Podcast – AAIC 2018 Day Two

Voice Over:

Welcome to the Dementia Researcher Podcast, brought to you by dementiaresearcher.NIHR.ac.uk, a network for early career researchers.

Adam Smith:

Hello, my name is Adam Smith. Welcome to the second of our podcast recordings for the NIHR Dementia Research website on location from the Alzheimer’s Association International Conference in Chicago. For those that didn’t yet listen to day one, this week we’ll be recording a podcast at the end of each day reflecting on what we’ve discovered at the AAIC over the course of that day and sharing with those early career researchers who haven’t managed to make it out to Chicago. I’m really grateful to today’s panellists, who have once again skipped the last session of the conference to talk with us. Firstly, I’d like to welcome Nika Seblova, who’s a PhD student at the Karolinska Institutet in Sweden. Next, we’ve got Sarah Gregory, a research coordinator for the PREVENT and EPAD studies at the university of Edinburgh. And last but not least, we have Ivanna Pavisic, a PhD student working on neurocognitive assessments at University College London. So let’s get started by finding out a little bit more about our panel. So could you tell us a little bit about yourself, Nika?

Nika Seblova:

Hi everyone. I’m Nika, and I originally come from Czech Republic and currently I am doing a PhD in Sweden at Karolinska Institutet at the Aging Research Institute and Department of Public Health Sciences, and I’m in my last half yeah of PhD, trying to wrap up. So to relax, I do a lot of hiking and outdoor activities and kayaking, which is really nice to find some break from all the hard work.

Adam Smith:

Yeah, your last year, so you’re nearly there. Do you know what you’re doing next?

Nika Seblova:

I have no idea. I’m trying to figure it out one day.

Adam Smith:

Well, I’d like to think that our website might have a few suggestions, so do check it out.

Nika Seblova:

Great. I’ll check it out.

Adam Smith:

How about you, Sarah? Please go ahead, introduce yourself.

Sarah Gregory:

Yep. Hi, I’m Sarah. I work in the Centre for Dementia Prevention at the University of Edinburgh. And I coordinate a few studies, but the main studies I work on are the EPAD and PREVENT programs, and these are big cohort programs looking at midlife risk for dementia and running intervention trials within the EPAD cohort as well. I’ve previously worked on lots of different clinical trials of medications down in London and moved up to Edinburgh about a year ago.

Adam Smith:

I don’t know if we have to kind of fess up to this as well, but I’m a participant in PREVENT. Maybe I shouldn’t say that cause that gives away my age, cause you have to be over 40 to be a participant in PREVENT, I believe.

Sarah Gregory:

Yes, you do.

Adam Smith:

But yes, I can say it’s a fantastic study. I’ve enjoyed being a part of it. I don’t enjoy the biannual phone calls to say that my cholesterol is too high.

Sarah Gregory:

Yes, everyone gets them.

Adam Smith:

But it is quite useful. And Ivanna.

Ivanna Pavisic:

Yes. Hello everyone. My name is Ivanna. I am a first year PhD student at University College London, and I am trying to study the potential use of neurocognitive tests to detect early onset Alzheimer’s and other AD pathologies. I’m also a part time research assistant and I do assessments for other studies and other dementia syndromes. And I guess a fun fact about myself is that I have a dog named Sherlock.

Adam Smith:

Sherlock. What kind of dog is it?

Ivanna Pavisic:

It’s a mountain dog.

Adam Smith:

A mountain dog.

Ivanna Pavisic:

A Bernese Mountain Dog.

Adam Smith:

A Bernese Mountain.

Ivanna Pavisic:

Yeah.

Adam Smith:

Aren’t they really fluffy?

Ivanna Pavisic:

Yes, they’re very big.

Adam Smith:

He can’t be enjoying the weather back in the UK right now.

Ivanna Pavisic:

No.

Adam Smith:

I gather that there’s a massive heat wave today.

Ivanna Pavisic:

Yeah, yes.

Adam Smith:

Well thank you very much everybody for introducing yourselves. Before we move into talking about what we’ve learned today, Ivanna and Nika, I believe you’re also both presenting. I imagine you’re both relaxing today because you’ve managed to finish your presentations yesterday and today. So Nika, maybe you could tell us, what have you been presenting on while you’ve been here?

