An integrated Research environment dedicated to dementia

Our approach: dementia is a preventable

outcome, not a disease

Pathologies underlying dementia develop through life and represent the outcome of interactions between gene-environment-lifestyle

Jack et al: Lancet Neurology 2013

Age

Preclinical

Prodromal

Dementia

60 75 90 45

Cognitive Health

The challenge

Identify early determinants

Identify early treatments to delay onset

Identify treatments To relieve symptoms and slow progression

Age

Preclinical

Prodromal

Dementia

60 75 90 45

Cognitive Health

The challenge

Identify early determinants

Identify early treatments to delay onset

Identify treatments To relieve symptoms and slow progression

Age

Preclinical

Prodromal

Dementia

60 75 90 45

Cognitive Health

The challenge

Identify early determinants

Identify early treatments to delay onset

Identify treatments To relieve symptoms and slow progression

Science step-change

• Dementia dedicated ‘big data’ platform

• Triangulation between multiple independent datasets

• Closer synergy between scientific specialties

• Closer partnership between academics and industry

• More targeted analytic questions

• Reducing transaction costs………

Methods Development

Dementia Resources

Readiness Cohort

Amyloid Cohort

Genetics Discovery

Cohort

Omics Discovery

Cohort

Biostatistics

Dementia Outcomes

Cognitive Assessment

Trials Recruitment

ELSI

Brain & iPSC Donation

Deep & Freq. Phenotyping

Experimental Medicine

Synaptic Function

Immunity

Vascular Determinants

Metabolic Determinants

Early Phase Trials

Research Networks

Imaging

Stem cell (iPSC)

Informatics

DPUK

Analytics

Portal Informatics Platform

22 Cohorts

Cohort Integration

Research-based Infrastructure

The Cohorts

Mature Population Cohorts

Familial Disease Cohorts

Prodromal Population Cohorts

Data integration and communications to

join epidemiology and experimental

medicine Creating the context for a new generation of highly stratified,

highly informative, smaller, cheaper clinical trials

The wider context

Dementia Platforms UK Imaging Network:

delivering the vision

Linking cellular and molecular changes to patient selection and response

Building a national network

Integrated MRI-PET: combined structural and

molecular imaging

http://www.healthcare.siemens.com/magnetic-resonance-imaging/mr-pet-scanner/biograph-mmr

http://www.auntminnieeurope.com/index.aspx?sec=ser&sub=def&pag=dis&ItemID=607775

Lowering barriers to increase imaging

research impact

• Coordination activities and collaborative working groups

• Economies of scale

• Sharing expertise

• Sustainability

• Realising a step change in molecular imaging capabilities

• Making radiotracers more widely available

• Introducing and developing novel MRI-PET platforms

• Harmonising approaches to create a distributed laboratory

• Moving from unlinked to linked imaging data collection

• Building on rigorously maintained cohort studies

• Integrating soluble biomarkers, ‘omics, clinical phenotype and patient reported measures

CRI funded Informatics network

• Cohorts (Swansea)

• Imaging (Oxford)

• Devices (Manchester)

• Genomics (Cardiff)

• Linkage –CRIS (Oxford)

• Brain banking (Bristol)

CRI funded iPS Cells network

• Collaboration across 6 centres

– Cardiff, Oxford, Cambridge, Manchester, Edinburgh, UCL

• Provide neuronal models of clinical phenotypes

• Preserve cell lines from cohorts

• Develop cellular basis of disease stratification

• Interrogate pathogenic pathways

Integrated EM strategy

COHORTS

Innate and

Adaptive Immunity

Integrated EM strategy

COHORTS

Synaptic Health

Vascular Risk

Synaptic Health Vascular risk

Innate and

Adaptive Immunity

Integrated EM strategy

COHORTS

Molecular Imaging

IPS Cells

Informatics

Synaptic Health Vascular risk

Innate and

Adaptive Immunity

Integrated EM strategy

COHORTS