Tell us a little about your academic and professional background – what led you to the field of Geriatric Medicine, how did you come to your position as Clinical Lead for the ADNeT Registry and what does your role entail?
I am a geriatrician, which is a specialist physician for older adults. I was drawn to geriatric medicine for a number of reasons – because it is based on a holistic approach, because teamwork is such an important part of the care delivery and because it is complex. But, probably most of all, I enjoy working with older people and their families. It’s humbling to learn from the wisdom and experiences of others, whilst I am also incredibly inspired by family caregivers.
As a geriatrician, the diagnosis and management of dementia is a core part of our practice, so I became aware of just how much variation exists in the clinical settings and also in the approaches to dementia diagnosis and management. And that too often, the experience reported by people living with dementia, and their caregivers, has been unsatisfactory.
This is why the concept of a clinical quality registry really appeals to me. A clinical quality registry systematically collects clinical data about what doctors like me do, and what the outcomes and experiences are for the people we treat. It helps us to understand if our practice is as good as it can be, or if there are opportunities to do better. Registries use “benchmarked” data to help us clinicians understand more about our clinical services, who we treat, and how this compares to other services. It also helps to draw us clinicians together, in a clinical community, to work together to do better.
As the clinical lead, I ensure that what we are measuring with our registry is meaningful to both our clinicians, and people living with, or at risk of, dementia.
You have recently been a part of the highly successful Old People’s Home series, for both 4-year-old’s and teenagers. How did you become involved with the program and what was your role? If you had to summarise one key message/ observation from your time on the show, in relation to healthy ageing, what would it be?
I am one of the experts involved in the intergenerational experiments aired on ABC as part of the Emmy-award factual series “Old People’s Home for 4-Year Olds”, and now teenagers.
Intergenerational contact is something I am very passionate about. Structured and supported intergenerational programmes can provide great benefits to both age groups when there is an opportunity for reciprocal learning to take place. These programmes can address pernicious problems in today’s society, such as loneliness and isolation, and by doing so, help participants have a restored sense of purpose and connection. This in turn can lead to other benefits, such as improved healthy behaviours (like exercise), improved mood, and a better quality of life. It can be a real win-win!
Older and younger generations have so much to learn from each other, and so much to give each other. It’s been a real honour to help raise awareness of the magic and joy that can result from intergenerational contact through involvement in the series, and to see the impact this has had in inspiring other intergenerational initiatives.
The recent positive findings from Phase III trials of Lecanemab, with more drug therapies to follow suit in coming months, are an excellent opportunity for ADNeT’s Screening and Trial’s program to bring these drugs to the Australian people through clinical trials. How can/will ADNeT’s Clinical Quality Registry also play a part in supporting the roll out of these new therapies?
The ADNeT Registry is really well placed to be adapted to help us understand, in the future, what the uptake of new medications like Lecanemab will be, and importantly, what are the real-world, long-term outcomes for patients. This type of data helps supplement data from clinical trials.
What are your hopes for the ADNeT Registry into the future?
The whole team in ADNeT have worked incredibly hard over the last few years to establish the Registry. The prevention, treatment and care of dementia poses great challenges for all of us, so, it’s not surprising that establishing a clinical quality registry in this area has been complex as well.
But we are really proud of the inroads we have made thus far, in bringing a community of people with lived experience, clinicians from differing backgrounds, and registry experts together to build this Registry. We are especially grateful for the input of people with lived experience who partner with us to help us shape this project and inspire us to do better. To date, our Registry has met with clinical sites from all Australian States and Territories, and we now have over 50 sites participating, and some 20 more poised to join.
In the future, I hope that the Registry is something all clinicians involved in the diagnosis of mild cognitive impairment and dementia participate in and find of great value in supporting their delivery of the best possible clinical care. I hope that the Registry data helps inspire improvements and innovations with respect to clinical care, research and policy settings. And ultimately, that our community benefits from better diagnosis, better treatment, and better outcomes and better experiences – as this is what it’s all about.
Drawing on your experience, what are some activities or modifying factors we can practice to support healthy ageing and protect against cognitive decline?
Move! Exercise is so important to prevent numerous adverse health outcomes, which includes cognitive decline and dementia, frailty and falls, improves mood and is good for well-being. I love the saying that it is never too early and never too late to start. Think about ways increased movement and exercise can be built into day-to-day activities – eg walking to activities or parking further away, taking the stairs. Or, adding exercise into your daily routine – having a timetable can help embed this.
To learn more about the ADNeT Clinical Quality Registry visit: https://www.australiandementianetwork.org.au/initiatives/clinical-quality-registry/