Nika Seblova:

Yeah, of course I can tell you. My entire PhD is on causal effect of education on lifelong cognitive ability and dementia. And today I have been presenting the last project from my PhD, actually, sorry, yesterday, jet lag. I have no idea what day it is. So yesterday I presented and it was an oral presentation and I’ve been looking at dementia incidence trends in inpatient record data in Sweden. So I have a national population and I was able to look at 30 year trends and I looked at two factors, how does this differ by sex and education? And we were able to show that up to year 2011 there has been an increase for all ages and for both sexes and for education levels. And after 2011 the dementia incidence in the hospital records started to decrease, which is quite good news in some way. So that has been my presentation.

Adam Smith:

Well that’s really interesting cause we were just talking about that on, for those who haven’t listened, we were talking about that on yesterday’s podcast cause I think, I can’t remember, one of the panellists was a bit sceptical about incidence rates dropping and I referred to, I can’t remember who it was. I can’t. The presentation the year before from, they used the example of a bath tub with a tap going in-

Nika Seblova:

Yes. The prevalence and incidence.

Adam Smith:

Yeah, exactly.

Nika Seblova:

And I think that it’s really important to know because even in my case, I’m looking at first time cases, so my conclusions are that the hospitals might see fewer first time cases, which doesn’t mean that they will see fewer dementia cases overall because the population is aging and there are more people. The number of older adults is increasing, but there has been an entire session on it yesterday. And close to everyone has been seeing these decreases in smaller cohort studies and my study is one of the first ones to look at it a national sample in a real world data. So that it has been my contribution.

Adam Smith:

That’s really exciting and I guess as well, because we know that people are living with dementia for longer, partly because of the early diagnosis, but also changes that they make to their lives. Of course the overall prevalence doesn’t come down, it’s just the-

Nika Seblova:

Yeah, there we probably will see a lot of people, but it’s good to know for healthcare services to be able to plan, so yeah.

Adam Smith:

So we can’t all give up. This isn’t always going to be the case.

Nika Seblova:

I think there are good things and some positive messages, even if we don’t have cure or treatment. And sometimes we should take a moment and think about what is good and a lot of the good work that’s being done here and presented.

Adam Smith:

And that’s really interesting, because we’re going to go on to talk in a little while about the risk factors and a presentation from earlier on today about what you might change. Ivana, you’ve also, you’ve had two.

Ivanna Pavisic:

Yes, I’ve had two posters. My poster today, I presented some work that I did with an eye tracker. It’s a machine that you’re able to follow the person’s eye movements and it gives quite a lot of information about the brain and cognitive function. So we presented this task, which was a spatial anticipation task, basically the person was looking at a screen and they had to anticipate the movement of a dot. And it relates to cognitive, excuse me, to executive function, which is known to be impaired in behavioural FTD patients. So we presented that work including other dementia symptoms from the frontotemporal dementia umbrella term. And we showed that behavioural FTD patients performed worse at the task and it was quite nice cause it’s quite a short task and we did quite some good sensitivity. So it’s just a computer task.

Adam Smith:

That’s really interesting as well. Was that the topic for both or is that-

Ivanna Pavisic:

No, that was the topic for today’s. The topic for yesterday’s, as part of my PhD, I’m looking at, again, cognitive assessments, but for the familial AD cohorts at the dementia research centre. And we’re looking into visual short term memory, which we know is impaired in AD and in familial cases as well. And we presented some longitudinal work on that. So again, it was a computer task and people had to remember the identity and the location of specific items on the screen. And we looked at how that differed between gene carriers and noncarriers who are asymptomatic. And unfortunately we didn’t see any change longitudinally, any difference between the two longitudinally, but we did see a difference between symptomatic gene carriers and controls and also quite a strong correlation between the performance of this task and the age at which individuals tend to present symptoms. Because we know that in this specific rare form of Alzheimer’s, the age of onset is quite similar within a family. So yeah, some mixed results, some exciting-

Adam Smith:

There must be so many new ideas come out of that as to what to do next?

