Associate Professor Yen Ying Lim is a clinical psychologist and researcher. Her primary research interests are in integrating and translating the effects of genetic, biological, and lifestyle factors on cognitive decline and clinical disease progression in Alzheimer’s disease. She is also interested in the development and validation of web-based cognitive tests for the early detection of cognitive dysfunction in preclinical Alzheimer’s disease.

Yen dedicates her dementia research work to people in their midlife (ages 40-70) who have a family history of dementia. She focuses on detecting early signs of Alzheimer's Disease, even in individuals who currently show no symptoms of dementia. This early detection presents a fascinating dilemma. While these individuals can't be officially classified as having early-onset Alzheimer's, they are intriguing cases to study. They might face a heightened risk of developing dementia in the future, though there's also a possibility they may never experience it. Tracking their progress could provide invaluable insights into the onset and progression of dementia.

Yen explains the world of cognitive assessments and how the tests evaluate memory, executive function, attention, language, and processing speed. These assessments offer a window into the brain's intricate workings, capturing a spectrum of cognitive domains to better understand cognitive health.

With the onset of COVID-19, Yen is at the forefront of pioneering online cognitive assessments, responding to the need for flexible, accessible testing. The traditional face-to-face evaluations often require travel, which can be a significant barrier for many. Yen weighs the advantages and limitations of both online and in-person assessments, highlighting how online options can reduce logistical hurdles but may lack the controlled environment of in-person testing.

Yen explains the comprehensive nature of neuropsychological tests and the reasons behind their sometimes unconventional design. However, many existing tests were created for highly educated, Western populations, leading to potential disadvantage among diverse groups. Hence people may score worse on a test, not because of cognition, but because a word in the test is unfamiliar. Yen is deeply committed to dementia research across culturally and linguistically diverse populations. She strives to ensure that cognitive assessments and related advice are both culturally appropriate and sensitive, enhancing their relevance and effectiveness.

"The most important modifiable dementia risk factor is the one that you are willing to address”

Hosted by Darshini Ayton and Sarah Carmody

Produced by Darshini Ayton

Music by Luke Champion

An initiative of the Centre of Research Excellence in Enhanced Dementia Diagnosis which is funded by the Australian National Health and Medical Research Council.

This podcast was recorded on Wurundjeri Country. We acknowledge the Traditional owners and custodians of the Wurundjeri Land, the Boonwurrung and the Woiwurrung peoples of the Kulin Nation. We pay our respect to their Elders past and present. Lands which Sovereignty was never ceded. Always was, always will be Aboriginal Lands.

Associate Professor Michael Woodward is Head of Aged Care Research and the Memory Clinic at Austin Health in Melbourne, Victoria. He is a specialist in geriatric medicine with major interests in the treatment of Alzheimer’s disease (AD) and other dementias. He is Principal Investigator for numerous research trials of new therapies for AD and related disorders.

Michael describes working in aged care as a uniquely holistic approach to medicine, addressing not just the symptoms but the entire well-being of the patient. Michael’s journey into geriatrics and dementia care came through his involvement in various clinical trials where he developed a profound passion for the field. Michael's role involves evaluating patients referred for dementia assessments as a geriatrician and also managing cases in his capacity as a rehabilitation physician, where he often encounters patients who reveal memory issues that predate their surgeries.

When faced with the question, "Is this dementia?" Michael starts with a thorough patient history, engaging with both the patient and their family. This is followed by a series of clinical assessments, cognitive screenings, and routine tests. Michael is fortunate to work at the Austin Hospital in Melbourne, where he has access to cutting-edge diagnostic tools such as amyloid PET scans and specialised blood tests. These advanced facilities allow him to detect biomarkers indicative of Alzheimer’s Disease, ensuring a high level of diagnostic accuracy.

In addition to his clinical work, Michael is dedicated to shaping the future of dementia care by mentoring the next generation of doctors. The field of geriatrics is the fastest growing speciality within the Australasian College of Physicians, yet Michael notes a significant need for specialised dementia training among general practitioners and other specialists, like cardiologists, who work with older people. He also points out the uneven distribution of geriatricians, with a concentration in metropolitan areas compared to rural regions in Australia.

