Podcast – Inside the Global Brain Health Institute

Voice Over:

Welcome to the Dementia Researcher Podcast, brought to you by University College London and the NIHR in association with Alzheimer’s Research UK, Alzheimer’s Society, Race Against Dementia, and the Alzheimer’s Association supporting early career dementia researchers across the world.

Adam Smith:

Hello and welcome to the Dementia Researcher Podcast, bringing together early career researchers and leaders within the field to discuss their research, hot topics, and to share career tips. I’m Adam Smith. I’m the program director for Dementia Researcher, and today I have the pleasure to be recording on location at Trinity College in Dublin. Located in a beautiful campus in the heart of Dublin City Center, Trinity is Ireland’s highest ranked university. It’s home to 20,000 undergraduate and postgraduate students across all major disciplines. Trinity’s tradition of independent intellectually inquiry has produced some of the world’s finest, most original minds. Including writers, Oscar Wilde and Samuel Beckett and scientists, William Rowan Hamilton and Ernest Walton. It’s also the home of the Global Brain Health Institute, or GBHI, which happens to be the topic for today’s podcast. So let’s meet our guests who are going to talk about that. It’s my pleasure to welcome our three guests, the incredible Dr. Dominic Trépel.

Dr Dominic Trépel:

Hello.

Adam Smith:

The amazing Dr. Claire Gillan.

Dr Claire Gillan:

Hi.

Adam Smith:

Did I say that right?

Dr Claire Gillan:

Yes.

Adam Smith:

I did? And the fantastic Dr. Alejandro Lopez Valdes.

Dr Alejandro Lopez:

Hi, everyone.

Adam Smith:

Why don’t you all introduce yourselves properly and what you do at GBHI and what your own field of research and expertise is? And I’m going to go to Dominic first.

Dr Dominic Trépel:

So, hi. Welcome to GBHI. My name’s Dominic Trépel. I’m the faculty health economist here at GBHI. So a lot of what I do with the program is getting people to think about what they’re doing and has to represent value for money. So we would encourage the fellows to learn about what governments need to do to spend resources towards dementia.

Adam Smith:

And that’s important because that’s not thought about as much as I think it should be, and by doing that at that stage, I’m guessing that this helps problems down the line with translation. One of the topics we’ve talked about on the podcast before and has come up in our blogs quite often, particularly from NIHR fellows, about from some of the frustrations of developing a great intervention, and then that intervention just lives in the form of a nice publication and doesn’t find its way into actual real life services. And I’m guessing that’s where health economics and-

Dr Dominic Trépel:

That’s right.

Adam Smith:

… value assessments can make a difference?

Dr Dominic Trépel:

Yeah. So increasingly, lots of research funders require a health economist to be part of a funding application, so that from the very inception of a project, value for money and cost-effectiveness is being tough about. So the likelihoods of translation are vastly improved if you’re thinking about what do governments need to see to implement something in a real world setting. In the absence of that, if you do that, you’re very likely to have exactly what you say of something that just ends up on a shelf.

Adam Smith:

Well, then I’m definitely going to get you back to do an entire show just on that topic. Thank you, Dominic. Claire, why don’t you go next?

Dr Claire Gillan:

Sure. So I’m an associate professor of psychology here at the Global Brain Health Institute, and what my lab is interested in is using data science techniques and big data sets, citizen science, things like this to push the needle forward for brain health. So we work a lot in the digital space to make sure that our data sets are big enough to produce impacts or insights, I suppose, that are reproducible and that we can try and roll out across large populations.

Adam Smith:

Do you reuse other data sets as well, or are you also creating your own great longitudinal cohort that-

Dr Claire Gillan:

Yeah, so we’re not focusing necessarily on longitudinal cohorts, but we generate an awful lot of data. So we have a smartphone app that has 20,000 citizen scientists.

Adam Smith:

Oh, wow.

Dr Claire Gillan:

It’s called Neureka! And so they log on and donate their time to try and generate new insights that can help us learn about brain health. So that’s across 120 different countries, people logging on and spending their time kind of sharing their life with us to help us learn.

Adam Smith:

That’s brilliant. We’ve had the Game Changer people on the podcast before as well, talking about that spatial navigation.

Dr Claire Gillan:

Oh, yeah. Sea Hero Quest?

Adam Smith:

Yeah.

Dr Claire Gillan:

Yeah.

Adam Smith:

Yes, that’s right.

Dr Claire Gillan:

Absolutely. Yeah.

Adam Smith:

Brilliant. Thank you very much for joining us, Claire. And Alejandro?