Ivanna Pavisic:

Yeah, definitely. I think the properties of certain tests are good for cross-sectional studies and not so good for longitudinal ones. So I think in terms of the properties of the tests, that’s something to look into and probably combine different techniques as well. Yeah.

Adam Smith:

That’s really interesting. And I guess you must, do you have to work with engineers and tech people and all of those kind of groups of people for that kind of work?

Ivanna Pavisic:

Yeah, definitely.

Adam Smith:

And of course, I’m not biased cause I also work at UCL, but UCL is a great place for that.

Ivanna Pavisic:

Yes, a great place to collaborate.

Adam Smith:

There really is a real sense of collaboration. Yeah. Yeah. Okay. So just before we move on, I’m sure that some people might be really interested in getting in touch and learning more. Obviously I think some of your posters might already be uploaded to the AAIC app, but maybe if you could give us your Twitter names maybe and then people can get in touch if they want to. Nika, you’re on Twitter, right?

Nika Seblova:

Yes, I’m on Twitter. That’s how I ended up being on this podcast by contacting you. So my Twitter handle is Nika Seblova, spelled S-E-B-L-O-V-A. And yeah, that’s a good way to contact me or find my email by searching for Dominika, full name, Seblova.

Adam Smith:

Fantastic. Was yours an oral today or a-

Nika Seblova:

It was an oral presentation yesterday, yes.

Adam Smith:

Oh, yesterday of course. So there isn’t a picture of you next to your poster on the-

Nika Seblova:

There isn’t one, unfortunately. But if anybody is interested in learning more, I do have all of my slides in a PDF and I’ll be more than happy to share them. And I also have already a manuscript that’s now under revision. That will be hopefully coming out soon, so I will be happy to share everything with people who want to know more.

Adam Smith:

That’s really cool. Thank you very much. And Ivana?

Ivanna Pavisic:

Yes, my Twitter is I-V-I underscore P-A-V-I-S-I-C. And you can also find me just Googling my name and UCL.

Adam Smith:

And there are pictures of you next to your poster.

Ivanna Pavisic:

Unfortunately, yes.

Sarah Gregory:

Nice. Well done.

Nika Seblova:

Were you screened on the big Twitter-

Ivanna Pavisic:

I hope not.

Nika Seblova:

Information centre. It’s a bit weird when you see your face enlarged on it.

Adam Smith:

For those that haven’t been to an AAIC before or for those that have, I’m sure you’ve seen these at conferences, they have the Twitter wall outside the main reception where there’s a feed of everybody that’s used #AAIC18 and suddenly you can be walking past and see your face blown up too to the size of a wall.

Nika Seblova:

Yes, it happened to me. I took a selfie before my presentation and now I have seen it repeatedly blown up and people pointing it out to me.

Adam Smith:

I saw mine but by the time I got my phone out, it moves on, they’re only on there for a few seconds on there. Okay. So moving on, today was the second day. It’s been another jam-packed day and I don’t think too many people seem to have suffered with sore heads after last night’s fantastic welcome reception at the Navy Pier. I did enjoy the drinks and the band were really exciting as well. I didn’t get my picture taken on the surf board. Did any of you?

Ivanna Pavisic:

No.

Adam Smith:

No?

Sarah Gregory:

No.

Adam Smith:

You didn’t do the surf board.

Ivanna Pavisic:

I think I enjoyed looking at that situation by not being part of it.

Adam Smith:

More of a watcher. Did anybody see the Ferris wheel turn purple? I missed that.

Nika Seblova:

Yes, I went on the Ferris wheel when I was walking back. I had never been on a Ferris wheel and I saw it being incredible. So yeah, I went with a friend.

Adam Smith:

You’re not afraid of heights, then?

Nika Seblova:

I love heights.

Adam Smith:

I have to say, I’m planning to go back when I’ve got a little bit more time, but I ended up chatting to so many people that I was just tired. By quarter past nine, felt early, thinking, “Well, I could do another hour,” and I really couldn’t by the end of that. So did you enjoy the famous Chicago pizza? I think you’ve got some strong feelings on this, Ivanna.

