Clinical Geriatric Medical Research

CERA's clinical research is conducted though the Cognitive Disorders Clinic, a tertiary referral service and research clinic. The clinic has gained recognition for its expert assessment of cognitive impairment including unusual and complex presentations. Patients are seen by a team of health professionals who provide a multidisciplinary approach to accurate diagnosis and relevant counselling for patients and their families. All staff meet after the assessment to formulate a management plan which may include treatment, further tests, information, education, advice about local community services and the chance to participate in further research. This allows us to provide ongoing support to patients and carers, either through this clinic or their local community services. The clinic is funded by the Department of Veterans' Affairs and Sydney South West Area Health Services to provide enhanced services to the NSW veteran and war widow community and the general community. Suitable patients have the opportunity to participate in research projects. These may include:

• blood collection for genetic and biochemical factors contributing to brain disease
• testing for specific areas of interest, for example atypical dementias such as frontal
• lobe or Lewy body dementia; and
• clinical drug trials

Methology

Qualitative data are collected on all patients who attend the clinic. This confidential information can suggest damage to specific regions of the brain and can be correlated with neuroimaging, such as magnetic resonance imaging (MRI), positron emission tomography (PET) and computerised tomography (CT). This information is invaluable to clinicians to better understand the illness and may assist with early diagnosis, which is essential for testing potential interventions which are postulated will be more effective when used prior to the onset of significant cognitive loss. Specific audits of carer expectations and outcomes and of clinical outcomes are also performed.

We aim to follow patients longitudinally and some patients neuropathologically. Information collected during the disease course is invaluable to the understanding of the results at autopsy. Many projects have been completed in recent years or are ongoing, based on clinic materials or using the staff and assessment instruments of the clinic. Most of the projects are collaborative and receive additional funding contributions from a variety of sources including the NHMRC and the Department of Veterans' Affairs.

Key contacts:
Staff Specialist, Geriatric Medicine: Dr Louise Waite
Senior Staff Specialist, Geriatric Medicine Dr Helen Creasey