With dementia now the greatest cause of disease burden for Australians over 65 – overtaking heart disease – a Griffith University researcher has created a dedicated program designed to improve the memories and cognitive functions of older Australians.

According to new research, dementia is the second leading cause of disease burden and death for Australians of all ages, behind heart disease. For women, it’s the number one cause – regardless of age.  Unlike heart disease though, there’s currently no known way of preventing, slowing, or curing dementia.

“Dementia causes a huge burden on the person, families, and the health system,” says Clinical Neuropsychologist, Associate Professor Kerryn Pike.

“Being the second leading cause of disease burden in Australia, dementia leads to the loss of 241 500 healthy years of life,” she says.

“As dementia causes progressive decline in the person’s memory and thinking functions, they lose the ability to be able to function independently.  They will need more assistance as the disease progresses.

“It will lead to them being unable to work, volunteer, help look after grandchildren, drive or take public transport, manage their finances, take part in their usual leisure activities, prepare meals, purchase groceries and other needed items, and eventually look after their personal needs.”

Dementia costs the health system in Australia more than $3 billion, with more than half of this being the costs of permanent residential aged care. People with dementia also experience longer hospital stays – around five times that of people without dementia.

“I’m not sure we have good evidence for the risk factors for cognitive decline in older age, in general, but we do know quite a bit now about the risk factors for dementia,” Associate Profession Pike says.

“There are several non-modifiable - things we cannot change - risk factors for dementia which include age, family history, some genetic factors, and gender.

“Research has also identified 12 modifiable risk factors, which account for around 40 per cent of dementias worldwide.  Thus, if we work on reducing these risk factors, we may be able to prevent up to 40 per cent of dementia.”

The modifiable risk factors with good scientific evidence are: less education, high blood pressure, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, low social contact, excessive alcohol consumption, traumatic brain injury, and air pollution.

While there is no known way of preventing all cases of cognitive decline or dementia, Associate Professor Pike says we can all work on reducing our risk factors, which will reduce the overall number of cases of dementia.

“Sometimes cognitive decline can be reversed, depending on the underlying cause,” she says.

“As part of a comprehensive assessment of cognitive decline, the medical team would screen for known treatable causes of cognitive decline and treat as appropriate.  We do not currently have any medications or interventions that can reverse cognitive decline due to dementia, however.

“One of my core values is about making a difference to people. This area of research enables me to work on programs that help older adults get the most out of their memory.”

One such program is the LaTCH (La Trobe and Caulfield Hospital) memory program is a 6-week group program. The program aims to teach older adults, including those with mild changes in their thinking and memory, to better manage their memory in everyday life.

“Mild cognitive impairment refers to older adults who have some difficulties in their memory or thinking on formal assessment, but are still able to function independently, and do not have dementia.

“People with mild cognitive impairment are often looking for assistance in how they can improve their memory in everyday life.  LaTCH was developed to provide people with mild cognitive impairment information about evidence-based strategies they could use to manage their everyday memory better.

“It also enables them to meet other older adults in a similar situation, which helps normalise the difficulties they are having.”

The LaTCH program was originally developed for older adults with mild cognitive impairment. It has since been extended to older adults who would like to improve their everyday memory, but don’t necessarily have objective difficulties on formal assessment.

“The program involves psychoeducation about how memory works, what impacts on memory, and the difference between normal ageing and dementia,” Associate Professor Pike explains.

“It also involves learning about specific evidence-based strategies to improve memory in daily life, covering all the common memory slips - remembering names, where you put something, remembering to do something, etc.

“Finally, LaTCH is a group program, which means that participants hear from other older adults in a similar situation.  They learn from each other and realise that the difficulties they are having are common. This helps reduce their fear of developing dementia and provides them with greater confidence to use the strategies in everyday life.”

After conducting a large randomised controlled trial, the team found LaTCH participants reported improved memory ability, strategy knowledge and use, and improvement in how they felt about their memory.

“Even years after taking part in LaTCH, people note that it helped them realise they were not the only ones dealing with these memory difficulties, it improved their confidence, enhanced self-efficacy and confidence, and enabled people to accept their situation. 

“This can lead to re-engagement in activities, can reduce carer stress, and enhance family relationships.  LaTCH benefits older adults who want to learn more about optimising their memory in daily life, including those with some mild memory difficulties.”

Currently, the program is not routinely available, but there are several places in Australia where LaTCH is offered. The team are now working towards making it more accessible for older adults, with more clinicians being trained all the time.