Ivanna Pavisic:

Well, I am half Italian, so I don’t think that should be called pizza, but it was still very tasty. So if we just remove the word pizza, that’s fine.

Adam Smith:

I stopped eating meat about a year ago and that’s been a bit of a struggle so far that everywhere is quite meaty. I think I might have struggled if I’d have been a vegan last night, but there were vegetarian options. It was good. What about you Nika? Did you have the-

Nika Seblova:

No, there were too many things to do, too many people to see, good music to dance to. So no, I ate ice cream for dinner. Very healthy. So no pizza for me.

Adam Smith:

I’m not deliberately excluding Sarah at this point, cause I realize that I’ve been bouncing backwards and forwards between Nika and Ivanna. But of course, Sarah, you’ve already told me in advance, you didn’t manage to make it last night.

Sarah Gregory:

I didn’t make it last night, no, but I am going to have a pizza pie before I go home.

Adam Smith:

You are.

Sarah Gregory:

I definitely am, have to.

Adam Smith:

Just to put you on the spot, what did you do last night that was far more fun than going to the welcome evening?

Sarah Gregory:

We had an EPAD dinner at a Mediterranean restaurant.

Adam Smith:

That sounds quite civilized.

Ivanna Pavisic:

What is EPAD again?

Sarah Gregory:

It’s the European Prevention of Alzheimer’s Dementia consortium. We were preparing for what we’re doing throughout the rest of the conference.

Adam Smith:

So you’ve collaborators all over, I’m going to say Europe, but is that across the world now?

Sarah Gregory:

It’s all over Europe, but collaborating with other groups across the world as well.

Adam Smith:

Okay. So the AAIC is a great opportunity to just, everybody’s in one place and you can-

Sarah Gregory:

Yeah.

Adam Smith:

Okay, that’s a good reason.

Nika Seblova:

So while we were playing, you were actually working, so there was both play hard and work hard last night.

Adam Smith:

Okay. So before we get into talking about today’s talks, I should confess, I haven’t had a lot of time to take on board many of the talks today. Dementia Researcher has a booth here at the exhibition hall, and I’ve had a really great time talking to lots of people about the Dementia Researcher website. There’s been so much in stress, particularly for my search student volunteers, but also people from overseas asking if it’s got things and content relevant to them. And I really think probably only about 20% of the content’s UK specific, the jobs and funding, but even those, if you’re in the US and you’re thinking that the UK is a great place to consider, I think the jobs, events, and funding are still relevant to you. I did have a particularly interesting chat with Sharon Salt and Lauren Pulling, who both work and manage the Neuro Central Online Journal.

Adam Smith:

I don’t know if any of you have seen that. They’re quite active on Twitter as well. I think that’s a journal looking at bridging the gap between neurology and neuroscience and the potential, we had a chat about the potential for us to collaborate on some content there about guidance on how you might get your articles published and things. So watch this space and hopefully that’ll turn into something in the future. So today’s talks, there have been so many, haven’t there? It’s been such a-

Nika Seblova:

Very busy day again.

Adam Smith:

And I know that some of you have obviously had the stresses of trying to deal with your own, you had flight problems. And hangovers aside, taking on board today’s talks has been so much to do. Nobody had hangovers.

Nika Seblova:

No, nobody ever gets hangovers. We’re all professionals here.

Adam Smith:

So first of all, let’s talk about, there was a session on multimodal strategies for dementia prevention and aging brain and the risk of Alzheimer’s disease. I know from our conversation before, Ivanna, you managed to get along to that talk, which was one of the big talks of the day. What did you think? What do you hear?

Ivanna Pavisic:

Yes. Well I had the opportunity to listen to Miia, I’m going to pronounce her surname wrong.

Nika Seblova:

Kivipelto. I can help you with that.

Ivanna Pavisic:

Thank you.

Adam Smith:

Cause you work in Miia’s, the same-

Nika Seblova:

Yes. Miia Kivipelto is at the same Institute as I am, the Aging Research Centre in Sweden, but she works international also in Finland and all over. But I missed her talk today, so I’m interested to hear what Ivanna has to say about it.