Michael observes that our understanding and management of dementia have evolved significantly over the years. While the time required for a diagnosis has increased compared to twenty-five years ago, the accuracy of diagnoses has improved, allowing for more personalised care. He emphasises the growing importance of dementia support services, such as dementia navigators, to guide individuals through the complex diagnostic and management process.

"I want to have better treatments, and I want the journey for those with dementia to be much better than it is for many of them now."

Hosted by Darshini Ayton and Sarah Carmody

Produced by Darshini Ayton

Music by Luke Champion

An initiative of the Centre of Research Excellence in Enhanced Dementia Diagnosis which is funded by the Australian National Health and Medical Research Council.

This podcast was recorded on Wurundjeri Country. We acknowledge the Traditional owners and custodians of the Wurundjeri Land, the Boonwurrung and the Woiwurrung peoples of the Kulin Nation. We pay our respect to their Elders past and present. Lands which Sovereignty was never ceded. Always was, always will be Aboriginal Lands.

Associate Professor Samantha Loi is an old age psychiatrist and neuropsychiatrist working at the Royal Melbourne Hospital Neuropsychiatry service and Department of Psychiatry at the University of Melbourne. Sam is the current Victorian Chair of the Faculty of Psychiatry of Old Age of the Royal Australian New Zealand College of Psychiatrists and Chair of the Young-Onset Dementia Special Interest Group.

Growing up, Samantha had little direct interaction with older individuals, but her perspective shifted dramatically during her placement in old age psychiatry. It was here that she encountered the remarkable resilience of older people and was deeply moved by their ability to navigate life's challenges. Samantha quickly came to admire how these individuals have crafted their lives, despite the complexities of ageing. She explains that Old Age Psychiatry is dedicated to addressing a wide range of conditions that affect older adults, from mood disorders to dementia and other medical issues. This field not only aims to enhance the quality of life for older individuals but also recognises the importance of their personal relationships and community connections.

Samantha’s passion extends into her research from her PhD where she explored ageism and the often misguided attitudes people hold towards older adults. Her current research also tackles the misconceptions older people themselves might have about ageing. She emphasises how our views on ageing and the process of growing older evolve as we age, highlighting a dynamic shift in perception that occurs over a lifetime.

In her description of neuropsychiatry, Samantha discusses how this interdisciplinary field bridges neurology and psychiatry, offering a holistic approach to patient care. Neuropsychiatry is crucial for individuals who experience both neurological disorders and psychiatric symptoms, providing comprehensive support that addresses both dimensions of their health.

Specialising in young onset dementia, Samantha describes the unique challenges faced by her patients. Some of them, she notes, might present with new mental health symptoms that could signal the onset of dementia. Others might have lived with chronic mental health issues since youth, only to develop cognitive impairments as they age. Her research focuses on improving care pathways for those with young onset dementia, aiming to create dementia-friendly communities that diminish stigma and support people in living well with dementia. Samantha concludes with a powerful call to action: as a community, we must strive to build a society that is supportive and inclusive for individuals with dementia, ensuring they can lead fulfilling lives.

"“Some people don’t have dementia, and that’s fantastic, but people then obviously have to come to terms with the fact of well, 'what’s then been going on'? And there is actually a lot of stress with that. All the anger, grief and loss that comes with giving a diagnosis of dementia, [is also there when] not giving a diagnosis of dementia, so I think as psychiatrists we are well placed to do that”"

Hosted by Darshini Ayton and Sarah Carmody

Produced by Darshini Ayton

Music by Luke Champion

An initiative of the Centre of Research Excellence in Enhanced Dementia Diagnosis which is funded by the Australian National Health and Medical Research Council.

This podcast was recorded on Wurundjeri Country. We acknowledge the Traditional owners and custodians of the Wurundjeri Land, the Boonwurrung and the Woiwurrung peoples of the Kulin Nation. We pay our respect to their Elders past and present. Lands which Sovereignty was never ceded. Always was, always will be Aboriginal Lands.