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Vascular Contributions to Dementia

Centre of Research Excellence (VCD-CRE).

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Brain disease diagnosis with medical doctor seeing Magnetic Resonance Imaging (MRI) film diagnosing elderly ageing patient neurodegenerative illness problem for neurological medical treatment

A transformative approach to reducing the burden of cognitive disorders

The total contribution of vascular pathology to dementia is estimated to be as high as 50-70%. Vascular Cognitive Impairment and Dementia (VCID) has been characterised as 鈥減reventable鈥 dementia, and the data from cohort studies and intervention trials thus far suggest that this may indeed be the basis for the changing epidemiology of dementia. Despite this promise, investment in research on VCID has lagged that in Alzheimer鈥檚 disease (AD), even though significant advances have occurred in our understanding of vascular disease mechanisms and the brain-vascular interface.

罢丑别听VCD-CRE听brings together leading experts from the fields of neuropsychiatry, cognitive neurology, cerebrovascular and cardiovascular disease, endocrinology, geriatrics, neuroimaging, genetics, proteomics, lipidomics, bioinformatics and statistics to develop a collaborative national network to address the major research themes in VCID, with the objective of reducing the vascular contributions to neurocognitive disorders, without which the overall burden of dementia will be difficult to reduce.听

The work of the Centre is structured on five research themes to:

  1. Advance the diagnostic criteria of VCID.
  2. Coordinate an international effort to further develop its analytical epidemiology, and harness ongoing trials to enhance the evidence for risk factors.
  3. Identify and validate the clinical utility of biomarkers.
  4. Contribute to the international effort to identify its genetic underpinnings.
  5. Develop a portfolio of interventions for its prevention and treatment.
Related research group

Project Status

Current

The core aims of the VCD-CRE are to:

  • Bring together leading researchers in the fields of cerebrovascular disease and dementia, nationally and internationally.
  • Address the most important issues relating to the analytical epidemiology of Vascular Cognitive Impairment and Dementia (VCID), its robust biomarkers, and its treatment and prevention, so as to reduce its overall health burden.
  • Place VCID research at the forefront of dementia research alongside that of Alzheimer鈥檚 disease.

The work of the VCD-CRE can be divided into the following areas:

Diagnostic criteria for VCID

  1. To update the 2014 VASCOG criteria in view of recent developments in the field, involving international experts and a Delphi consensus process.听
  2. To harmonise the neurocognitive assessment batteries for VCID to be used for screening, clinical diagnosis, and outcome of interventions in Australia and internationally. A neuropsychological norming tool will be developed for ease of use of these batteries.听
  3. To validate computerised and online neuropsychological batteries for application to VCID.听
Project:
  • Harmonisation of diagnosis and assessment of VCD
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Analytical epidemiology of VCID: expansion of the STROKOG consortium

  1. To identify risk and protective factors for VCID across geographical regions and ethnic groups such that听strategies for prevention can be developed based on a strong evidence听base in a personalised and precision medicine approach.听
  2. To harness current and future cohorts and trials focused on vascular risk factors in any discipline (neurology, cardiology, renal medicine, endocrinology) for VCID research by including cognitive measures as secondary outcome measures. The data from trials will complement the evidence from cohort studies and place the evidence on a stronger footing for prevention.
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Biomarkers of VCID

  1. To identify, validate and demonstrate the research and clinical utility of biomarkers of VCID, especially small vessel disease contributing to cognitive impairment and dementia.
  2. To facilitate the adoption of biomarkers for diagnosis in clinical practice and research, and as outcome measures in intervention studies.
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Genetics of VCID

  1. To identify families with monogenic forms of VCID as models for the study of clinical manifestations and pathomechanisms of VCID.听
  2. To identify the genetic underpinnings of SVD and VCID using large-scale collaborative genome wide association studies (GWAS) and/or whole genome sequencing (WGS).

Contributions to Consortia including ISGC, BRIDGET, CHARGE, ENIGMA
Project:听听
  • AusCADASIL
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Interventions for the prevention and treatment of VCID

  1. To develop novel strategies for the prevention of cognitive decline in individuals with, or those at risk of, cerebrovascular disease.听
  2. To develop novel strategies for the prevention of cerebrovascular disease, and thereby VCID.听

Our research
Vascular Cognitive Impairment and Dementia (VCID) study
This project aims to develop novel imaging biomarkers of early cerebrovascular alterations in VCI.
AusCADASIL: An Australian Cohort of CADASIL
This project aims to establish an Australian cohort of patients diagnosed with Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL).
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Delphi
Project to establish consensus on the diagnosis and neuropsychological assessment of vascular cognitive disorders.
Vascular Cognitive Impairment (VCI) Study
There is a major move to characterise the different pathologies that contribute to the various types of dementia.
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Our team

The VCD-CRE supports the education and development of students in a range of projects related to VCID.听
  • The following PhD students are supported by, or work in conjunction with, the VCD-CRE:
    • Gurpreet Kaur Hansra: Molecular blood biomarkers for the diagnosis and prognosis of vascular cognitive disorders
    • Jess Lo: Vascular risk factors for cognitive impairment and dementia
    • Dr Ashley Park: Imaging and cognitive determinants of post-stroke outcome
    • Dr听Matthew Lennon: Blood pressure, antihypertensive use and dementia risk 鈥 An international harmonisation of longitudinal studies
    • Dr Louise Goodall: Cardiometabolic contributors to brain aging
    • Shizuka Hayashi: Enlarged perivascular spaces in the ageing brain, automated detection using deep learning, and analysis of their association with vascular risk factors
    • Keshuo Lin: Poststroke white matter hyperintensity, its progression, relationships with cognitive change
    • Mai Phuong Ho: Investigation of individual heterogeneity in brain changes in relation to cerebrovascular risk factors, using deep learning
    • Nikita Keshena Husein: Investigation of neuroimaging cerebrovascular markers of different ethnic groups.
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The VCD-CRE project is generously funded by the NHMRC Centres of Research Excellence (CRE) scheme (RG203943; 2021-2026).