányi:

Well, it’s quite difficult to pick a highlight because I am in that stage where everything is incredibly exciting. However, I have been to quite a few very interesting talks today. But one thing that really stood out to me was the ASK session actually with the lifetime achievement award winner, Bruce Miller.

Adam Smith:

Bruce is brilliant. He’s been on the podcast as well before. He’s the UCS F and also the lead for the GBHI. And we did a podcast on GBHI a few weeks ago. Tell us about that.

Sára Zsadányi:

Yes, so I mean, I do feel like I’m bringing a lot of things together and making some connections, at least in my brain, for how we move forward with Alzheimer’s disease.

Bruce strikes me as a very big picture guy, I guess that’s in the job title of being part of GBHI and having so many years under his belt. There were quite a few questions that he got about all the comorbidities that can come along with Alzheimer’s disease. Because of course we are talking about people who are getting on in age and have lots of vascular contributions. They may have some Lewy body; they may have Parkinson’s.

And I found that very interesting. And I really enjoyed it, he answered a few questions where he was talking a lot actually about sleep and about exercise and the importance of these two things in trying to mitigate Alzheimer’s disease potentially. So very, very interesting talk. And he seems like the sort of person who would be lovely to have a very long conversation with.

Adam Smith:

I think inspiration for anybody who’s thinking about applying for the GBHI fellowship program, which I think is still open right now, that you could find yourself next year at UCSF being taught by Bruce. I completely agree. I think he’s a really engaging speaker and I love that.

I mean, the program is involved with GBHI in that they involve artists, musicians, and poetry. And he talks about this kind of bigger enrichment picture. And that he does talk about sleep and diet, which to hear from a neurologist at that kind of senior stage in their career, is quite unusual to have that big picture. And he’s a great speaker.

I don’t think those are, the ASK sessions sadly aren’t available online, are they? So, you can’t go back and watch that.

I’m going to bring up, now I’m going to jump ahead and bring up the other big news today, which is Alzheimer’s, the first ever county level estimates of Alzheimer’s dementia prevalence were published. Which covered all 3100 and some, 3142 United States counties finally had their prevalence data shared. And the study found that east and southeast regions of the US had higher prevalence of Alzheimer’s disease.

And this is using cognitive data from the Chicago Health and Aging Project, the CHAP Project, and population estimates from the National Center for Health Statistics. They also picked particular counties and Miami-Dade County, Baltimore City, Bronx County came out as having the higher prevalence, which can probably be explained because specific demographic characteristics.

I think in the UK, you’d think that it’d be the equivalent of Bournemouth and places where older people tended to live and retire too. But the older age and higher percentages also of Black and Hispanic residents in those places. Where Black and Hispanic residents lived, were twice as likely to have Alzheimer’s compared to older whites in those places.

So that was particularly interesting. Of course, anybody who’s listening to the States, that all this data has been published in Alzheimer’s and Dementia Today, so we’ll pop a link to that in the show notes.

But this is particularly important. I think in the UK we’re quite lucky. There’s been prevalence data for quite some time, although more on prevalence rather than instance, which is really poor. We don’t report on incidents at all. You won’t get incidence rates in the UK. We don’t publish it.

So, I think it’s a great first step, but moving on to incidence rates is going to be important, particularly when you’re starting to consider treatments and how many people are going to need this per year. And those estimates because those numbers just don’t exist. So that was a hot one today as well.

And I’m going to go around again. We’ve got time. To you, Aoife, first of all. Aoife, what else do you want to share from today?

Dr Aoife Cosgrave:

I’m going to share something kind of short and sweet because it was a poster presentation that, pardon the pun, caught my eye when I was walking through. It came from a PhD student, and it was looking at tears, teardrops as a biomarker for Alzheimer’s disease.

Adam Smith:

Tears? No way.

Dr Aoife Cosgrave:

Yeah.

Adam Smith:

Tears?

Dr Aoife Cosgrave:

Yeah, this is really cool.