Ivanna Pavisic:

Yeah. I’m not as familiar with her work because back at UCL we mainly work on diagnosis and cognitive assessments. But it was actually very interesting to listen to all the studies on how nutrition, exercise, and cognitive training can have an impact on just cognition in general. And then there was also mention of the effect of APoE4, so it was quite an interesting talk. It was very nice for me to listen to this side of research as well that I wasn’t as familiar with. And then they mentioned as well that the next steps, or maybe it has already started, is to move on to a World Wide FINGERS program, so they are expanding into new sites and it all sounds very exciting and definitely relevant.

Adam Smith:

I have been following social media today, and something that was much tweeted about was, I don’t know if it was that 30% of Alzheimer’s cases could be prevented by addressing a limited number of factors. I mean, I think we kind of knew some of this before, but the diabetes, depression, hypertension, smoking, obesity, low education and lack of physical activity. As a participant of PREVENT, I know that these are all things that you look at in that study too, do you track some of those things?

Sarah Gregory:

Yep. PREVENT at the moment is taking baseline and two-year follow-up visits and we collect data on all of those alongside multiple other cognitive measures, MRI measures, physical health, and we’re planning to continue those follow up assessments for a longer period of time as well. So we do hope that we will have a really good measure from people who are aged 40 throughout their lives to see if it does have an impact on dementia risk. We measure a few of those within EPAD as well, so that’s people who are age 50 and above, and we’re taking a lot of those measures for that as well to see what are the risk factors that could potentially be modifiable.

Adam Smith:

Yeah. Well yeah, that’s interesting. How long is that going to take before we can get that, is that going to be a long way off? When do you think you’ll start to see?

Sarah Gregory:

That’s probably a question for [crosstalk 00:19:48]

Adam Smith:

Good point. Okay, let’s move on and talk about, never mind the main sessions, what interested you today? Nika, what did you manage to get along to see today? What presentations or posters have you seen today?

Nika Seblova:

I have managed to go to a few presentations and posters and I realized that there is a theme to what I have liked today. So I’ll do my disclosures of interest, I’m really interested in health inequalities and disparities in healthcare. One of the main sessions I went to was the NIA Health Disparities Research Network and they were presenting on novel approaches for addressing Alzheimer’s disease and related dementias. There were a few presentations that were really fascinating and overall the whole concept of bringing dementia research for everyone and including all populations because it is something that we need to do and also improve our research to include all populations.

Nika Seblova:

One of the studies looked at algorithmic dementia diagnosis and health disparities, basically how we can assign a mental diagnosis in different research studies because a lot of the times we don’t have the data to know if they do have or do not have dementia. But if we use other factors and cognitive tests, we can maybe assign it and then study this as a proxy for dementia as the first step on existing databases and get some information on minorities. That was really interesting. I mean, it was also very interesting because it’s using complicated modelling and predictive modelling. And one of the big issues with the predictive modelling, which I think is now super sexy, is that it uses the data that we already have. So the presenter, Melinda Power from George Washington University, she also talked about we need to be really careful what we put into these models. So that was one interesting talk that I’ve seen today.

Nika Seblova:

Yeah. And then there was another very exciting poster I would like to point out to everyone. It’s been titled, Feels Like It’s For Us and It’s For Us. And it was about minority retention in, a retention project in a research study. So it is a little study in Portland and they were trying to design a physical activity that we just heard from Sarah is really important and from Ivanna, also from FINGER trial. So, they design a little physical program where they got three African American adults, older adults, to walk through neighbourhoods at least a mile and then together record a history and how has the neighbourhood been changing over time? So there’s a social component, recalling a cognitive component, and also a physical one.

Nika Seblova:

And then in this program, it was a six month program, they do these walks repeatedly. And this research study, they have been following how many people stayed in the study because dropouts are a lot bigger in African Americans in the United States. And they have really focused on creating an environment and a research project that is targeted to African Americans so we can learn more how to be culturally appropriate and involve everyone. So that was very exciting. The project was presented by Edline Francois from Layton Aging and Disease Centre, I think. You can look her up.

Adam Smith:

I was in Portland. Did you say Portland?

Nika Seblova:

No. Oh, Portland, Oregon.