Dr Alejandro Lopez:

Hi, everyone. Thanks for the invitation to the podcast. I am an assistant professor in engineering, so I’m part of the School of Engineering. Particularly interested in neuro engineering, specifically on translational aspects of neural engineering from the laboratory space to the real world. More in tune with neuro technologies and how this neuro technologies can support brain health throughout the lifespan and find more ecologically valid settings where we can start translating the findings that we have in laboratory environments to real world situations where we’re engaging in social interactions. And there is an effect of whom and where you are at that particular time.

Adam Smith:

Brilliant. That’s fascinating. So you all talked a little bit about your own field, but then you all have this other role, which is of course as faculty for GBHI, which is what we’re going to talk about today. Thank you. So Claire, if I could come to you with the first question for the podcast, why don’t you give us an introduction to the Global Brain Health Institute or GBHI?

Dr Claire Gillan:

Okay. Well, I’ll do my best because it’s a very unique opportunity. I think particularly in this space of brain health from someone with a research background. It’s a leadership training program for people across all kinds of different disciplines, from basic research to policy to economics that was mentioned earlier, all the way to the creative arts and journalism. The idea is we take people in who are really poised for leadership, we bring them in here to interact with one another, to expand their own knowledge, to think outside of their silos and come out of the program in a better place to enact the kind of change that we all want to make in our own siloed and perhaps smaller ways. So it gives people a much bigger vision to realize the big changes we want.

Adam Smith:

So that’s an opportunity then to step away from whatever they’re doing day to day to have that big picture view that we often know that we don’t get a chance to do?

Dr Claire Gillan:

Absolutely. And what’s nice about it is it’s a 12-month residential program, so either based here at Trinity College Dublin or at the University of California, San Francisco. So people literally come in and have this wonderful new bunch of contemporaries with vastly different backgrounds and really can grow and bounce things off each other in a way that is very unique and that normally we don’t have the opportunity to do.

Adam Smith:

And I can attest to the benefits of that as well because that’s what we do at Dementia Researcher as well, the idea of bringing basic scientists together with clinical researchers and qualitative and care researchers because new things emerge from that, right? I guess I’m putting you on the spot here, but I mean, you mentioned your own work there? Are you an alumni of the program yourself?

Dr Claire Gillan:

No, I’m not. But I’ve worked with many fellows. I think one of the more interesting things that we’re doing now that’s very new for me as a basic scientist, is thinking about applying sorts of data that we collect through our app for basic research in lower income settings and the potential for these to be used as scalable diagnostic tools. So working with a fellow in Chile, for example, at translating our app to Spanish and rolling it out broadly in that context, something I as a faculty member would’ve probably never arrived at on my own.

Adam Smith:

Yeah. And I guess by bringing everybody with these various backgrounds together, you’ve got a great advisory group, you can just go and ask somebody who’s from India, I guess, about whether something would translate there or how that would work. That’s brilliant. And so you mentioned Trinity College and UCSF, so that’s in San Francisco. And can people apply to be in either place or do you get placed?

Dr Claire Gillan:

So you apply in general to the program and you can of course indicate the kinds of people that you’d like to work with at the two sites and any preferences that you have. But ultimately, what we’re trying to strive for is a multi-site program that’s balanced in terms of the disciplines and the countries of the world that are represented. So there’s a little bit of thinking about where might someone benefit from being the most, depending on their particular background, et cetera. So you apply generally to the program and then you are placed with some of your preferences in mind.

Adam Smith:

And is it… I’m jumping ahead to a question I got for later on, but is it the same then… I mean, if you go and go to UCSF or you come to Trinity, I know that there’s a taught element to this program as well, isn’t it? Is it the same?

Dr Alejandro Lopez:

The taught element is shared across the sites and aligned as much as possible, but the experience is very different because the experience is definitely depending on the site that you are, the clinical rotations that you get involved with differ vastly from the UCSF cohort to the Trinity cohort. And the expertise of the faculty as well are different. So those interactions make the program unique at both sites. So it’s always good to have a look at the faculties in different sites and be able to pinpoint what you’d like to do, what aligns more with your future plans and your ambitions. Because you could definitely find some key differences between the two sites.

Adam Smith:

And if you want good Guinness, you come to Trinity and if you want Kombucha, you go to San Francisco.

Dr Dominic Trépel:

I think it’s also fair to say that every year when we put together a cohort, we try to make one cohort. There isn’t two cohorts at each site. So we have a lot of touchpoints throughout the year where we bring people together. They have a leadership development week that they spend together. They often also go to the AAIC Conferences together, so they have opportunities to break down that siloing so that amongst themselves… Each year, every cohort is very tight and knows each other very well, even if they are at opposite sides.

Adam Smith:

I mean, brilliant that you make… Yeah, I imagine that’s quite challenging to make people feel the same cohort when they’re at opposite sides of the world. But I know from having interacted with some of your fellows at the conferences you mentioned, that they do come across together as a single group. So well done on that. So you touched on before, what makes the program unique in terms of bringing together, you talked about, artists and basic scientists and clinical people, what else? Is there anything else you would say that makes this program unique, Alejandro?

