In this ISLAND Newsletter

• Depression, Anxiety and Dementia Risk
• Our Stress and Resilience Study
• Mental Health Helplines
• New Drugs Offer Hope for Dementia
• Books About Dementia for Children

Thanks for being involved in ISLAND and helping us reduce dementia risk in Tasmania. 

Depression, Anxiety and Dementia Risk

We often get asked about the potential link between stress and/or anxiety and risk of dementia. Any of us can be affected by depression or anxiety at any time. Both are also common experiences of people living with dementia but what about whether either, or both, may actually increase risk of dementia developing? 

Research has shown that mid-life depression can increase risk of dementia in later life. Depression is highly variable – some people only have it for a short time and fully recover and others may have recurring depression over a longer time period. More severe depression earlier in life is thought to be associated with higher dementia risk. There is a strong link between later life depression and dementia but depression at that time might be an early symptom of dementia which emerges before diagnosis. 

Any of us can experience anxiety (such as worrying about a test) and some of us can experience more prolonged feelings of unease that can be difficult to control. Both can be distressing, and the latter can impact many aspects of someone’s life. Anxiety can also affect our sleep, our concentration and manifest as panic attacks. Stress and anxiety are closely linked – stress refers to worry and tension caused by something in the present or past, and anxiety refers to fears and worry about something in the future.  

When your brain detects a stressful situation, it stimulates release of a hormone called cortisol. Cortisol helps your brain and body adapt to the stressful situation. This is helpful for your recovery. But if cortisol is produced in excess and/or for too long this can be harmful. In this context, cortisol appears to be important in dementia, particularly Alzheimer’s disease. People living with Alzheimer’s disease often have higher levels of cortisol than people not living with Alzheimer’s disease. Alzheimer’s disease also appears to progress more rapidly in people who have higher levels of cortisol. Cortisol may also contribute to some other events occurring in the brain in Alzheimer’s disease, such as the formation of amyloid plaques. Work underway at the Wicking Dementia Research and Education Centre is exploring mechanisms by which cortisol impacts the brain in Alzheimer’s disease, in the hope of identifying therapeutic approaches for counteracting the effects of stress. 

It's impossible to predict whether someone who has anxiety and/or depression earlier in life will go on to develop dementia. Nonetheless, if you know someone who is struggling please encourage them to get help, starting with their GP. It’s also reasonable to suggest that reducing anxiety and depression by addressing areas of modifiable risk and taking medication after advice from your doctor could help reduce risk of dementia later in life.

Stress and Resilience Study

In the ISLAND Resilience study, we are delving into the role of stress in dementia and exploring ways to build resilience.

In 2021, we invited ISLAND participants to join our ISLAND Resilience sub-study, and 1400 people kindly volunteered. We then asked these Resilience participants about their previous life experiences, levels of stress and coping strategies. They have provided annual follow-up information, and many have also donated hair and saliva samples for measuring cortisol levels across time. If you are one of our participants, thank you! Together, we are beginning to shed light on how stressful life events, and the stress hormone cortisol, relate to changes in cognition and dementia risk reduction behaviours across time.

In addition, we have tailored our ISLAND Resilience study to investigate the impact of bushfires in particular. Bushfires are highly stressful events which, when they occur, can profoundly impact many people across Tasmania. In the ISLAND Resilience study, we have asked about participants previous experience of bushfires and developed a free short course called ‘Bushfires and Your Health’. This short course aims to help participants increase their bushfire preparedness and awareness of the health impacts of bushfire. It is now being rolled out across Australia.

Findings from the ISLAND Resilience study are hitting the press. Recently we published a paper outlining how the ISLAND Resilience study was planned and developed (https://doi.org/10.1016/j.ijdrr.2023.103919). A paper describing the Bushfires and Your Health short course is about to be published, and Bushfires and Your Health recently won the Resilient Australia 2023 award.

Coming up, there is an exciting opportunity to help us shape our research! After the ISLAND October surveys, we will invite ISLAND Resilience participants to join us for workshops to discuss research priorities, ideas and goals. As we think about future research activities, we would like you to partner with us to co-design these activities. It will be a fun and different way to be part of the research process- stay tuned!

Mental Health Helplines

If you, or anyone else, need help now you can call 000 or Lifeline on 13 11 14 - 24 hours a day, 7 days a week. 

Several organisations provide support and education about mental health, some of the main groups are included below and a full list can be found at Health Direct. 

Beyond Blue - raising awareness about depression and anxiety and reducing stigma. Call 1300 22 4636, 24 hours/7days a week.

Blue Knot Foundation - national centre of excellence for complex trauma. Call 1300 657 380, Monday - Sunday between 9am and 5pm. 

FriendLine supports anyone feeling lonely and wanting a chat. Call 1800 424 287, 7 days a week.

MensLine Australia offers support to Australian men - 1300 789 978, 24 hours/7 days a week.

New Drugs Offer Hope for Dementia

There have been some recent press reports about promising medications for Alzheimer's disease. 

These medications represent a new approach to Alzheimer’s disease, seeking to modify the series of brain changes that lead to symptoms. Whilst the hope associated with these medications seems real, the degree of benefit is not substantial and there is also a risk of significant side effects. There’s still a lot of work to be done on these drugs but, at this point, it seems that younger patients or those with only mild cognitive impairment showed most benefit through a decline in disease progression. This is yet another illustration of the importance of early detection of cognitive issues.  

It is too early to say if we will get involved in clinical trials, or when the drugs might be approved for use in Australia and if they will be subsidised by the Australian Government. In the meantime, focussing on reducing the modifiable risk factors for dementia remains an important approach to tackling the growing number of people who develop dementia due to the ageing of our population.

You might enjoy this article about the drugs and the latest results. 

Childrens Books About Dementia

Many of us know a person or people living with dementia and we try to inform ourselves - but are we prepared to any questions that children might put to us? The Forward with Dementia website lists a range of books that aim to create awareness and understanding among children. Important learning and a great way to start conversation with the little ones in in our lives. You can find out more here.

The University of Tasmania received funding from the Australian Government. Views and conclusions expressed in this publication are those of its authors, and may not be the same as those held by the Department of Health.

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