Sebastian Crutch
Seb Crutch is Professor of Neuropsychology at the Dementia Research Centre, UCL Institute of Neurology, & Director of the Created Out of Mind dementia & arts residency at The Hub, Wellcome Collection.
Location London, UK
Activity
-
Sebastian Crutch made a comment
Good morning all, and welcome back to Week 2 of the Many Faces of Dementia MOOC. We hope you find the content of this week's videos, articles and discussion interesting and valuable. Just to let you know I have added a summary of last week's questions and discussion as a downloadable pdf at the bottom of section 1.19.
-
On your important point about examining the brain via autopsy, this relates to the important difference between the symptoms of the condition and the underlying disease causing those symptoms. In the past, the condition could only be discussed as 'possible' or 'probable' without evidence from autopsy (or, in exceptional circumstances, a brain biopsy). More...
-
It's really important in considering the inherited forms of dementia discussed this week to remember that only about 1% or less of Alzheimer's disease is directly inherited, and this typically occurs at a young age (usually in the 30s, 40s or 50s). As the Alzheimer's Society note in their helpful section on genetics...
-
I think there is a lot of evidence to support a role for education and continuing cognitive activity in moderating the risk and timing of dementia, but this evidence comes almost exclusively from people living at risk of the sporadic (not directly inherited) forms of dementia. Sadly for people living a dominantly inherited form of Alzheimer's disease, like the...
-
On the odds ratio for developing AD after 70 decreasing – if you mean the odds of developing AD conferred by having an e4 allele - this may be a statistical effect. If APOE4 shifts the age of onset to a younger age (essentially a normal distribution to the left compared with e3) then because you are looking at a normal distribution of ages of onset then the...
-
On your point about gender differences Laurence, my colleague Jo Barnes commented: Women tend to disproportionately get AD, however, they live longer and age is the greatest risk factor for AD development. It is likely that differential longevity according to sex partly explains why there is a higher proportion of women with AD. However, there may be sex...
-
Our colleague Ian Malone added: Masking is used for registration, however a similarity measure for the images is used to drive the alignment (cost function), this makes it somewhat robust to noise (which will occur whether image intensities are normalised or not). Creation of brain masks can be done a number of ways, this includes manual segmentation and...
-
I'm no imaging expert but consulted a couple of much wiser colleagues. Jo Barnes said: The short answer is – yes. The longer answer is yes that’s right and there’s image intensity normalisation to produce the BSI. There are also different ways in which noise (inhomogeneity) can be removed from the images. These post processing techniques occur on the...
-
Absolutely Laurence, the genetic picture is substantially more complex than in certain monogenic diseases like sickle cell disease.
-
Absolutely Effie. As the famous physician William Ostler is thought to have said, 'Ask not what disease the person has, but what person the disease has'. One doesn't have to look just at the disease or just at the person; as you describe very clearly, the challenge is to hold the two together to provide the best and most appropriate, tailored support that one...
-
Thanks Krissy. Although we mainly discuss language in Week 2 in relation to the frontotemporal dementia (see sections 2.12-2.14), section 2.13 on 'logopenic progressive aphasia' or LPA is particularly relevant to the question of language impairment in Alzheimer's disease.
-
Completely agree Barbara that there is much that interests us but also challenges us here. Regarding brain injury, we know that damage to the brain of many kinds, whether a large stroke or mild traumatic injury, can increase our risk of dementia. However, as with most of the other risk factors, it is very difficult at an individual level to know by how much,...
-
Sebastian Crutch replied to Lorraine M
...and this website for the US Alzheimer's Disease Co-ordinating Centers can help you find a center near you: https://www.alz.washington.edu/WEB/family_home.html
-
Sebastian Crutch replied to Evelyn Ketterer
The Dominantly Inherited Alzheimer Network is an international collaborative study and includes study sites in the USA, Australia, England and Germany. The Australian sites are Sydney (at NeuRA), Melbourne and Perth.
-
Sebastian Crutch replied to Jo Goddard
You're absolutely right that this is naturally an issue many people think about when considering entering a trial. In DIAN, the study design includes a pooled placebo group shared by all study drug arms (they are testing different drugs in parallel). People with a genetic mutation are assigned to a study drug arm and subsequently randomized within that arm in...
-
Sebastian Crutch replied to Kate Gibbon
Currently people would not be offered genetic testing unless there was a very strong family history (multiple people in multiple generations experiencing similar symptoms at a similar young age). Unlike Huntingtons which is caused by changes in a single gene, there are a number of different mutations that can cause this rare familial form of Alzheimer's...
-
Sebastian Crutch replied to Shakuntala Sengupta
Type II diabetes has been identified as a risk factor for dementia, but the evidence I'm aware of doesn't prove it to be a cause, as many other factors may be contributing. It is suspected that having diabetes may be relevant to dementia risk through the impact it may have on our vascular system (the system delivering and returning blood to/from the brain. For...
-
Sebastian Crutch replied to Danny Buckley
As far as we understand it, no. These genes are what is known as fully penetrant, meaning if you have the gene you get the disease. So you can't be a silent carrier and pass it on to a future generation without exhibiting the symptoms of the disease yourself.
-
Sebastian Crutch replied to Christine Z
Lots of things can affect our memory and thinking processes. For example, many of us have probably noticed our thinking slowing when we have a cold or the flu, or are overtired, or experiencing physical pain. A number of medications can also impact on our cognitive abilities. These experiences challenge the notion that our mental abilities and skills are...
-
Sebastian Crutch replied to Katie Baker
One of the purposes of the DIAN study mentioned is to address this kind of really important question, i.e. do people living with this rarer inherited form of Alzheimer's disease have the same symptoms as people living with the more common typical, so-called sporadic form of the disease. It seems from the data published so far that the main cognitive symptoms...
-
Sebastian Crutch made a comment
Thanks to many of you for sharing something of your own personal stories and motivations for being involved in the course. The sheer prevalence of the dementias mean that many of us have relatives and friends affected by one of these conditions. It is estimated that around 700,000 people act as informal carers to those currently living with a dementia (see...
-
Sebastian Crutch made a comment
Good morning all. Delighted to welcome you on this first morning of the course. I really hope you find much that interests and moves you in the comments, images, thoughts and ideas of the 50 colleagues and collaborators who have contributed to this MOOC. Enormous thanks to many but especially to Janette Junghaus for leading the creation of the course, and to...