Dr Alejandro Lopez:

Yeah. I mean, I think the diversity of the program itself is very unique, but also the fact that they’re not coming here to stay, but they’re coming here to train and then go back to their regions and make an impact there. I think that is one of the key flagships of the program is we’re seating and training around 600 leaders in brain health that can have an impact back home. And that could be in a myriad of areas, could be clinical, could be practice, could be policy, could be awareness, advocacy. So that really brings a program to the forefront of how we approach brain health issues at the moment and allows us to topicalize the broadness of brain health to each particular region. This translate ability from concepts to practice within specific cultures, I think is key for creating good impact worldwide.

Adam Smith:

Can we just pick up on that brain health there for a second? Because obviously, this is the Dementia Researcher podcast and we mostly have people who work in Alzheimer’s or neurodegenerative diseases more generally. But when you talk about brain health here, is this lifespan brain health? Is this people who might work with people with Alzheimer’s, but they might also be working in say, mental health challenges or younger people or-

Dr Dominic Trépel:

I think as a program, we have a strong emphasis on dementia, but I think that’s within the context of brain health. So there’s this growing hypothesis, particularly given our reflections on many years of failed trials to find a curative treatment for dementia, that you have to do things earlier in the life course. So I think with GBHI’s mission in brain health, we are considering anything. So we are going from childhood, we have a child brain health group where we’re thinking, do things like education have an impact on later life outcomes? And also a lot of the literature recently is focused on midlife modifiable risk factors. So there’s a great emphasis on that. And also when we start to throw those paradigms in, we’re thinking much more in terms of public health than just clinical post diagnostic. Where are the opportunities most likely to be best?

So one of the programs of research I’m doing is on the economics of brain health, and that’s really trying to say, “Well, where should we invest our money throughout any life course?” Possibly, that next drug treatment could provide the best benefit and best return on investment, but maybe there’s things that we do earlier on in life that could equally be a good investment. So this could be the next stage performance that gets people breaking down the stigma and talking about early and midlife risk factors and seeing similar paradigms to what we’ve seen with heart disease where people are now proactively going to get them checked. We don’t do that with our brains. So I think that’s the future.

Adam Smith:

That’s great. So actually, that really clears this up for me. So this isn’t about being a dementia researcher already or working in dementia. If you are a occupational therapist that works with professional sports people, for example, or in coaching or something like that where we know there’s lots to talk about the impact of concussion and things… So this program would also be for you as well. It’s about that. Or if you’re a dietician, for example, looking at what we eat or plant-based diets and the benefits and things, those… Brilliant. That really clears that up for me. So lots of your fellows, I imagine, in whatever field they work in, there’d be quite passionate about what they do and they’re clearly… to apply for this. They want to improve themselves, society and work. So generally speaking, what more do you think we can do to influence policy? You touched on there about… because I mean obviously, there’s lots we can do as individuals, but we know whether that’s government policy or the society we live in, this has to all contribute to brain health. What more do you-

Dr Dominic Trépel:

Yeah. So imagine that you’re a fellow who’s come to our program from a lower resource setting, right? You might be the only psychiatrist, neurologist, or geriatrician in that context. The likelihood is that you do have to do a lot of clinical work, but you will also be that person that the government might also turn to and say, “What do we need to do about this agenda?” So when fellows come to our program, whether they’re clinical or from other backgrounds, they have to learn… Health economics for example, is a program that I teach them. So all our fellows will learn health economics and how to make economic arguments for developing services that are sustainable and can be implemented in a real world setting. What the fellows will then do is that they’ve just done the practical exercise there. We encourage them to also imagine that they are speaking to a national decision maker and presenting that argument.

So they’re also learning skills of how to lobby and maybe argue against other agendas because dementia isn’t the only agenda that a healthcare decision maker will be thinking about. They will thinking about cancer, some countries it’s malaria and nutrition if it’s lower resource settings and trying to understand what the trade-off is of investing there. So the fellows do that. They think about doing that in a practical sense, in the safe confines of where we teach and we encourage them to do that. So we’ve seen lots of our fellows go out and speak to the WHO, so we have fellows who are advising there. To the OECD, so we have people that are advising in kind of sandbox arenas there. And also the European Parliament, for example. We’ve had fellows be invited to speak there. And then most of our fellows come away with a much bigger position towards speaking at a national context in their country. They should be recognized far more as a local expert.

