Preparing for the next big thing in dementia treatment

The Australian Dementia Network (ADNeT) is a partnership of leading dementia researchers that draws on the expertise in 17 Australian universities and research institutions, as well as people with lived experience of dementia. The network is led by the University of Melbourne.

ADNeT creates a powerful translational research infrastructure for dementia prevention, treatment, and care. ADNeT has three key initiatives:

• The Clinical Quality Registry is Australia’s first to measure the quality of diagnosis and care for people newly diagnosed with dementia or mild cognitive impairment. The initiative will drive improvements in the clinical quality of care of people living with dementia.
• Development of best practice guidelines for the diagnosis and treatment of dementia in Memory Clinics helps ensure all people living with dementia have access to quality diagnosis and care, wherever they live.
• Detailed screening of patients suitable for participation in clinical trials (Screening and Trials) facilitates the development of effective therapies.

ADNeT provides tools for people with dementia, researchers and clinicians alike. The network’s website consolidates valuable educational resources for people newly diagnosed with dementia and carers, as well as researchers and clinicians. The Australian Dementia Network Neuropsychology Norming Tool streamlines cognitive assessment, diagnosis and care by combining information from a range of neuropsychological tests for the use of clinical neuropsychologists.

“Globally, important outcomes have recently been achieved in dementia research. But further research is crucial to demonstrate clinical usefulness,” says ADNeT Director, Professor Christopher Rowe.

With the dementia research community on the cusp of breakthroughs in diagnosis and treatment, the coordinated ADNeT clinical and research community means Australia is ready to be at the forefront of trialling and embedding these new dementia treatments into practice.

“ADNeT helps Australian researchers find participants to trial their therapeutic discoveries and for longitudinal observational research to learn more about the development of Alzheimer’s disease and other dementias,” Professor Rowe says.

Slow build-up of two toxic proteins called amyloid and tau are believed to be the cause of Alzheimer’s disease. Previous studies have shown amyloid in all participants with Alzheimer’s disease. But they have also observed that amyloid begins to deposit in the brain 15 to 20 years before symptoms such as memory decline develop. Amyloid may speed up the formation of the toxic tau protein.

“The earlier that drugs designed to slow the build-up of amyloid or to clear it from the brain are given, the greater the chance of preventing this major cause of dementia,” Professor Rowe says.

ADNeT developed and implemented a national network using common operating and analysis procedures to enhance research. The network provides new technology such as novel brain scans and blood tests that identify people suitable for early treatment trials aimed to slow the disease and prevent dementia.

ADNeT is pioneering a study on implementing blood-based biomarkers into memory clinics. The study follows recent global breakthroughs in blood tests that detect tau protein implicated in Alzheimer’s disease, and a protein known as neurofilament light chain which is associated with brain damage in several neurodegenerative diseases, including Alzheimer’s disease.

The test will improve diagnostic accuracy, allowing treatments to be started sooner. Importantly, such blood tests would be less invasive, more accessible, and more affordable with the ability to be implemented widely in clinical practice.

ADNeT will closely monitor the uptake, risks and benefits of the new treatments for Alzheimer’s disease using the ADNeT Clinical Quality Registry. This data will be used to reduce the risk and improve the benefits of these treatments.  This compliments the ADNeT aim for earlier and more accurate diagnosis for Alzheimer's disease using the new blood tests and scans, as earlier treatment increases the treatment benefit.

ADNeT is also implementing early post diagnosis cognitive therapies, virtual clinics for areas of Australia that do not have access to dementia specialists, and lifestyle change to slow progression of dementia.