Adam Smith:

Wait, can you imagine the process though? You have to make somebody cry to get-

Dr Aoife Cosgrave:

I know and this is a whole area of which I was not aware. There’s a tear research network looking at lots of different diseases. So, this student, she works in Maastricht University, so that would be in the Netherlands, and its pilot data.

But they were able to detect A beta40, 42, tau, total tau, phospho-tau, in the teardrops. And then they looked at, and they found that the total tax, how I’m reading my notes here now, was significantly elevated or higher levels in dementia patients.

Adam Smith:

Stunned silence from the audience.

Dr Aoife Cosgrave:

Yeah, amazing.

Adam Smith:

Wow. So that’s even easier than blood.

Dr Aoife Cosgrave:

I know.

Adam Smith:

I mean, if that works, why are we bothered with pinpricks and blood? Let’s just a little sniff of some smelling salt and you could drop a tear onto a card and get a … Wow.

Dr Aoife Cosgrave:

Yeah, this would be amazing if it got, yeah, if it develops into something bigger.

Adam Smith:

Did they talk about, are there any other diseases we measure through tears?

Dr Aoife Cosgrave:

So, the are-

Adam Smith:

Is it already clinically, have we got efficacy somewhere else?

Dr Aoife Cosgrave:

No. Yeah, they were looking, so there’s other groups looking at different diseases, but they weren’t familiar with them. I’m going to have to do a bit of digging myself.

Adam Smith:

Okay. We need that poster. Everybody’s got to go look at this poster now.

Dr Aoife Cosgrave:

And actually, I bumped into their colleague, and he looked at thickness of the, it was the retinal nerve fiber, and that thickness can change. So, they’re showing it to be thinner in Alzheimer’s disease.

Adam Smith:

That’s really interesting. Can you remember the name of the presenter so people can look that up?

Dr Aoife Cosgrave:

Yes.

Adam Smith:

I’ll tell you what, I’m going to move on. I’ll let Sára tell her highlights while you look that up and I’ll give you a minute. Sára, back to you.

Sára Zsadányi:

Well, first thing this morning, 8:00 AM, I was attending a talk about 7-Tesla MRI. Quite an interesting topic actually. Although there are not so many 7-Tesla MRI scanners in the world. But yes, as you can imagine, they’re very expensive.

One thing that really stood out to me, there was a talk at the end about it, so they were mostly talking about COVID survivors when they were talking about the 7-T MRI that they were looking at. And there was one talk about white matter hyperintensities, which I’m a big fan of as you can probably tell, in COVID survivors.

And something that stood out to me was that she was talking about how 7-T could be quite useful in being able to detect more subtle injury in the white matter. So, I’m very interested to see all these higher Tesla MRI scanners and all the research that’s coming out of it in the next few years.

Adam Smith:

Fantastic. Thank you. Yeah, I mean more MRI machines. I saw some stats this week that showed how many MRIs the UK had, when we were very behind in other parts of the world. Sonata, I’m going to come back to you. Oh wait, Aoife, did you find the name of that speaker?

Dr Aoife Cosgrave:

Yes.

Adam Smith:

While we remember.

Dr Aoife Cosgrave:

Ninka Van Dersandy is the name of the researcher.

Adam Smith:

Check that out about tears.

Dr Aoife Cosgrave:

PhD researcher. Yeah.

Adam Smith:

Sonata?

Dr Sonata Mačiulskytė:

Okay. I attended one more session on sensory loss and sleep disturbances in persons with dementia and their care partners. Yeah, I’m interested in everything what is related to care partners as far as I, myself, care. There were two talks about sleep disturbances in care partners, both talks presented pilot projects. So, it’s a very initial stage of research.

The samples also were very small, so it’s very difficult to do any generalized outcomes of it. One research had only 70 ads explored, the other one 30. But the first one didn’t have … This is very initial data. It was interesting to hear that sleep is bad for caregivers even if they are separated from their care recipients.

So, it’s very interesting, but I think that still for me as a career, it’s not enough. I’m just looking for something what will be done with these results. Of course, there are needed much bigger and much longer researchers, but of course I’m always thinking what will be done with these results?