Adam Smith:

And given that confidence as well that they can feel they can speak with authority whatever field they’ve come from, I guess, making a case for why that… whether that’s music in research or arts or things like that are important. So we’ve talked a little bit about leadership. So practically take me through, somebody comes here, so it’s nice in summer, they’ve just traveled all the way from Brazil. They arrive in Dublin, realize the first thing they need to buy is an umbrella. And having bought their umbrella and an overcoat, what are they going to do every day? How are they going to spend that year on campus? Or are they on campus? What do they do through the course of the year?

Dr Alejandro Lopez:

They are here on campus, they’re actually literally just a few doors down here working away.

Adam Smith:

So in this room?

Dr Claire Gillan:

Usually, in this room.

Dr Alejandro Lopez:

But the course is divided into modules. So there is of course leadership modules where they train in leadership, they come together as a group, they meet everybody for the first time and everything, and then they split up again into pods. Learning skills for proposal grants, writing for example, making sure that they’ll be able to source funding for their future endeavors. They also have thought models about the psychosocial and physiopathology of dementia, brain health, health economics and other skills like presentation skills, for example. So they have all these training modules throughout the year. And parallel to that, they’re preparing a grant proposal that they’ll be submitting for the Alzheimer’s Association Pilot Program towards the summer. And we mentor them throughout that process. They have their own original idea of the project that they would like to start as a pilot, and we make sure that that is in line with where they’re heading in their career wise so that they can use this as a platform and trampoline to have an impact.

Adam Smith:

Great. So this is I mean, a very practical introduction to many things. So if you arrive here in you are an artist that doesn’t kind of really know anything about the neuroscience part, you’re going to have a module which is on neuroscience?

Dr Alejandro Lopez:

Correct.

Adam Smith:

That’s going to be pitched at your level though, that you can understand.

Dr Alejandro Lopez:

Yeah.

Adam Smith:

If you’re a clinical person and you arrive, do you also go off and talk about the psychosocial interventions? It’s the same for everybody?

Dr Alejandro Lopez:

They’re together all the time. So they’re having the same courses and this enables them to have discussions from the very expert voices to the fresh set of eyes in the groups. So it’s really interesting to see how they interact and how do they assimilate the material and the discussions that they have afterwards as well because they have… everything is facilitated by faculty from GBHI and then they go back to their fellow room and they have the discussions on their own. So it’s really interesting to see those interactions, particularly for people who come from non-nonclinical backgrounds, discussing all the clinical aspects. The case studies, the round tables, the clinical lived experience, all of that information gets cemented throughout their peers as well.

Adam Smith:

I love that. I imagine that really pushes some… that pushes everybody out of their comfort zone. So you’re not going to turn up here as a clinician and feel uber confident that know everything, because the chances are you only know your bit. And there’ll be some part of the course that’s not really something that you’d thought of as part of your clinical training.

I caught up with some fellows and alumni from the institute to get their perspectives on different aspects of the program.

Dr Agustin Ibanez:

I am Agustin Ibanez, Senior Atlantic Fellow from the cohort 2018, ’19.

Adam Smith:

So you love Dublin so much that you just decided to stay?

Dr Agustin Ibanez:

Well, absolutely. So Dublin first of all is one of the sites for the GBHI. It’s a wonderful city, but it’s a huge opportunity to support the Latin American networking, research and awareness that is the most part of the work that I love.

Adam Smith:

So where does your original work… was from Latin America?

Dr Agustin Ibanez:

Yes. Yes. I am from Argentina and I have been doing research in dementia for almost 15 years across different Latin American countries, including Argentina, Chile, Colombia, Peru, Brazil, Mexico. And before the GBHI, I was trying to create in fact a consortium, a Latin American consortium, because in that region the people works in isolation, they don’t have funds, they don’t have training, they don’t know how to share data. And this is the region with the largest inequality in the world. The inequalities have a huge impact in dementia. So I come to GBHI with a big, big dream but never imagined that we were able to go after.

Adam Smith:

So what makes a researcher with an established career already within their field, leave that to go and be a GBHI fellow? Why did leave and what did you think you’d gain from that?

Dr Agustin Ibanez:

Yeah. So first of all, I have a kind of internal crisis. I was just a typical researcher doing paper, paper, papers, data analysis, students, and that’s it. And then I realized that this doesn’t have a direct impact or immediate impact in the people. But at the same time, when I started to do multicentric studies, I realized that different centers across Latin America have the same problems. So I changed the view. I started to think about in the long term impact of the research, how we can create capacity building, how we can empower in other people, how we can make emerging leaders creating the space for them? So that was the big change. The GBHI really provides a global view that respects the regional challenges and barriers and specific aspects. So we were able to surpass the barriers that we face in the region.

Adam Smith:

So how have you been able to put what you learned from the fellowship into use… a few years on now, how have you put that to into practice?

