Proactive Measures

These two Albertans are taking vastly different approaches to dementia research, both with the ultimate goal of improving people’s lives

Dr. Matthew Macauley

Matthew Macauley isn’t an expert in neurology or dementia, but he may just be on track to finding a cure to Alzheimer’s disease. The researcher at the University of Alberta (U of A) specializes in glycomics (the study of sugars) and more specifically, the protein receptors that recognize those sugars. To most, it’s a fairly abstract area of study, but Macauley is currently doing work that may shed some light on why some people develop Alzheimer’s and others do not.

Originally from British Columbia, after seven years studying and researching in San Diego, Macauley moved back to Canada in 2017 to take a position as an assistant professor at the U of A in the faculty of science. With funding from GlycoNet, a body that supports glycomic research in Canada, Macauley and his lab have been trying to figure out how a genetic variation in certain receptors present in patients’ microglia (a type of white blood cell found in the brain) provides protection against Alzheimer’s.

Macauley, who works closely with John Klassen, another researcher at the U of A, was set on this path after several studies revealed about one in 10 people carry specific DNA variances related to microglia receptors that seemingly protect them from developing Alzheimer’s. (A 2008 study foreshadowed the link and two 2011 studies took a closer look at the findings.) The studies caught Macauley’s attention because the DNA variances weren’t a predictor of who would develop Alzheimer’s, but of who wouldn’t. He knew that if the lab could figure out exactly what that DNA variant was doing to prevent Alzheimer’s, he’d be on his way to potentially discovering a cure.

“We thought that if we could understand why that DNA sequence protects someone from getting Alzheimer’s disease, we could then leverage that to try to develop a drug that creates the same effect,” Macauley says.

Macauley isn’t the only scientist working on developing a cure via the information revealed in the studies, but as someone whose expertise lies in glycomics rather than neurobiology, he’s able to bring a different perspective to his research. Currently, he’s researching these receptors at a molecular, cellular and physiological level.

“We are doing work at all three levels, which increases our chances of figuring out the mechanism, which is a prerequisite to create a drug,” Macauley says.

Macauley says if he and his team can find a way to mimic these protective variants that one in ten lucky people have, then a medical cure that does the same thing is not far off.

“It’s potentially a fairly straight shot to develop a drug,” he says.

Dr. Theresa Green

Few things can shake a family like a diagnosis of young onset dementia. Most of us certainly don’t expect to experience a dementia diagnosis when we’re only in our 50s, and the impact of illness at such an early age can complicate the lives of younger patients and their caregivers who are still in the workforce or have children at home in ways that go beyond what older people with dementia may experience.

Theresa Green is a researcher and a professor in the faculty of nursing at Queensland University of Technology in Brisbane, Australia. Originally from Calgary, Green was previously based out of the University of Calgary and, before that, worked clinically in neurosciences at the Foothills Medical Centre for many years, then completed her PhD and moved into the U of C academic environment. After studying questions of care surrounding stroke patients she shifted towards working on projects focused on early onset dementia with the U of C’s Dr. Eric Smith, an area of study she’s continued since moving to Australia in 2015.

As a nursing academic, Green focuses on patient and family-centred care. While her scope is broad, she’s particularly interested in the ways that doctors deliver diagnoses to young onset patients, which can be an emotionally fraught process that can leave families blindsided.

“I’ll never forget the story of a couple who had just received a dementia diagnosis,” Green says. “They left the doctor’s office and went to the river and just walked very fast for a very long time, holding hands and without saying a word to each other because it was hard for either of them to breathe. It rocked the very foundation of their lives and sense of self as part of a couple and as individuals.”

Green’s research is primarily based on interviews with people with young onset dementia and their care partners, usually a spouse. While every family’s story is different, there are common themes: frustration with the diagnosis process, worry about financial and physical burdens since both partners are often still in the workforce, concerns about childcare and other familial relationships and trying to ensure that those with dementia are still able to enjoy the activities that make them happy. Having done interviews both in Calgary and Australia, Green says these priorities are consistent in both countries.

Green’s goal is to use the material gathered from her qualitative research to help inform clinical guidelines, both for inpatient and outpatient care, which will address the specific needs of families dealing with early onset diagnoses. She also hopes that it will encourage health care providers to think beyond guidelines and think carefully about each family’s individual needs.

“The very bottom line for me is that we can never forget that we’re talking about people and their lives,” Green says. “Guidelines are just a guide. More importantly, it’s about how care fits with the individual you’re working with.” [ ]