Adam Smith:

I think it’s an under-researched area, I would imagine. Because of course we look at sleep all too often in that preventative kind of brain health space, don’t we? As the importance of sleep for clearing the brain at the end of the day. And we know that that’s, in the last few years, that that’s been found to be more important than ever. And then looking at that.

But I don’t think I’ve come across very much that really looks at the importance of sleep for carers. Because if you’ve got the full-time job of looking after somebody living with dementia, and you’re at home and you have poor sleep, your capabilities to actually care for that person effectively, and the risk of you then also going on to develop the disease, are particularly relevant. Is this the talk you’re talking about? Is this the Yuzu Song from VA Greater Los Angeles?

Dr Sonata Mačiulskytė:

Yes, this is the second one. And there is Mike Quick, I guess. So also, from-

Adam Smith:

Mark Quake from University of Virginia. Quantifying Care or Sleep Disturbance Using Dynamic Models.

Dr Sonata Mačiulskytė:

It was interesting. It was catching, but still very underdeveloped. But yeah, I can really confirm that it is a problem when you are an intensive carer.

Adam Smith:

So many carer issues are overlooked, aren’t there? Or dealt with in a separate space that doesn’t consider them to be dementia research. Whereas actually the impact on carers is probably more significant than the person living with dementia themselves at that stage. So, do more research on this please.

We’ve burnt through our time. Are there any burning talks that you wanted to talk about that I didn’t give you a chance to? No? Good. In that case, there is one last one. I’m going to hold this up. For those who are watching on YouTube, you can see this, the poster I’m going to talk about next looks like this.

And I’m going to measure this because I’m one of the co-authors on it. It’s Diana Karamacoska, who is a colleague of mine, who we both collaborated on the ISTAART PIA to elevate early career researchers. And there’s been a piece of work going on for quite some time now, but it’s finally got this poster, which compared the G 20 countries for how they support early career researchers. And how early career researchers are or are not mentioned in their particular dementia strategies.

You’d be pleased to know the US and UK did particularly well, but it compares all the countries from G 20 to see what support they had for ECRs. Probably no surprise to see that there were lots of countries who didn’t have any mention whatsoever of support for ECRs. I mean they do provide funding for research, but they’re not specifically mentioned as a group of people that need extra support or mentoring.

There’s certainly nothing in their national strategies, which I think is a real missed opportunity given that they’re the people that are driving these discoveries. So, if you don’t support the careers of researchers, how are they ever even going to be there to take advantage of the funding that you make available? So, it’s a great poster. Do have a look online. It’s Diana Karamacoska, who is K-A-R-A-M-A-S, no C-O-S-K-A. I think my name’s on there as well. So, you could look for Adam Smith. It might still bring it up.

So yeah, a little plug for our poster there. And if you’re not already a member of the ISTAART PIA to elevate allegory researchers, goo joins because you get the opportunity to be involved in great work like that.

Phew. Right. We’re going to have one last little segment where I’m going to talk to Sára about her work because I have no idea how she’s actually found time to talk about anything today because she’s also an ISTAART volunteer. So, let’s just ask a few questions about that.

So sorry, you’re not still wearing your purple T-shirt, but you’re one of the people who’ve been running around at the conference wearing one because you’re an ISTAART ambassador. What is that? What does that mean?

Sára Zsadányi:

Well, it’s actually very exciting. I’m so, so happy to have been given this opportunity. So, I am currently working with a whole cohort of ambassadors from this year until mid-next year. And so mainly our roles here have been to make sure that everything runs as smoothly as it possibly can.

So, if you’ve been at the conference, you’ve probably been able to see people in purple shirts running around quite a bit. And we’ve also been in all of the talks trying to make sure that the speakers know what they’re doing. And that we can help with the AV team to make sure that everything has been running as smoothly as possible. And yeah, it’s been wonderful. The other ambassadors have been so lovely to work with.

Adam Smith:

How many of you are there?

Sára Zsadányi:

I believe it’s 25. I could be wrong about that.

Adam Smith:

So, this is 25. Anybody can apply for this, and the application is usually open towards the start of the year. And then you get to go to AAIC, they cover all the costs of that, and it doesn’t preclude you from presenting either because as you say, you’ve got posters. I guess you don’t necessarily get to go to every session you might want to see because you go to wherever you go.