Dr Agustin Ibanez:

Well, I think that I was very, very lucky. We were able to do a lot of things. So first of all, we created a Latin American and Caribbean consortium of dementia that have almost 300 experts in the region, including national [inaudible 00:23:25], Minister of Health. And it’s a huge task for driving the main needs for dementia research and care in Latin America. Then we created the Latin American and Caribbean Consortium on Dementia or ReDLat, that is a research oriented consortium. We already have raised more than $24 million in research, empowering the region, doing genetics, doing socio determinant of health, socioeconomic factors, multimodal, neuroimaging, computational approaches. And then the last step was the Latin American Brain Health Institute that is founded by the University Adolfo Ibanez and is affiliated to the GBHI. That is the only regional center supporting all our networking in Latin America and promoting the brain health. So these three LAC-CD, ReDLat and BrainLat are the consequence of the work that we started to do in the GBHI during my fellowship.

Adam Smith:

So through those collaborations and that inspiration, it’s made you create these fantastic opportunities.

Jayashree Dasgupta:

I’m Jayashree Dasgupta and I’m a clinical psychologist with a specialization in neuropsychology. And I’m also a social entrepreneur who’s based in India. So I have an organization called Samvedna Senior Care, which provides services for mental health, active aging and dementia care in India.

Adam Smith:

And is that across India or is it in a rural or urban or-

Jayashree Dasgupta:

So so we are actually based in Gurgaon, which is an urban part of India, near the capital, Delhi. And we were initially, prior to the pandemic, a center-based model. And then with all these lockdowns, we really pushed to think about how we could start supporting people online because that was the only way to kind of reach people. So with that, we’ve had to kind of repurpose a lot of the services that we had. And we are now, I’m very happy to say, kind of reaching out to different places and different states across India to provide online mental health support and services for people as well.

Adam Smith:

We often think about dementia in the context of what’s happening in our own countries. Obviously, what we know. What impressions do you get for how dementia is perceived in India and then how that compares elsewhere in the world?

Jayashree Dasgupta:

Right. I mean, that’s really important and a huge part of the work that we do because a lot of people don’t really know what dementia is, so you can’t… and we provide services for dementia. So the first thing that we really have to do is create more awareness about what is dementia, how is this different from natural aging? Because there’s a lot of cultural perceptions around aging, decline is often seen as just a natural part of aging really. And so it was really important for us to create more awareness, help people understand what are those initial signs and symptoms that they should kind of watch out for. And also, help people realize that it’s not stigmatizing to reach out to a mental health professional or any professional really, if you have a doubt about the kind of issues that your loved one may be facing. So I think these were the two kind of things that we had to really work on in addition to talking about the kind of services, the kind of support that people living with dementia and their families can get.

Adam Smith:

And I’m assuming… I mean, I imagine India’s no different to the UK or to the US in so much as there’s no one prevalent view of this, that it depends on where in the country you are as to different attitudes towards this, right? Is that the same in India as well? Are there parts of the country where yes, there is more stigma than… or is it more accepted still that there are things that can be done and the brain health industry elsewhere?

Jayashree Dasgupta:

I mean, I have to say, I think overall public awareness about it is low, but I’ve seen it change over the years. I think majority of India, it’s… the people still don’t know what is brain health. It’s not a term… that’s a term that actually we’re using a lot more here at GBHI. But I think what people in India are still using is mental health. And that’s more restrictive. The term itself is in a way stigmatizing. So overall, I think public awareness is low across India, but definitely at least amongst more educated urban regions, people are beginning to talk about it. So hopefully, that’s the way in which the message will start to spread across India as well as probably other low and middle income countries.

Adam Smith:

So how has this program helped you personally for when you returned to India to pick up where you left off before?

Jayashree Dasgupta:

Yeah. So I think the program’s been absolutely fantastic. And for me what’s been really interesting is just getting to talk about the work that I’ve been doing back in India, sharing experiences of things that work, that don’t work and getting ideas from other people who’ve been working not only in the space of dementia and mental healthcare, but just basically very diverse areas. So it’s been really useful in terms of broadening the way to approach problems. And that’s been really great and I think that’s going to be very helpful when I go back in terms of at least trying to spread this message around how to focus on your brain health and how to look out for signs. How to seek help and support from people around you, from systems and structures. And hopefully, to get some advocacy going to push for brain health across the country. So I think that’s the kind of things that I think this program is really going to help you with.

Zach Bandler:

I’m Zach Bandler. I’m from the United States. I’m a 2022, ’23 Atlantic Fellow for Equity and Brain Health here at GBHI at Trinity College, Dublin.

Adam Smith:

What did you do before you became a fellow because we’ve heard throughout this podcast how people have very varied backgrounds? What did you do before you became a fellow?

Zach Bandler:

Yeah. So I’ve sort of had a few careers, but I’m a film director and a screenwriter. I do narrative films as opposed to documentary. I do mostly fictional material. And then I was an actor for a long time before that as well.