Adam Smith:

Yeah, Portland in Oregon.

Nika Seblova:

So yeah, those were the two talks that caught my eye today.

Adam Smith:

That’s both really fascinating as well, I think, particularly the look at those other communities. Did any of you pick up on those as well? No?

Sarah Gregory:

I didn’t get to either of those, but they both sound really interesting.

Nika Seblova:

Yeah. I think it might be slightly a bit of my bias coming in [crosstalk 00:23:49]

Adam Smith:

Was there something from that to take away for your own work as well?

Nika Seblova:

Well, yes actually, because I look at social economic inequalities and education, those are my main focus. So I thought a lot about, we do not have the same maybe racial or ethnic disparities in Sweden, but a lot of this could probably be expanded to inclusion of lower educated individuals and people from disadvantaged socioeconomic backgrounds. And so I’ve been thinking a lot about how I could use my data, let’s say look at quality of care among those individuals or retainment in studies, so yes.

Adam Smith:

When you were looking for ideas for your postdoc earlier cause you weren’t sure what to do next, that’s-

Nika Seblova:

Yeah, I’ve been actually scooping for ideas at this conference and I’m really excited to go home and take some time to think, sketch out my applications.

Adam Smith:

There’s no shortage of ideas. Sarah, how about you?

Sarah Gregory:

Yes. So mine unsurprisingly were about risk factors and prevention. So the first talk that I really loved this morning was about TV and the association with brain volume. As a serial Netflix binger, I thought it was important that I went to this to see if watching that much TV is dangerous and it was really interesting. They used TV as a proxy of sedentary behaviour as something that is not that cognitively engaging that you’re typically passively watching it so you’re not being physically active and you’re probably not being that cognitively active as well. And it was in the CARDIA study in the US and it was comparing self-reported hours of TV watched every week with outcomes of volumetric MRI analysis. And they found that for each hour that someone reported they watched TV, there was a significant decrease in total brain volume, total grey matter, and frontal grey matter.

Adam Smith:

Oh God. Really?

Sarah Gregory:

Yep.

Nika Seblova:

Oh that’s really depressing.

Sarah Gregory:

Concerning.

Adam Smith:

And the chances are, people probably under-reported their watching, cause nobody wants to confess to watch that much TV.

Sarah Gregory:

I think the mean was about 2.6 hours a day, which is probably, two hours a day, not that unusual maybe?

Adam Smith:

No, if you came home and turn the TV after dinner then it’s on till bedtime.

Sarah Gregory:

Exactly.

Adam Smith:

Of course, we all read books, right? Here we love them.

Nika Seblova:

No, no, we never watch TV and Netflix doesn’t count. If it’s on my computer, it doesn’t count. it’s only actual TV.

Adam Smith:

Oh, that’s bad.

Sarah Gregory:

And they controlled using additional models controlling for cardiovascular and physical activity, and the total grey matter and frontal grey matter decreases still existed. Their hypothesis from this was that it could be a link with cognitive reserve, so rather than being associated with being physically inactive and watching TV that maybe it’s that you’re not being mentally active and they’d be interested to look in the future to see if there’s particular types of TV shows that could be more protective. If you’re watching a documentary where you’re learning something, is that slightly different to-

Adam Smith:

Oh, that it could offset?

Sarah Gregory:

Yeah.

Adam Smith:

You can watch telly as long as it’s good telly.

Sarah Gregory:

If it’s good TV.

Adam Smith:

Isn’t that what we’ve been saying to children for years. “You can’t watch Scooby-Doo but you can watch Blue Peter.”

Sarah Gregory:

Yeah, they referenced that. With children, there is research in this already that there is good and bad TV and I think they wanted to kind of adapt it even to computer games. You’re sitting with a computer game but some of them probably are better for you than others. So I thought that was really interesting.

Adam Smith:

You can imagine, can’t you, a little rating scale? You get age appropriateness cognition scale for television. My boss, Professor Martin Rossor at UCL, has got their whole work on cognitive footprint. I can really imagine that being a measure in cognitive footprint. I’ll put that to you. Sorry, Nika, you had a question.

