Chris Hardy

Chris Hardy

I am a postdoctoral research fellow based at the Dementia Research Centre, UCL. My research focuses on the primary progressive aphasias, and the relationship between hearing loss and dementia.

Location London

Activity

  • Hi @ClodaghDaly-McKeown - thank you for your question - it's a really good one. There is some information about medications a bit later this week - sometimes people with DLB can derive some benefit from certain medications. In terms of advice for carers, I found this information from Alzheimer's Association - which is the big dementia charity in the USA:...

  • Hi @ChristineWilliams thanks for your question - you're right that Parkinson's disease dementia is most often caused by Lewy bodies (these are abnormal clumps of proteins that form inside brain cells, damaging them). So, the accumulation of these Lewy bodies causes damage to particular brain cells, leading to symptoms of Parkinson's disease dementia.

  • Hi @SahilAhammedKP thanks for your question. There is a section on treatment that gives some information about medications for hallucinations a bit later on in the course - it's a really complex issue. I'm not sure there is any evidence to suggest that people experiencing delusions due to LBD benefit from connecting with others experiencing similar things - I...

  • Hi @IreneNesbitt thanks for your question - this is such a fundamental issue in dementia research and vitally important if we are to arrive at preventive medicines in the future. We have some clues in familial forms of dementia - here we have a faulty gene that gets passed down through the generations and causes proteins in the brain to clump together, in turn...

  • Hi @SharonSanders thanks for your question - it's a very fair question to ask! All of the scans that are mentioned in this video are available in the UK - but you're right that they are not necessarily 'widely' available. Most people will be given an MRI or CT scan to help build up a picture of the structure of the brain and often this can be sufficient for a...

  • Hi @ValerieRussell thanks for your question - it's a really good one. Your'e right that most people will be offered a more 'routine' scan like a CT scan (https://www.nhs.uk/conditions/ct-scan/) or structural MRI scan (https://www.nhs.uk/conditions/mri-scan/). Again, you're absolutely right that more specialised scans looking at brain function or tracking...

  • Hi @SamanthaWalters it's a great question. You're right that people with PCA will often consult an optician first of all, but the optician may not be able to help unless they have come across PCA before - because actually, the person's eyes are typically completely healthy - the problem comes with the areas of the brain interpreting the information from the...

  • Hi @JoMcBay - thank you for sharing your story about your downstairs neighbour - it sounds like she is very fortunate to have you around to help her when she needs - but I'm so sorry for you both because it must be very distressing for her, and for you as well. It does sound like she needs some more help and support around the home, but it must be so difficult...

  • Hi @JoAnnFeeler - this is a really good question too. We know that if somebody has a stroke in an area of the brain that affects their language abilities, rehabilitation with a speech and language therapist can help 'retrain' other parts of the brain to take over some of the functions that used to be performed by the damaged part. We're starting to see...

  • Hi @JoMcBay thanks for your question! I'm sorry to hear that you experienced PTSD, but it's great that CBT really helped. I agree with your points and I checked both studies:

    Spector (2015) recruited participants who had mild to moderate dementia and who lived in the community - so you're right that these were people at relatively early stages of dementia....

  • Hi @NorbertaCaballero thanks for your question. I'm really sorry to hear about your husband's difficulties - that must be so hard for both of you. Your question is a really good one. We know that there can be quite a lot of overlap between FTD diagnoses - and actually it is quite commen for somebody with behavioural variant FTD to also have problems with...

  • Hi @FionaFletcher it's a great question and can depend on the individual's circumstances. In some cases, one scan would be sufficient - if it showed clear signs of atrophy in the lobes of the brain that Professor Crutch mentions in this video. In other cases, repeat scans might be required - I've written some more about this process in my reply to Susan below....

  • Hi @SusanSadler thanks for your question and apologies for the late reply! You're right that the first scan that is mentioned in the video would likely be what's called a 'structural' MRI scan, so-called because it helps build up a picture of the grey matter (as you said), but also the white matter and cerebrospinal fluid. In some cases, this scan would be...

  • "A reviewer looking at this finding might say that perhaps the participants with bvFTD just did not engage with the VR as much as the healthy volunteers, and that’s why you see a difference (i.e. it’s nothing to do with the lack of empathy, but more apathy towards the whole scenario). When we did a post-VR questionnaire on the two groups to review their...

