Research Challenges

The term “dementia” is nowadays used to describe a syndrome that results, firstly, in cognitive function impairment and in many cases, since effective treatment remains elusive, eventually in death.

The challenges around dementia are underpinned further when diagnosis and treatment are considered. The importance of early and unambiguous diagnosis has been shown to have dramatic benefits for the individual but also for the healthcare system as a whole: delaying the onset of the disease by amere one year leads to a 10% reduction in symptomatic cases – with dramatic consequences on the quality of life for the subjects but also with very significant savings for the healthcare system. Unfortunately, both early and differential diagnosis, but also robust methods to predict the evolution of disease in a patient-specific manner, and thus decisions on suitable care and hopefully treatment, elude us. It is exactly these challenges that we will address in this project.

The DementiA Research Enabled by IT (VPH DARE@IT) project is a Virtual Physiological Human initiative that tackles the most pressing unmet clinical needs in this syndrome: we respond to the brief to provide early and differential diagnosis and management of the onset and progression of dementias, by integrating, in a truly multidisciplinary manner, heterogeneous data from individuals and populations, genetic, biochemical and metabolic pathway models, mechanistic and phenomenological multiscale imaging/modelling paradigms and sophisticated information processing tools to deliver highly innovative clinical decision support systems.

By bringing together new knowledge and innovative methods in these fields, we will deliver the first ever model that can account simultaneously for the patient-specific multiscale biophysical, biochemical and biomechanical brain context, as well for a number of heterogeneous genetic, clinical, demographic, lifestyle and other environmental factors. We shall investigate a number of observed and speculated links, including the effect of metabolic syndrome, diabetes, dietary habits, exercise, pulmonary conditions, and how the effect these conditions have on the ageing brain influences onset and evolution of dementia. This biomedical research and decision support platform will be underpinned by access to a cadre of almost a dozen databases of previously collected international cross-sectional and longitudinal studies (totalling over 9,000 subjects), including exclusive access to an invaluable longitudinal population database that has tracked the development of dementia in nearly 15,000 individuals for over 20 years and is still on-going (Rotterdam Study).

This distinctive integration of innovative data analysis and modelling paradigms and access to state-of-the-art studies puts this consortium in a uniquely favourable position for making a real and measurable breakthrough in fighting the colossal health and societal burden resulting from dementias.

Lessons learnt

  • Breakthroughs in IT for healthcare will come from interdisciplinary clinically-led yet IT-enabled approaches to healthcare, not an IT-centric approach, to innovation where clinical drivers are essential. This requires funding with the scale of ambition of Integrated Projects and breaking the boundaries between ICT and Health funding streams. Future projects need to enable simultaneous methodological development and rich clinical data collection.
  • Advanced ICT for Health, particularly in the area of the Virtual Physiological Human, requires specific Health Technology Assessment strategies that may not fit within the standard patterns of traditional HTA. It requires flexible and intertwined cycles of technological innovation and clinical evaluation that calls for, cross technical-clinical partnerships and long-term funding schemes.
  • Patient-specific physiological modelling plays a crucial role, not only in diagnostics and therapeutics, but also in deeper disease understanding and clinical research. As such, it needs to permeate future clinical research calls and a timeframe for “deployment” cannot be imposed in this area.