Dementia in Tasmania: The Island Resilience Initiative
by Lily Whiting
While physical trauma presents a tangible effect on the body, mental trauma is a harder to observe. In a worldwide first the effect of trauma on the brain is being tracked by seven Tasmanian researchers from the Wicking Dementia Research and Education Centre in a statewide population study. With a focus on which trauma exposures (such as bushfires and lockdowns) may lead to increased risk of a dementia diagnosis, The Island Study Linking Ageing and Neurodegenerative Disease (ISLAND) Project is hoping to unearth how Tasmanians and the world can build a resilience to a dementia diagnosis. We spoke to PHD candidate James Brady about the work.
When did the study commence? The ISLAND Resilience Initiative had its first intake late 2020. We’re hoping to keep it running for as long as possible in order to detect any changes – however subtle – in people’s mental and physical wellbeing over time, or after a disaster event.
How many Tasmanians have signed up to the study? We were very fortunate to have about 1300 people from across Tasmania sign up to the Resilience Initiative in its first year, just under half of these people also donated their hair for research into stress hormones. We would love for as many people as possible to participate in the study, it is crucial to have strong enrolments in order to do good research.
What do we know about dementia already? Fortunately, dementia has received a lot of scientific attention in the past few years and we mostly know quite a lot about its direct impact on brain health and associated deficits in cognitive function around memory and attention, and changes in behaviour and mood. These are obvious to us, we can see which parts of the brain are shrinking and how people are behaving or scoring on psychological tests. What is far more difficult to understand about dementia is what causes it and when it begins. It’s believed that dementia may begin decades before any cognitive changes can be observed.
What happens in our brain when undergoing a trauma event? The most important factors of brain health are how many cells (neurons) we have and how effectively they communicate with each other. Psychological and physical trauma can threaten our cognitive function by killing brain cells and/or damaging the connections between them. The key difference is that physical trauma can occur quite suddenly, whereas psychological or emotional trauma tends to be more insidious and build over time. Preferably trauma of either instance would be avoided in the first place, but if it is to occur then early intervention is essential – particularly in relation to head injuries. Our study looks at emotional and psychological trauma, which is often accompanied by a change to our stress hormone systems. These changes, if left unattended over time, can begin to damage areas which are involved in dementia.
What is the short-term solution? There are a range of approaches which can be used for young trauma, like talking to a psychologist and/or finding the right medication. There is exciting new research that uses psychedelic substances in highly controlled and supervised environments to try and assist those who have been unresponsive to other treatments. This research is still in its infancy, and these methods should absolutely not be tried at home!
Does the body just heal differently to the brain? Neurons (brain cells) are different to other cells in our body, they’re more sensitive and don’t readily repair themselves. If you graze your arm, your skin will heal itself in days or weeks by repairing or making new cells. This can happen anywhere in your body. The brain is very different, there are only (as far as we know!) a couple of places where new neurons can be created to replace those that have been lost. Even when new neurons have been created, there is no guarantee they will develop in a way that replaces the ones that have been lost. New neurons need to be “trained” to communicate as a team with other neurons, this can be a slow process. This is why we need to put in lots of practice to perfect new skills.
Why does Tasmania work well for a research project of this kind? Tasmania is quite unique as a study area because its population has been relatively stable over time. Many older Tasmanians have been born and raised here and, in general, tend to remain in the state. This provides quite a contained sample to study, which is important when considering the many factors which can influence people’s health outcomes. This is changing quite quickly, though, as our population becomes increasingly diverse.
Are you anticipating an effect of COVID related stress to our population? We have some data which will tell us how older adults fared when Tasmanian borders opened, we expect to publish some research on that next year! Other research tells us that although older adults may be more susceptible to experiencing feelings of loneliness – which may be a dementia risk – overall, they have been less psychologically impacted by COVID than their younger counterparts. We published a paper in 2020 which found that older adults were quite resilient against the psychological impacts of lockdown.
With such a wet summer ahead, does this affect how your research progresses without trauma events like bushfires or lockdowns? Natural disasters are a hard one to study, particularly if you want to get an accurate measurement of change. I’m quite relieved about the prediction of a wet summer, hopefully it will mean that people are safe and will have more time to prepare. In terms of research, it can be challenging. Our job is to try to retain our participants and keep them engaged so that if a disaster does occur, we will be able to follow up with them. We can then compare how people were before and after the event – there are very few research projects that have achieved this. This kind of data is vital if we want to understand what makes some people so successful when it comes to coping and even growing after traumatic events.