World Alzheimer's Day: An interview with Miguel Vasconcelos Da Silva

For World Alzheimer's Day (21 September) we talk with Miguel Vasconcelos Da Silva who works as the Dementia Theme Manager at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) about his role and current studies he is working on at the King's CRF.

"Hello, I am the Dementia Theme Manager at the Old Age Psychiatry Department, IoPPN. Our department is focused on promoting healthy ageing and improving the quality of life for older adults and individuals with Alzheimer's and dementia. We strive to provide access to information and innovative therapies for all stages of dementia. Since 2014, I have been involved in clinical trials focused on Alzheimer's and dementia. My work includes various research projects that aim to improve the lives of older people living with dementia. I am pursuing a PhD at the University of Exeter, focusing on apathy in Alzheimer's disease.

My interest in working with older adults and individuals with dementia and Alzheimer's began during my early career in care homes. I witnessed first-hand the impact that Alzheimer's and dementia has on individuals and their families. In addition to memory problems, individuals often experience other behavioural symptoms, with apathy being one of the most common. This sparked my interest and led me to develop my PhD project.

Within our department, we have a portfolio of projects for healthy older adults and spanning to all the dementia stages. Below are some of our studies:

• Our CARE Network aims to involve ethnically diverse communities in research beyond older adults. Unfortunately, there is a severe under-representation of individuals from these communities in research, leading to less diverse and potentially non-generalizable data. To address this gap, we have launched a study that assesses the mental health needs and well-being of Black, Asian, and minority ethnic communities and faith groups. The study also aims to understand the barriers to service use within these communities and includes an interactive intervention to increase dementia knowledge and research participation.

• The Brain Health Clinic study was set up to assess the feasibility and acceptability of delivering a remote memory clinic, helping to manage early cognitive decline using a prevention approach and assisting those with Mild Cognitive Impairment (MCI) to live well for longer. Furthermore, the study assesses the feasibility and acceptability of biomarker and remote cognitive assessments to help sub-type MCI​. This study equips patients with preventative measures, and those at high risk of developing dementia receive timely support and intervention.

• The ABATE study is investigating the effectiveness of a vaccine called ACI-24.060 on people experiencing mild cognitive impairment or Alzheimer's disease. These individuals have difficulty with memory, learning, concentration, and decision-making, which may be caused by the accumulation of a protein called amyloid-beta (Aβ) in the brain. This protein can build up for up to 20 years before symptoms appear, so targeting it early on in the disease is crucial. Unfortunately, there is currently no treatment that can slow or halt the progression of the disease. AC-Immune has developed a vaccine that stimulates the immune system to produce antibodies against Aβ, which may improve cognitive function and memory.

• The Care Home Research Network was established in 2013 to enhance the quality of life of individuals with dementia residing in care homes. The network provides training and assistance to care homes that want to participate in research. The CHRN has already supported more than 15 studies, including a long-term study on neuropsychiatric symptoms in people with dementia in care homes. The findings of this study could significantly improve our understanding of these behavioural symptoms and how to manage them. The NightCAP program, part of the CHRN, focuses on providing care homes with support for nighttime care, including sleep disturbance and hypnotics. This care area is often overlooked, and the increased use of hypnotics is a concern. The study is in its final stages, with initial analysis underway, and results will be published soon."