  • "Preliminary findings indicated a difference between people with bvFTD and healthy volunteers in the way they reacted to the avatar falling over. Participants with behavioural variant FTD did not elicit as many utterances as the healthy volunteers, nor did they use as emotive language in response to the fall. There were also far fewer movements towards the...

  • "From these descriptions, it was clear that we needed to simulate some kind of injury to one of the avatars. We designed a scene whereby a waitress walking past the participant slips on some water and falls (with a relatively gruesome-sounding ‘crack’ sound effect on impact with the ‘floor’). We were interested if the participants with bvFTD would react...

  • Hi @ChristineWilliams thanks for your question - I think this is a very fair comment! I spoke to the lead researcher for this study and she sent me a detailed response about what they did and what they found. It's quite long so I'll have to split it up - see below:

    "When we were designing the VR scenes, we initially asked carers (usually spouses) of people...

  • Hi @ME - thanks for your question. It isn't still being used currently but the preliminary results were quite encouraging, showing that there were differences in how people with behavioural variant FTD reacted to the virtual scenarios compared to people without dementia. I asked the lead reasercher for the study about plans to continue the work in future and...

  • @PhilMorgan Thanks for your question - I see what you mean and it's a really good point. You're right that in some rare cases, the person with FTD may develop a mutation in an FTD-causing gene that neither of their parents had - and if this happened this could be passed down to that person's children. That really is very rare though - under 10% of people with...

  • Hi @DanaBovee thank you so much for finding this and including it here. I've updated the link in the article above to this one now - thank you again for your help.

  • Hi @SusanSadler - thanks for your question - it's really interesting! As we'll learn this week, PCA is most commonly caused by the same problematic brain proteins that we see in typical Alzheimer's disease - the main difference here though is that they are clumping together and damaging cells in the back parts of the brain, which control things like visual...

  • @ValerieRussell Hi Valerie I'm so sorry to hear that you don't feel you have the support you need - it must be so difficult, especially with local support groups stopping due to Covid-19. Kaz M is right - the Alzheimer's Society do run an online forum called Dementia Talking Point that many people find very helpful - you could access that here:...

  • Hi @ColetteStewart - thanks for your question - it's a really interesitng one! A very important study published this year found that there is a strong relationship between 'parental age at onset' and 'individual age at onset', meaning that an individual might be expected to experience symptoms for the first time at roughly the same time as their parent with...

  • Hi @ME - thanks for your question. I'm not sure about whether the funding you mentioned the government are putting into Mental Health is also applicable to dementia - or if the funding for that is separate. I do know that the UK government allocates around £85 million a year to dementia research - but unfortunately, as you might expect, the Covid-19 pandemic...

  • Hi @GuillermoGarcia thanks for your question - I'm really sorry to hear about your sister - it must be very worrying for her to have these kind of thoughts, and very difficult for you to see her being affected by them. You're right that schizophrenia and dementia are different, but actually they can affect the same regions of the brain, depending on the type...

  • Hi @PhilMorgan thanks for your question. Pick's disease is the term that used to be used instead of frontotemporal dementia - which will be covered in a lot more detail in week 2 of the course (the term Pick's disease is now most often used by scientists and doctors to describe a specific type of damage caused by problems with specific brain proteins). In FTD...

  • Hi @InezBischof-Keemink - thank you for your question. You're absolutely right that education (or lack thereof) is associated with risk of developing Alzheimer's disease, although scientists don't really understand the precise mechanisms involved yet. It seems to be the case that people who spend longer in education have more 'cognitive reserve' - which we can think...

  • Hi @DianeAddy - thanks for your comments and your question - it's a really interesting point. Dr Cath Mummery talked briefly about the DIAN-TU study in one of the previous steps for this week - and actually that study was set up to do exactly what you've suggested. Lots of evidence suggests that the earlier doctors could give somebody a potential medication,...

  • Hi @IreneNesbitt - thank you for your question. It's really difficult to answer this, but I think the main reason really is the complexity of the problem - there are 86 billion neurons in the brain and understanding what goes wrong in one of these cells, how that spreads to different cells and how we can measure and track disease progression in people in early...