Sára Zsadányi:

So, for example, I was not able to attend in person the donanemab today because I had other things that I needed to get done. But we do get a choice to go to specific sessions.

Adam Smith:

Perfect. So, if there’s one that’s really for your research field, you could state a preference as well.

Sára Zsadányi:

Yes, absolutely.

Adam Smith:

Awesome. This of course is just the start because you have the whole year then where there are other events, and I know that they provide extra training and sessions for you all. And so, you’re going to find all that out over the coming year.

Sára Zsadányi:

Yes. And we’re very active on social media at the moment. Anywhere there is the hashtag AAIC23, you’ll be able to see somebody who is wearing a purple shirt. And yeah, I’m very excited to see where the rest of the year takes us.

Adam Smith:

Great. So, I’ve given Sára a chance to plug her thing. Aoife, is there anything going on at AI? You’ve got a big reception. I’m not sure when this podcast will come out. It’s either going to come out today or tomorrow morning, but which is still plenty of time to sign up if you’re in Amsterdam right now. Are there still places in your reception?

Dr Aoife Cosgrave:

The networking reception is with places, I think we’re at full capacity now.

Adam Smith:

Okay. I shouldn’t have mentioned that then, shouldn’t I?

Dr Aoife Cosgrave:

But it’s-

Adam Smith:

Just turn up. Just turn up. Just go knock on the door, say you know Aoife and Aoife said it was okay and they’ll let you in. Is there free wine? I assume there’s wine.

Dr Aoife Cosgrave:

Yes. And nibbles and it’s with other, so it’s with the Alzheimer’s Society, the Dementia Research Institute, and the Dementia Platforms UK. So, we’re all co-hosting a networking event. But it’s actually-

Adam Smith:

It’s incredibly irresponsible of me to say go. But have a look on your Twitter, you can always fill in the form. You never know. There might be a wait list.

Dr Aoife Cosgrave:

Yes. Yeah, exactly. And I just yesterday seeing 1000s of people. I think if anyone gets the chance to go to one of these kinds of smaller offshoot events, it’s just that little bit of a smaller crowd. You might get to chat to more people and not as overwhelming as the big 1000s that arrived yesterday.

Adam Smith:

I completely agree. I think one of my best bits, obviously I’m not at the AAIC in person this year, but one of my favorite bits is the kind of socializing and networking. And that’s where so many of the connections and things that we’ve made. So many podcast guests and people who’ve contributed to dementia research over the years have come from chance conversations in a bar or at a reception after the AAIC. So do take the chance to go look at those.

Sonata, have you got anything lined up for the rest of the week? Is there anything particular that you’re going to be looking forward to for the rest of the conference?

Dr Sonata Mačiulskytė:

Yes. Tomorrow, I guess it’s more like a dementia care practice session. So, I will be tuned for half of the day at least and spend it next to my computer.

Adam Smith:

Brilliant. Well, do you know what? I also didn’t acknowledge, just I imagine it’s quite late in Lithuania right now, so I’m really sorry if I’ve kept you up.

Dr Sonata Mačiulskytė:

Yes.

Adam Smith:

And I know it’s getting past 10:00 o’clock in the night in Netherlands as well, and I’m keeping you both from the bar, I imagine. So, I’m going to wrap things up there.

Thank you so much to my incredible guests, Sára Zsadányi, Dr. Aoife Cosgrave, and Dr. Sonata Mačiulskytė, for all your amazing contributions and for sharing your highlights with us today. We are going to be back tomorrow with day three and tune in. I’m Adam Smith and you’ve been listening to the Dementia Researcher Podcast.

Voice Over:

The Dementia Researcher Podcast was brought to you by University College London, with generous funding from the UK National Institute for Health Research, Alzheimer’s Research UK, Alzheimer’s Society, Alzheimer’s Association, and Race Against Dementia. Please subscribe, leave us a review, and register on our website for full access to all our great resources. Dementia Researcher.nihr.ac.uk.

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