Adam Smith:

Brilliant.

Zach Bandler:

Yeah.

Adam Smith:

Everybody asks you, “Have you been in anything I would’ve seen?”

Zach Bandler:

Yes. Yes. Well, that depends on… Yes. So I was in a show called The Good Wife, a show called How I Met Your Mother, and most people know me for a show called Switch at Birth, which was on ABC Family.

Adam Smith:

Okay. And I’ve definitely seen How I Met Your Mother and they’ve just redone that for How I Met Your Father, right?

Zach Bandler:

Yeah, that’s right. They did. Yes. Yes.

Adam Smith:

So how long are you into your fellowship?

Zach Bandler:

Going on six months into the fellowship.

Adam Smith:

What have you covered so far in the first six months?

Zach Bandler:

Yeah, so they definitely throw a lot at you at the very beginning in terms of the coursework and trying to get everybody just on the same page. So for those of us who don’t come from a scientific or clinical background, it’s been a lot of just introduction to neurology and brain health and various types of dementia and biomarkers and things like that. So that’s kind of been going on in tandem with other skills they want people to develop in terms of leadership, in terms of how to make presentations or how to start writing grants. So it’s very comprehensive. I will say, truth be told, the most riveting part of it has actually been the collaboration between the fellows themselves, because we come from… we’re a very diverse cohort in terms of careers and where we’re all coming from. And so a lot of collaborations have started to coalesce between everybody, and that has been very exciting. And I have a feeling it’s probably what the mission has been all along.

Adam Smith:

It’s one of the aims, isn’t it?

Zach Bandler:

Yeah.

Adam Smith:

So from the things you’ve covered so far, is there anything being… particularly surprised you? What has a kind of key takeaway that you’ve learned that you went, “Oh, I had no idea, that surprised me”?

Zach Bandler:

So I think a couple of things. It’s interesting, I came to this with… as a filmmaker, I’m really passionate about… I come from Hollywood, literally. And dementia is viewed as a tragedy narrative in basically everything, right? You see these characters in various films and it’s like they’re kind of in a living death, right? And something that’s really important to me as a filmmaker is to start to change that narrative so that we can actually look at more hopeful stories about dementia, about brain health in general, but specifically dementia and brain injury. So for me, I think a lot of it has been mining the information out of some of these faculty who come from really distinguished backgrounds and deep levels of expertise in totally different fields that I can use to start to craft more hopeful narratives with hard data to back it up.

Now is that the most… that’s not the sexiest Hollywood way to spin something, but I think for me, accuracy is really, really important. On the flip side, I have felt very much that I think sometimes the artists who might come into a program like this are feeling like a fish out of water because everybody around us has a PhD and I just have a bachelor’s degree from university. But what I have found is that I think there’s a real need for better communication skills in the sciences and in research, and that’s something that I do every day of my life. And so to be able to work… I just did a seminar on pitching, which I do frequently. I’ve pitched at HBO and Lionsgate and Sony and I make TV and movies. And it was really exciting to watch fellow fellows really respond to like, “Oh, my gosh, these are skills that we desperately want and need.” And I was like, “Well, I have these skills, so let’s work together.”

Adam Smith:

And having sat through lots of neurology conferences, I can honestly say some of those skills will be invaluable to some of those neurologists.

Zach Bandler:

Yeah. Yeah. Well, I’m a storyteller, so my whole thing is how to build and craft a story.

Adam Smith:

So that’s great that, and that helps you really get over that initial imposter syndrome of, “Gosh, I shouldn’t be here.”

Dr Dominic Trépel:

Yeah, absolutely. I think I’m entrenched enough in my career, certainly as a writer and as a director for the past five or six years, that I feel pretty confident with what I’m bringing to the table, that it matters. But you’re right, I mean there’s definitely… there have been courses, seminars that I’ve sat through, I’m like, “I have no idea what we’re talking about.” But someone I can pull aside afterward and say, “So can you just translate this a bit more for me?” And somebody can, and it’s great.

Adam Smith:

And I can’t help but feel that you’ve got to… In addition to filmmaking, of course, you’re going to become the Hollywood expert of making films more accurate and properly representing dementia.

Zach Bandler:

Well, yeah.

Adam Smith:

So obviously, we heard that awful news that Chris Hemsworth found out he was an APOE4 carrier.

Zach Bandler:

Yes. Yes. Yeah.

Adam Smith:

You can’t help but feel that something is going to come out of that later down the line, some documentary you can advise on.

