UCSF Profiles

search, discover, network

Dementia prevalence is expected to quadruple worldwide over the next 40 years at tremendous monetary and emotional cost. Dr. Barnes' research is designed to minimize the impact of the impending dementia epidemic using a three-pronged approach for developing and evaluating strategies to maintain cognitive function and prevent or delay dementia onset in late life: 1) identification of risk factors for cognitive impairment and dementia in older adults, 2) evaluation of prevention strategies for helping older adults to maintain cognitive function with age, and 3) development of dementia risk prediction models that can be used to estimate the impact of risk factor reduction and to target prevention strategies toward those who are at greatest risk.

Dr. Barnes' has published numerous observational studies related to identification of factors associated with increased or decreased risk of cognitive decline and dementia. She has been particularly interested in the potential protective effects of physical and mental activity as well as the complex relationship between depression and cognitive impairment. Taken together, this work suggests that there are a variety of potential strategies for lowering risk of cognitive impairment and dementia in late life.

Dr. Barnes also has lead several randomized, controlled trials (RCTs) to evaluate the effectiveness of interventions for enhancing cognitive function in late life. One study examined the effects of a computer-based cognitive training program in individuals with mild cognitive impairment. Another study used a factorial design to examine the effects of combined physical (aerobic vs. stretching) and mental (intensive computer training vs. educational DVDs) activities on cognitive function in older adults who self-report a recent decline in memory or thinking. This trial, called the Mental Activity and eXercise (MAX) Trial, was funded jointly through a K01 award and an Alzheimer’s Association grant. Another recent project involves developing and pilot-testing an exercise program called Preventing Loss of Independence through Exercis (PLIÉ), which integrates elements of yoga, Tai Chi, Feldenkrais and occupational/physical therapy to help older adults with dementia maintain functional status.

Finally, Dr. Barnes has been at the forefront of efforts to develop dementia risk prediction models and to project the potential impact of changes in risk factor profiles. One study found that a combination of demographic, cognitive, behavioral, functional, medical, genetic, cerebral MRI findings and carotid artery ultrasound measures could be used to predict an individual’s six-year risk of dementia with high accuracy. This publication generated substantial interest from clinicians and researchers world-wide as well as the lay press, including interviews with CBS Evening News, ABC News Online, US News & World Report, and Time. A follow-up publication found that an abbreviated index that included only items that could be administered quickly without special equipment was almost as accurate as the original index. This line of research has led to invited editorials about dementia risk prediction and involvement with an NIA workgroup that is developing national guidelines for dementia risk assessment.

This work was recently expanded in a study that projected the potential impact of risk factor reduction on future dementia prevalence, which found that up to half of Alzheimer's disease cases were potentially attributable to 7 modifiable risk factors--including physical inactivity, low education, smoking, depression, diabetes, mid-life hypertension and mid-life obesity--and that relatively small reductions in these risk factors at a societal level could potentially prevent millions of cases of Alzheimer's disease from ever occurring. These findings also received extensive international media coverage, including the New York Times, Wall Street Journal, and International Herald Tribune.

Implementation Science, Older adults, Persons with physical disability, Persons with mental illness, cognitive impairment/dementia counted as 'mental illness', Community-based organization, intervention research study, older adults, cognitive function, dementia, physical activity, mental activity, Interdisciplinary research collaboration, Implementation & dissemination science listservs