Identifying middle-aged people at risk of developing dementia, and finding ways to prevent or delay its onset, is the aim of a Monash University trial about to get underway.
Announced by the federal Minister of Health, Greg Hunt, the program will be a key part of the new National Centre for Healthy Ageing (NCHA) launched today, 19 July 2019, at Monash University’s Peninsula campus.
While the main factor in dementia is age, there’s increasing evidence that issues such as cardiovascular disease, metabolic and psychiatric factors, diet, lifestyle, medications and education all contribute to the likelihood of someone developing dementia.
Dementia is a leading health burden and a major cause of morbidity and mortality globally. In 2018, there were an estimated 436,000 Australians living with dementia, with an expected increase to 1,076,000 by 2058.
The $2 million program – called Holistic Approach in Primary Care for Preventing Memory Impairment and Dementia (HAPPI MIND) – will involve 40 general practices across Victoria and NSW.
More than 4000 attendees will be interviewed, and 600 people aged 45-65 at risk of dementia, as determined by clinical records and interviews, will be invited onto the trial. Risk factors include high blood pressure, uncontrolled diabetes, weight gain, physical inactivity, lack of mental and social stimulation, depressive symptoms, difficulty with sleep, hearing impairment, smoking and poor diet.
Half of the group will receive access to an online program aimed at improving memory, while the test group will participate in the HAPPI MIND program, under GP supervision.
Led by Dr Johnson George, Centre for Medicine Use and Safety at the Monash Institute of Pharmaceutical Sciences, the program will involve three-monthly face-to-face or telephone meetings with the practice nurse, a personalised risk reduction action plan, and referral to targeted additional interventions as needed in the first year, and tailored mobile phone-based risk reduction support for three years.
“This is the first time a holistic approach has been taken to both the early identification and the preventative treatment of a disease that is rapidly on the rise, is devastating for families, and costs the community $15 billion annually,” Dr George said.
Minister Hunt also announced funding for a project in the Frankston-Mornington Peninsula region that will the first in Australia to use electronic record data to develop ways of monitoring the prevalence of dementia.
The $600,000 grant to Monash University’s Professor Velandai Srikanth and Dr Nadine Andrew will use the unique aspects of the region to conduct a pilot study for a program that, if successful, will be rolled out across Victoria and nationally.
The researchers will collaborate with colleagues at the Mayo Clinic in Rochester, in the US, to develop and validate the program. The design and conduct of the project will be informed by active engagement with members of the public, consumers of healthcare.
According to Professor Srikanth, the Frankston-Peninsula region is distinctive in that it has a population older than the state average, with one in five people over the age of 65. In a 2012 report, the region was ranked as having the highest rates of dementia in metro Melbourne. with estimates of a 70 per cent increase in prevalence in those over 70 by 2050.
Importantly, unlike most other hospitals, Peninsula Health has an integrated data capture system that makes it possible to track residents of the region through a single identifying or UR number across all public health services – hospital, ambulatory care or community health service.
“This data integration across all residents in the Frankston-Mornington Peninsula region allows us to track the health of the population as well as the effects of treatment – it’s a true ‘living lab,’” Professor Velandai said.
Source: Monash University