Nika Seblova:

No, that’s really fascinating. Yeah, I was thinking, I just had a research question about what type of a study was it? Was it a cross-sectional or longitudinal study that they were presenting?

Sarah Gregory:

It was longitudinal. They had the data from 25 years and they had at 5, 10 15, 20, and 25, measures of TV.

Nika Seblova:

And was there any trend over the time because it’s also like the longer you do it, the worse it is?

Sarah Gregory:

They basically averaged it out over the time point, so it was an average. So yeah, we didn’t know if it had suddenly increased over time or if there was a particular danger time for watching TV.

Nika Seblova:

Yeah, sensitive period. Like, “It’s okay if you have a really demanding job and then you just turn it on after dinner because you do still your cognitive stimulation.” So that might be the low cognitive [crosstalk 00:28:24] TV.

Adam Smith:

TV in your twenties is okay, but in your thirties it’s bad.

Nika Seblova:

Yeah, sort of. Yeah. Okay. Cool.

Sarah Gregory:

I just think it’s, we all kind of use screens constantly now and it’s Netflix, all of these streaming channels. It’s an interesting area to look at for the future. Is it helpful? Is it harmful? Does it do neither? That was really interesting for me today.

Adam Smith:

Well, and is there also, I don’t know, maybe I’m just thinking on my feet here, but things like flicker and the quality of the screen as well.

Nika Seblova:

Yeah, possibly.

Adam Smith:

That’s probably for your work actually, Ivanna.

Ivanna Pavisic:

Yeah, probably, I mean, it wouldn’t surprise me if that was the case.

Adam Smith:

Was there anything else, Sarah? Did you want to pick up on anything particularly else?

Sarah Gregory:

So the only other one that I was really interested in today was a talk about using screening programs for dementia and whether, there’s no real evidence that’s existed so far. So that was the IU-CHOICE study, which was a randomised controlled trial in primary care. And they took participants who were 65, no cognitive impairment listed in their medical notes, in community dwelling and randomised to no screening or screening to see if that actually had any effect on quality of life as a benefit or on mood as a harm or on resource use and care planning. And they actually found that there was no effect on anything. So the screening program didn’t cause any harm, but it also didn’t seem to provide any benefit on either quality of life or resource use. And it was a randomised trial of 4,000 participants, so it was relatively sizeable.

Adam Smith:

Yeah. That’s a good size.

Sarah Gregory:

Yeah. So I thought that was really interesting. But I know we get popping up in the news in the UK, “Well, maybe we’ll launch screening programs.” But yeah, from this first trial, there was no real evidence for or against starting something.

Nika Seblova:

How did they define harm? Could it lead to higher stigmatization or on-

Sarah Gregory:

Yeah. So harm they were doing via depression and anxiety. So they had two measures there.

Nika Seblova:

Cool.

Adam Smith:

I didn’t catch, did you say who did those talk?

Sarah Gregory:

It was Nicole Fowler and it was the IU-CHOICE study.

Adam Smith:

Okay. And what was the TV one?

Sarah Gregory:

Tina Hoang. And it’s on the CARDIA study.

Adam Smith:

Fantastic. Well that’s one I think we should all probably go away and have a look at.

Sarah Gregory:

Yes.

Nika Seblova:

Yes.

Adam Smith:

Ivanna.

Ivanna Pavisic:

Yes. I actually quite enjoyed the aging brain and the risk for AD, so it was the plenary session and they talked a bit about cognition and why it’s important. We often talk a lot about biomarkers and CSF and things like that, which are definitely important, but Denise Park I believe mentioned that cognition is important because it represents our ability to function every day and it’s what really matters to an individual. And then she also mentioned amyloid deposition and how that’s one of the earliest markers of AD and how APoE4 enhances aggregation of amyloid and therefore increases deposition. That was quite an inspiring talk. And lastly she also mentioned the importance of considering amyloid as a continuous measure. We often have this cut-off score of the person being amyloid positive and amyloid negative. And there are certain people that are at the cut-off and it’s quite important for an individual to know exactly how far away they are from that cut-off, So I thought that was really good.

