Investigating brain ageing with multiple biomarkers in advanced elderly participants
What are the main aims of the study?
The aim of the study is to access individuals who are at an advanced age (60 – 100 years), and do not have any measurable problems with their memory. To do this a combination of psychological tests and brain scans will be performed that will help us understand the nature of healthy brain ageing. The study also aims to recruit a group of Alzheimer’s disease patients who are 90 years old or older to understand the disease in this very old group of patients.
What does it involve for a participant?
The study will involve a set of psychological tests initially and further testing two years later in order to measure possible changes in memory during that time (we will not repeat the follow-up tests for the Alzheimer’s disease patients).
Initially potential participants will be contacted by telephone to determine their eligibility. Those individuals who meet the study’s criteria will then be invited to participate and undergo the required tests. Normally the first set of investigations will involve three separate visits to The University of Manchester research facilities. We aim to perform these three visits within a 6-week time frame. The visits are explained below:
Visit 1 – Participants will be given a presentation on the aims of the study and the study requirements and will be given an opportunity to ask questions and share any concerns they may have about any aspect of the study. They will then be asked to complete some psychological tests that measure cognitive health. These tests might use words, pictures and symbols and will help us determine whether participants have normal brain function for their age. The testing session lasts about 2 hours. Finally, participants are given a short tour of the clinical imaging facilities at the Wolfson Molecular Imaging Centre in Manchester so they can see the brain scanners and then know what to expect during the research.
Visit 2 – Participants will attend The Wellcome Trust Manchester Clinical Research Facility primarily for an MRI (Magnetic Resonance Imaging) brain scan. Individuals will be required to lie still in the MRI scanner for up to 45 minutes. The MRI scanner is a noisy machine but ear protectors are provided during the scan.
We will also assess participants’ physical health by assessing grip strength, walking ability, blood pressure and measurement of other vital statistics (height, weight etc.)
A retinal investigation is completed at this visit. This will involve administering some eye drops into a participant’s eyes to dilate their pupils, after which a picture of the back of the eyes is taken (this is not a normal eye test). Certain eye conditions, i.e. glaucoma, will make a participant ineligible to undertake this investigation.
The blood vessels in the neck (the carotid arteries) will be assessed using a Doppler ultrasound scan. This is a non-invasive technique and requires the participant to lie down as the sonographer takes the necessary measurements. Some additional cognitive tests will be administered during this visit and we request that participants attend with a family member or close friend who knows them well so that we can ask the family member/friend questions (with the participant’s permission). If this is not possible, we can conduct an interview with the friend or family member over the telephone prior to the participant’s visit.
Visit 3 – Participants will return to the Wolfson Molecular Imaging Centre to undertake some more psychological tests. They will also undergo a second brain scan, the PET scan (Positron Emission Tomography scan), for which they will need to lie still in a quiet room with their eyes closed for a maximum of 40 minutes. Unlike the MRI scan the PET scanner does not produce any loud noise.
For the PET scan, participants will be exposed to a small amount of radiation (no more than 2.5 times the average annual background dose for the UK). This will be injected as a solution into a vein in the participant’s arm at the beginning of the scan. Before this injection, a small amount of blood – no more than 50ml (10 teaspoons) – will be taken to analyse general haematology, biochemistry, DNA and RNA.
For any Alzheimer’s patients recruited into the study, we aim to minimise the burden of the research as much as possible by reducing the number of visits to The University of Manchester facilities. As such most, if not all, of the psychological tests can be performed where the patients live (in the patient’s home/care home). Alzheimer’s patients will therefore only need to make two visits to the university’s facilities.
After two years, participants without memory problems at the first visit will be invited to return for some repeat tests. At the two-year follow-up, we will repeat tests to determine if there has been a change in the participant’s general health and/or cognitive function. There will be no brain scans at this visit.
How long is the study for?
The study takes place in two parts. There are three separate visits during the first round of testing and we aim to perform all three visits within a 6-week time frame. Visit 1 lasts a maximum of 3 hours while visits 2 and 3 last approximately 4 hours. For patients with Alzheimer’s disease the visits will be shorter in duration.
The two-year follow-up visit will involve two sessions (which can be completed on the same day) and each session will last approximately 1.5 to 2 hours.
What do you hope the outcomes of the study will be?
The main outcome will be increased understanding of how the brain ages and can fail in old age. By investigating people who have reached an advanced age and have not developed a dementia condition, like Alzheimer’s disease, new light may be shed on, as yet unknown, protective factors. The factors could be related to lifestyle, individual physiology and/or genetics. We believe that understanding the factors that support healthy brain ageing could potentially lead to the development of improved early, accurate diagnosis of and more effective treatments for dementing diseases like Alzheimer’s.
Where is the study based?
The study is primarily based at The University of Manchester and the tests take place at the university’s research facilities (The Wellcome Trust Clinical Research Facility and the Wolfson Molecular Imaging Centre).
Who can take part in this study?
The study team are recruiting Alzheimer’s patients who are aged 90 years or above whose symptoms are at the mild/moderate stage of the disease.
This study are also recruiting healthy volunteers without memory problems, aged 60 – 100 years, who have been involved in the Manchester Age and Cognitive Performance Research Study started by Professor Patrick Rabbit in 1983. At a future date the study may open up to individuals of the correct age who meet the study’s criteria and who weren’t originally involved in the ageing research named above.
You can see if you are eligible for this study or others around the nation by logging into your Join Dementia Research account.
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