New CRE to drive fast, accurate and equitable diagnosis for dementia

Dr Darshini AytonDr Darshini Ayton will serve as the Monash lead on a new $3 million Centre of Research Excellence (CRE) announced in the latest NHMRC round announced. The CRE in Enhanced Dementia Diagnosis (CREEDD) will be managed by researchers at The Florey Institute, and will be a highly collaborative affair with research teams from both organisations bringing their specific expertise to the table.

CREEDD’s vision is to enable fast, accurate and equitable dementia diagnosis across Australia.

Dementia is a complex neurological condition with numerous sub-types. With no strong clinical diagnostic test available, diagnosis is made via a combination of cognitive function tests and brain scans, which engender a degree of diagnostic uncertainty and imprecision.

For some people, this can result in one of two unwanted scenarios. One, in which diagnosis is delayed due to uncertainty, leads to missed opportunities for interventions to delay or control symptoms, and creates anxiety and distress for families and carers. The other involves incorrect diagnosis. Some cognitive symptoms of dementia are mimicked by transient conditions like depression or delirium. This can lead to life-changing decisions, such as early retirement, being made based on misdiagnosis, as well as incorrect treatment decisions.

With dementia a growing problem in the face of an ageing population, the disease has been a recent focus area for researchers. A number of promising drug candidates and targets have been identified over the last ten years, and transformative digital technologies are enabling faster, superior imaging capability. But there is a blockage in shifting these discoveries into the clinical research arena, so they can be tested in the real-world for efficacy, utility and acceptability with patients and clinicians.

It is this gap that the Centre seeks to reduce.

The Head of the CRE will be the Florey Institute’s Head of Translational Neurodegeneration, Associate Professor Scott Ayton. His team conduct laboratory and clinical research relating to neurodegenerative diseases such as Alzheimer’s and Parkinson’s diseases, in order to better understand underlying disease mechanisms, discover new biomarkers, and develop new therapeutics. He and his team will lead the work on identification and development of novel diagnostic candidates. Associate Professor Yen Ying Lim from Monash’s Turner Institute for Brain and Mental Health will lead the cognitive function tests.

Darshini will lead School researchers on the Implementation Stream of the CRE’s projects. They bring expertise on the successful integration of new health programs, change management and health program evaluation.

The project will harness the data and reach of the Australian Dementia Network Registry (ADNeT), housed within SPHPM. This clinical quality registry, served by academic lead Professor Susannah Ahern, collects data to monitor and enhance patient experiences and outcomes across the dementia journey including diagnosis, management, access to services and support, potentially preventable complications and disease progression. ADNeT have previously recruited several memory clinics and numerous individual medical specialists, and continue to grow.

The Monash team will focus on a series of pre-implementation studies to identify barriers to uptake, and develop the program using a co-design model with key stakeholders. They’ll also lead the roll-out of programs, using a framework they’ll design to cover all clinical sites. Finally, the team will take charge of monitoring the success of each intervention, using implementation studies, and including clinical outcomes and cost benefits analyses.

Another focus for the CRE will be dissemination of their results. The team are planning a podcast to be shared over their soon-to-be-built website, and an annual symposium aimed at health professionals and the public. They’ve also outlined a social media strategy to target both patients and health workers, and have planned how findings will be rapidly incorporated into educational courses provided by Monash University.

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