Zach Bandler:

Potentially so, yeah. I mean, I think there are little pops of that starting to get through to the mainstream. I don’t know if any of your listeners have seen Robin’s Wish, which is about Rob Williams having Lewy body dementia. We viewed it here as a cohort and that was a big deal, but nobody knew what Lewy body dementia was before that. I think for me, I see that there’s a lot of potential to bridge GBHI and Hollywood and I’m really… that’s kind of become my mission in a way.

Adam Smith:

I think you’ll be a great middle man. Thank you very much for joining, Zach.

Zach Bandler:

Yeah, thank you. Thanks for having me.

Adam Smith:

I’ve been listening to a few clips from some of the fellows as well to talk about their perspectives, but we’ll move on now and I’m going to come to Claire to ask… we’ve already touched a little bit on kind of… I do have one question about what kind of people apply. We’ve clearly made out everybody applies who might be a future leader in brain health. Is that age specific? I mean, do you have to have already achieved some career stage that makes you eligible?

Dr Claire Gillan:

No, there’s no hard and fast rules. A general guiding principle that we have is what we want to do is… we use the phrase bend the arc for people. So we want to achieve the maximum amount of impact for the world from the money that we invest in supporting and the training we provide to individual fellows. So we think about people as great candidates if they could come here and they’ll leave this program propelled towards the next thing. If we can triple or quadruple the impact that that person might have. So it’s really about thinking about the individual person. Do they come in with this zeal with the values that we aspire as part of GBHI and this interest in changing the world? And if they do and we think they can have a big impact, that’s a perfect candidate for us.

Adam Smith:

Great. So no age specific, and it’s obviously anywhere in the world as well as we’ve touched on… And what makes for a good application?

Dr Claire Gillan:

Passion I think is a big part of it. We want people to typically, not always, have demonstrated some sort of track record in terms of their interest and engagement with the brain health problem, as we’ve discussed earlier, broadly defined throughout the lifespan. So people who are really engaged with this problem and can show they have some commitment to it, but have much more to grow. So that’s a really good application. Hearing the enthusiasm, the ideas. And I would say particularly for me, the ambition in the ideas. We want people who want to change the world and want to be an agent for that change. And those are the applications I think that really shine.

Dr Dominic Trépel:

I’d just add as well, I think because the program is the Atlantic Fellows for Equity and Brain Health, so the word equity is important there. So when we are looking at applicants, we also want to see applications from people who recognize the inequalities that people with dementia or brain health problems may face. So they might be trying to target an underserved community in whichever way they could perceive that. So that for our values and our mission is super important. For example, if they’re coming from a lower resource setting, they may be setting up the first service, but if they’re applying from a higher resource setting, what are they doing to address some inequities in their world? Are they going to do something locally that speaks to that or are they going to work at a global level and try to share, for example, the good research in the UK to benefit other countries so that some of what may be learned elsewhere can be of benefit to places where there is a gap still.

Adam Smith:

And having prepared for this discussion today and having read the biographies, which are all on the website, if anybody’s interested to see if you can find somebody like you… all the cohort fellows from previous years are all on the website and you can read about their work and what inspired them. I definitely suggest you go look at that, is you don’t have to be looking at a big group of people either. You can be very interested in a very small niche group of people that are particularly affected and the program would still support you in that work.

Dr Dominic Trépel:

So I think I just want to bring in, we’ve been running for… we are now into our seventh cohort. So we have 200 people who are in the field and the program was partly modeled on the Rhodes Scholarship, which is a lifelong fellowship. We’re trying to make sure that people… yeah, they might take a small group, but if they’re taking a small group, they’re committed to them for the long term and they’re trying to drive forward an agenda with that. Hopefully, they’re trying to make as much impact as they can. So the impact goals are going to be increasingly important to the program over time. So to try and make sure that people, once they spend that one year with us, they go on, they have a solid five-year program at least of what they’re going to try to do beyond this.

Adam Smith:

Well, that’s a good question then. So what’s the legacy after this? I mean, I did have a question here about how people… Can you give me some examples of what people have done after the program? But when you leave the program, then you don’t just say goodbye and they vanish. There’s a legacy to this.

Dr Dominic Trépel:

So the program runs like an alumni program. So there are pots of money, for example, that fellows will apply for to keep their networks going and to get initiatives going. So we’ve seen various initiatives building up around the world. I suppose one of our most successful ones was in Central South America where we had our initial strategic focus and we’ve now seen a galvanization of countries across the region who are all kind of working towards this agenda. So that’s many years later and we are now shifting towards having a strategic focus in Africa and in Asia. So we hopefully see similar programs like that. So you might have people who are working very locally at grassroots level, but you might hopefully also have a leader that’s trying to bring the whole movement forward.