Ivanna Pavisic:

And then in terms of posters, I enjoyed the variety of it actually. There was a lot of variety in the techniques, a lot of machine learning, data driven approaches. And then quite a lot in biomarkers, CSF, blood-based imaging, which I think means that we should probably collaborate more on what we do and maybe use a combination of different techniques rather than just one. I think a particular one, they were describing the neuropathological hallmarks of AD in post-mortem retinas, so it was an in vivo labelling of amyloid beta. And it’s obviously post-mortem, so it’s a non-invasive biomarker. And they showed the presence of amyloid beta in the retina, which is different to what we observe in the cerebral cortex. But I just thought it was something different and interesting.

Ivanna Pavisic:

The last thing I enjoyed as well was the representation of some rare forms of dementia. Obviously Alzheimer’s is common, it affects a lot of people, but there was mentions of familial cases of AD, which represent less than 1% of Alzheimer’s overall, and then some other atypical presentations of AD as well, such as posterior cortical atrophy, which is what I work on back at UCL as well. So I thought everything was very well represented and varied. It was very nice.

Adam Smith:

They theme each day of the posters, don’t they?

Ivanna Pavisic:

Yes,

Adam Smith:

I think that each day has a different theme. The amyloid one, were they measuring that through PET or through, is that…

Ivanna Pavisic:

This was in retinas, so I think it was with antibodies.

Adam Smith:

Oh, okay.

Ivanna Pavisic:

Yes. With antibodies.

Adam Smith:

Again, I think that you made the point earlier as well about the idea for better collaborations across disease. Exactly the same point came up yesterday, it came up in two or three podcasts, it’s come up through some of the blogs we’ve got, is the idea that if we’re really going to address this that neurologists and neuroscientists need to spread out and they need to collaborate with people from other areas. As I look, everybody’s nodding and I think that’s exactly where we’re going. Well, we’re running short of time now. Before we wrap up, there’s obviously quite a lot of, I think in the last couple of AAICs, I’ve particularly noticed that through ISTAART there’s been a fantastic support for early career researchers and lots of events around the fringe to support people. I think there was a talk this afternoon on writing impactful papers and then this morning the Alliance of Women Alzheimer’s Researchers, also known as AWARE, did an early career breakfast on mentorship. I think, did you mention earlier before you managed to make that, Nika?

Nika Seblova:

Yeah, so thank you jet lag, I was up at 4:00 AM so 7:00 AM dinner was breakfast. As you see, still jet lagged.

Adam Smith:

Did it come with breakfast?

Nika Seblova:

It came with breakfast, really nice breakfast, very good after the alcohol intake last night. Was really interesting, so we were split into small groups and I sat down with William Jagust from Berkeley and then a few other people, junior researchers and we talked a lot. But I think my main takeaways were that if you are really curious and you’re engaged in science, it really at the end doesn’t matter which field you end up in. You might go a bit with the flow because there will be questions you find interesting. What is really important is finding the right people to work with, and that is people who you connect with who meet your expectations and also supervision styles and you meet theirs cause that really enhances and then communicating these expectations to each other to avoid any conflicts and mess. Because once you’re in it, it’s really hard to get out of the messy situation. So yeah, I guess in the public health sciences prevention of conflicts is important and can enhance your career.

Adam Smith:

For anybody who’s not already heard it, we did do a podcast a couple of months ago on how to have a good relationship with your PhD supervisor, so maybe you can tune into that and I’d suggest other people do too. I think we’ll wrap things up there. Listeners, don’t forget, you can visit our website to check out profiles on all our panellists. You can also post questions in our comments section and our panellists I know are all very happy to interact with you directly. So please do follow them on Twitter and have a look at their profiles and do subscribe to this podcast, which is available on iTunes and SoundCloud. And please tag us using the hashtag ECRDementia. I know we’re all keen to get away. It’s the ISTAART reception this evening.

Nika Seblova:

Yes, I believe so.

Adam Smith:

So we’ll all be getting off to the ISTAART reception now. So that’s it for day two. Thank you very much everybody for downloading this podcast and we’ll look forward to seeing you all again for with a new panel tomorrow for day three. Thank you very much.

Voice Over:

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