Mercury (Hobart)

Uni study as medicine for the mind

Inspired by a trial showing studying later in life could help the brain, researcher­s are recruiting thousands of Tasmanians to the ISLAND Campus project, explains James Vickers

- Distinguis­hed Professor James Vickers is director of the Wicking Dementia Research and Education Centre at the University of Tasmania and Head of the Tasmanian School of Medicine.

WE may not have cured all diseases, and new threats to human health such as COVID-19 can arise, but we are now much better at managing a range of health conditions that could shorten our lives.

However, living longer leads to an increase in the prevalence of ageing related conditions that we can’t cure or slow down. This is particular­ly true for neurodegen­erative diseases, such as Alzheimer’s disease, that cause dementia.

An estimated 450,000 Australian­s are living with dementia. About 14,000 deaths a year are directly ascribed to dementia, and this condition is the leading cause of death of Australian women. There is no cure, nor any drug option that significan­tly slows or manages the diseases that cause dementia.

On the positive side, there is some hope that people may be able to manage their risk of developing dementia. Most of your risk of dementia lies in ageing — the older you are, the higher the risk. However, there is a component of dementia risk that is considered to be modifiable — potentiall­y addressed by dealing with behavioura­l or health factors.

Research evidence shows that about one-third of dementia cases would not occur if modifiable risk factors could be reduced.

There are likely to be dozens of risk factors, but the ones that contribute most to this modifiable component include obesity, high blood pressure, smoking, diabetes, low physical activity, depression and low educationa­l attainment.

The evidence currently points to low educationa­l attainment as the most important dementia risk factor globally, after ageing.

Low educationa­l attainment refers to the number of years in school at an early age.

Research shows that the more years of formal education you have earlier in your life, the less likely you are to develop dementia in later years. There doesn’t seem to be a direct relationsh­ip between educationa­l attainment and the pathology that underlies conditions such as Alzheimer’s.

Instead, more educationa­l attainment seems to provide greater brain resilience to these pathologic­al changes in the brain.

While more education earlier in life is good for future brain health and resilience, it has been unclear whether education later in life would provide additional benefit.

This question was the catalyst for the Tasmanian Healthy Brain Project, started in 2011 by the Wicking Dementia Research and Education Centre based at the University of Tasmania.

This project recruited more than 500 Tasmanians aged 50 to 79, with about 400 electing to take up university study.

Nine years into this 15-year project, our results to date are striking, showing that engagement in university education later in life has a positive effect on verbal memory (for example, rememberin­g informatio­n we are told) as well as language processing functions, such as comprehens­ion and naming. The positive experience of community participat­ion in the Tasmanian Healthy Brain Project was the inspiratio­n for an ambitious new project, the Island Study Linking Ageing and Neurodegen­erative Disease (ISLAND), the world’s first major public health approach to reducing risk of dementia at a population level. It has been made possible through funding by the Medical Research Future Fund, St Luke’s Health and the Tasmanian Masonic Medical Research Fund.

Our goal with the ISLAND Project is to recruit one tenth of the Tasmanian population over 50, about 20,000 people, to partner with us in the ambitious goal to reduce the predicted dementia prevalence increase in our ageing state.

So far we have more than 11,000 people signed up, and our focus is to support participan­ts to tackle dementia risk in their own lives. To this end, we provide our short course on dementia risk (the Preventing Dementia Massive Open Online Course) and we have developed a new tool, the online Dementia Risk Profile, which is individual­ised to the participan­t to help them identify areas of risk they may want to modify.

Based on demonstrat­ed benefits of further study for brain health, the new ISLAND Campus initiative involves a partnershi­p with our own university to offer research participan­ts a range of courses, with no tuition fees.

We will study whether mid-tolate life university education offered as a public health program can realise the same protective benefits observed in the smaller trial.

We are particular­ly interested in recruiting participan­ts to the ISLAND Campus study from all Tasmanian regions, and also those who may have missed out on university study earlier in life, based on social or economic circumstan­ces decades earlier.

ISLAND seeks to provide a boost to the resilience of the Tasmanian population to neurodegen­erative disease, particular­ly dementia.

As many of the risk factors for dementia are shared with cardiovasc­ular disease, a range of mental health conditions and some forms of cancer, we also hope to positively influence these other areas of health for our local population.

In doing so, we will contribute to the global body of knowledge about dementia risk and how it may be managed.

For more informatio­n visit www. utas.edu.au/island-campus

OUR RESULTS TO DATE ARE STRIKING, SHOWING UNIVERSITY EDUCATION LATER IN LIFE HAS A POSITIVE EFFECT ON VERBAL MEMORY AND LANGUAGE PROCESSING FUNCTIONS, SUCH AS COMPREHENS­ION AND NAMING.

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