Adam Smith:

And you have that big picture view because we know that the dementia prevalence rates… obviously, it has not just been about dementia, but we know that they’re mostly going to grow in Sub-Saharan Africa, that’s where they’re pitched to grow. So you can look in advance of that and say, “Well, that’s actually an area where you particularly want to encourage people to imply.” I’m assuming you don’t give favoritism to applicants who are from certain places you’re strategically looking at, but you might encourage more people from those places to apply?

Dr Claire Gillan:

Yeah, I think there’s definitely targeted recruitment efforts and like Dominic was saying, I think a big… We know that people can do more together and that creating these local networks is really important for just synergizing and again, achieving the biggest change possible. So we will focus sometimes the recruitment efforts in regions, but we take candidates from all over the world.

Adam Smith:

So even if you’re in a wealthy kind of country like the US or somewhere in Europe or the… I was going to say the UK. The UK is wealthy, right? We are also wealthy. But that wouldn’t put you in a worse position?

Dr Claire Gillan:

No. There’s usually several fellows from a combination of the US, the UK, Ireland.

Dr Alejandro Lopez:

It is part of the diversity of the cohorts as well, so that they could actually bring the different perspectives together and enrich in everybody’s experience. I think the lifelong approach is very interesting because as you say, they don’t just finish and say goodbye. GBHI provides a platform for connection for them to find common grounds and continue to work together not only in the region but also across the different regions and throughout the world. So there are common learning groups or study groups that still get together… interest groups, they’re called, sorry. Where they still get together and discuss common interests, particularly from how to translate questionnaires into different regions, into different countries, share some of those experiences.

And I think that is something that makes this fellowship really interesting. That we provide that support as well. We don’t just disengage from alumni, we try to remain as much as possible, try to keep in touch as much as possible. And we also have a growing numbers of regional mentors that help us support the fellows as they go back to the region and now also have a way to connect with all the regional mentors from the world. So we really try to expand and share the impact that we can have throughout.

Dr Dominic Trépel:

So one of the things that Alejandro touched on is that every single fellow that applies to the program will develop a pilot application. So they will be applying for around 25,000 to take home to their home region and get that first step post program as a ongoing initiative. So when you’re thinking about a regional mentor, that’s something that will be shared with a mentor in GBHI, that regional mentor and the fellow driving that process forward. So that very first step is just seeding what the next 5, 10, 15 years of their ambitions might be.

Adam Smith:

Fantastic. So for anybody who’s listening, who’s thinking to applying, is there going to be another round opening soon?

Dr Claire Gillan:

Yeah, so I think next spring we’re looking to open the application cycle. So I’d encourage people who are interested to go check out the website.

Adam Smith:

So this is spring 2023?

Dr Claire Gillan:

Yes.

Adam Smith:

Okay. So sometime soon. I think if you’re listening to this and it’s… I’m not quite sure when this show’s going to come out but out, but if it’s March or April, it’ll be opening soon.

Dr Claire Gillan:

Yes, absolutely. And we do an annual call for new applications. So if this year doesn’t quite fit, you can know that reliably every year we’ll be applying and taking a new cohort of fellows.

Adam Smith:

And if you are successful, I’m assuming the course is funded, you don’t have to pay. Is there a stipend? Practically, I know people will be asking that question.

Dr Dominic Trépel:

No. You’re right. I asked the same question myself.

Adam Smith:

You pay us 50 grand and we take you on the course.

Dr Dominic Trépel:

No. I won’t be able to speak to the specific number, but every applicant… We went through a very rigorous process of making sure that what they’re offered at the sites is benchmarked. So it is a fully funded program, that if you’re in UCSF or if you’re in Dublin here in Trinity College, you’ve got essentially a similar level to what someone would be employed at as a research fellow.

Adam Smith:

Okay. Brilliant. I mean, genuinely, I can’t think why anybody wouldn’t apply for this, right? So this is a fantastic opportunity. I think if you are listening to this and you are an early career researcher or you’re in a postdoc right now… We’ve done shows in the past where frustrated postdocs that are kind of, again, a little bit annoyed that they’ve got stuck in this cycle of one position after another, but doing great work, this is a fantastic opportunity to take a year out, gain some new skills, get a perspective on different things, living in another country as well, work with a awesome group of people who you can collaborate with. Write a grant application through the year and get paid to do it. So this has been great. Thank you so much for joining us.

 

I’m afraid that’s all we’ve got time for today, but if you just can’t get enough of this topic, you’ll find more information in the show notes with the podcast or of course on the Dementia Researcher website where we’ll also have a full transcript and we’ll include any links that we have talked about today that would help you potentially apply. We’ll also have biographies on all of our guests from today. So I’d just like to thank the incredible Dr. Dominic Trépel, the brilliant Dr. Claire Gillan and of course, the wonderful Dr. Alejandro Lopez Valdes. Thank you so much for joining us. I’m Adam Smith and you’ve been listening to the Dementia Researcher Podcast.

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