  • Hi @JoMcBay - thanks for your question. The drug Stuart mentions in this video is Aricept - the brand name for donepezil that we'll hear about in a later step this week. These drugs are available on the NHS, so they wouldn't typically be given as part of a research study - and a clinician might prescribe them if they felt they could help to manage a person's...

  • Hi @JoyPhillips - thank you for your question. It's a really good one, and actually there has been lots of research into loss of smell (aka 'anosmia') as an early symptom in some forms of dementia. Our smell and memory centres in the brain are linked really closely - for instance, certain smells can trigger powerful memories decades old - and these regions are...

  • Hi @Dr.HansM.Rupp - thank you for this comment - it's a really fair point, and I think that the article is really just trying to make a distinction between autosomal dominant inheritance that would cause dementia to develop for certain, and genes that, as you say, may cause increased risk, like APOE: we'll cover this in some more detail in a later step this week.

  • @JoMcBay Hi Jo, it's a great question. Essentially, 'early onset' is used fairly arbitrarily as a term to refer to a dementia that causes symptoms to emerge in a person before the age of 65 (based on the fact that historically, this was the typical retirement age for most people). So if a person has a diagnosis of dementia before this age, they can be...

  • @GuillermoGarcia Hi Guillermo, thank you for your question - as @Dr.HansM.Rupp has kindly said, schizophrenia, depression, anxiety and personality disorders are not classified as forms of dementia. Dementias are typically associated with ongoing (progressive) decline of brain functioning, whereas the things you've mentioned in your question we'd probably refer...

  • Hi Irene, she is amazing isn't she! Your question is really interesting. The term 'protein' here is a confusing one - here it's really being used to refer to molecules in the brain, whereas the usage we're most familiar with is protein in a nutritional context. But having said that, you're absolutely right that some scientists have found evidence to suggest a...

  • Hi Marianne, thanks - this is a really good question. It definitely isn't always the case that there is a very long wait between symptom onset and diagnosis, but unfortunately this can happen, and as you might expect, seems to happen most often in rarer dementias like familial Alzheimer's disease and some other types of dementia that are covered in later weeks...

  • Hi Julie, this is a really interesting question. What you're referring to sounds a bit like the concept of 'neuroplasticity' that is exploited quite often in rehabilitation strategies for people after strokes: the basic idea is that if one part of the brain is damaged, then other brain regions can be 'co-opted' to take on the function that the damaged brain...

  • Hi Pat, you're right that other forms of dementia are less likely to run in the family: in fact, this is true for most types of dementia. There is some more information about genetic risk in Alzheimer's disease later this week, and about different types of dementia in the other weeks of the course, but there is also a nice article from the Alzheimer's Society...

  • Hi Amanda, this is a really good question and one that has generated lots of recent research interest - the thinking goes that if it's so difficult to treat or reverse these amyloid plaques, then surely it would be better to stop them happening in the first place, i.e. 'prevention' rather than 'cure'. Unfortunately, we still don't understand what causes these...

  • Hi Amanda, thanks - this is a great question. There's some more information later this Week about a trial that ran at UCL that goes into some more detail about this, but essentially, researchers are trying to remove amyloid plaques using different medications. A technique called 'immunotherapy' is what has most often been tried so far - essentially trying to...

  • Hi Amanda, thanks - these are great questions.

    Children of somebody with a known mutation are not automatically tested. There's lots of information here about the process: https://www.raredementiasupport.org/familial-alzheimers-disease/fad-at-risk/ - but essentially the child would need to go through a course of genetic counselling before deciding whether...

  • Hi Bronwen, thank you so much for pointing this out. The survey ran during a previous run of this course and shouldn't have been included here - I've removed the link now - thanks so much again for bringing it to our attention. Please do start the course whenever you're ready, and I hope that you find it interesting and useful!

  • Hello everybody and welcome to the course! My colleague Claire and I will be monitoring the comments for this course over the next few weeks, so if you do have any questions about any of the content here, please do feel free to ask. We hope that you find it interesting and informative, and are looking forward to answering any questions that you might have.

  • Hi Samiya sorry for the late reply. This trial was only focused on Alzheimer's disease - and specifically familial Alzheimer's disease (i.e. caused by a faulty gene). Trials for all-cause dementia are rare because we know that the underlying causes of different types of dementia are very different. So when we think about a cure for dementia, it's unlikely that...

  • Hi Samiya, sorry for the late reply. It's a great question and unfortunately at the moment, there are no medications that can target the faulty gene in familial Alzheimer's disease. There's more information later on in the materials for this Week that you may have already seen by now - that talks about things like Donepezil that might help to improve certain...

  • @VirginiaJarrell @GargiKanwar Hi Virginia and Gargi, I'm so sorry for the late reply. PCA is most often associated with the same problem proteins that we see in typical Alzheimer's disease - but in PCA they just take hold in the back of the brain; not in the memory regions. So these two proteins - the amyloid plaques and neurofibrillary tangles clump together...

  • Hi Mahan, this is covered in Week 1 of the course so do have a look back through the articles and videos there if it isn't clear. Essentially, dementia is an overarching label - what we call an 'umbrella' term - Alzheimer's disease is the most common type of dementia.

  • @JulieSlater Hi Julie, thanks for your questions and sorry for the delay in replying.

    1. If a head injury were to affect the same parts of the brain that are affected by FTD, then a person might experience some similar symptoms. However, the trajectories would be quite different: whereas FTD is a neurodegenerative process, meaning that things will get...

  • Hi Mahan, thanks for your question. There is a lot more information about this relationship in Week 4 of the course so I won't give too many spoilers here! In brief though, information is sent from the eyes to the 'occipital' lobe of our brain, which is right at the back. Electrical activity in these brain areas is how we process the information being sent...

  • Hi Emma, sorry for the delay in replying to you. The principle is exactly as you've described - and this is the way that Professor Fox teaches this to his students! The process is actually completely automated now - it's done using computers - but the basic principle is that you have two scans, at different times, the scan at the second timepoint should be...

  • Hi Lynn, I'm so sorry for not getting to your question sooner - I must have missed it. Not everybody with DLB experiences hallucinations - but they are one of the more common symptoms. If you're worried that your dad might have DLB it would be worth encouraging him to see a GP in the first instance, or a neurologist or psychiatrist if possible.

  • Hi Anindita, I think unfortunately certificates are only available if you 'upgrade'. If you go to the main course page here: https://www.futurelearn.com/courses/faces-of-dementia and scroll down to the section 'Join the course' it gives the information about different types of access and benefits.

  • Hi Jane, thanks for letting us know. The survey has actually closed to respondents now which is why you weren't able to access it. I've edited the text so that other people don't try to access it - thank you for raising this.

  • Hi Wendy, apologies for this - the survey has now closed which is why you weren't able to access it. I've removed the link in the text here - thank you for pointing this out.

  • Hi Carolynne, I'm not aware of a list like this I'm afraid. This course has given a good overview of visual impacts in PCA, Alzheimer's disease, and Lewy body dementia. We haven't really touched on vascular dementia (https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/how-dementia-progresses/progression-vascular-dementia), which can sometimes...

  • Hi Lynn, it's a good question and there is lots more information about Parkinson's disease dementia in Week 3 of the course! You're right that people with progressive nonfluent aphasia can develop features of 'Parkinsonism' as their disease progresses. It really comes down to the fact that different brain networks manage different parts of our behaviour -...

  • @AnadelE Thanks Anadel, that's really helpful for me to know for future in case I get asked this question again!

  • Hi Christine, I'm really sorry to hear that somebody you know is having these problems. 'Mixed' pathologies are certainly possible. The most common mixed dementia is vascular dementia and Alzheimer's disease, but a mixture of both Alzheimer's disease and LBD is possible too. There is a bit more information about this here:...

  • Hi Christina, this is a great question. As with other forms of dementia, it's quite tricky because posterior cortical atrophy (PCA) really refers to a clinical syndrome - i.e. it's a term used to describe a collection of symptoms that are defined by progressive problems with vision caused by damage to the back of the brain. As you suggested, this damage is...

  • @JamesBennett Hi James, no worries! Sorry for not answering your more technical questions though. I think these are a bit beyond me - but doing some further reading around cyclamate, it looks as though the fears around its carcinogenic properties were driven by early findings suggesting that some individuals appear to metabolise cyclamate to cyclohexylamine....