What is P.O.N.D.E.R ?
The P.O.N.D.E.R project is a free program aimed at preventing Neurodegenerative Diseases such as Dementia, Alzheimer's and Parkinson's.
The main objectives of P.O.N.D.E.R are to:
The approach to these objectives is quite different from other prevention programs as we target subjects in middle adulthood (40 to 60 years of age), who are healthy, computer and Internet confident, who would be attracted by an training program that in its first phase consists only of Internet training. Only in later phases, after establishing cognitive test-retest scores, will we proceed with biomarker (e.g., cortisol), genetic (APO-E4), and neuroimaging assessment, in a selected subgroup of our study population.
- Establish research that allows identifying variables that determine what can prevent age-related disease.
- Document and characterize what is now referred to as successful or healthy normal aging.
- Identify among the elderly those that are at risk of becoming ill from age-related disease.
- Prevent the onset of age-related disease in those elderly where it can be prevented through an extensive cognitive training program.
Who are we ?
We are a large team of highly skilled professionals comprised of: neuroscientists, doctors, psychologists, psychiatrists, university teachers, directors, researchers, graduate students, and software developers.
Why are we interested in P.O.N.D.E.R ?
The elderly in our society are the fastest growing segment of the population in Canada. Never before in our history did so many people grow so old. In the context of Neurodegenerative Diseases, this development brings with it tremendous challenges. Canadian Society will face an increasing number of aging related diseases in the elderly population. While one in 13 Canadians between the ages of 65 and 74 years is affected by Alzheimer's Disease (AD) and related dementias, this number changes to one in nine between ages 75 to 84, and one in four over the age of 85. By 2011, new cases of Neurodegenerative Diseases are expected to reach over 111,000 per year. By 2030, the total number of Canadians suffering from these diseases will have reached 750,000.
An excellent way to understand these diseases is by examining the interindividual differences related to the aging process, in order to comprehend what keeps people healthy into old age. There is now more and more research interest into this question; rather than trying to identify the factors that lead to dementia, attention is shifting to investigate the factors that might prevent these diseases from occurring. The research field of primary prevention of dementia has demonstrated that there is no inevitable decline in cognitive functioning with age; not all older people show continuous reduction of intellectual abilities and become dependent eventually (Rowe and Kahn, 1987). However, there is still poor understanding of the factors that promote prevention of disease in old age, which is why the P.O.N.D.E.R project is so important, because we will investigate these factors.
Despite the numerous challenges, there are an increasing number of prevention studies that have identified important factors in the prevention of Neurodegenerative Diseases. For example, the Alzheimer Disease Cooperative Study (Sano et al., 2006) has shown that memory training is efficacious when trying to slow down the progression, or delay the onset of dementia. Likewise, the multicenter 'ACTIVE' study has shown that memory training improves self-esteem and self-report of cognitive problems (Willis et al., 2006). However, it is at this point unclear whether this can serve as a substitute for cholinergic stimulation, and whether these effects are long-lasting (Bentley et al., 2008 ). Other Prevention studies have investigated the effects of physical exercise (aerobic versus resistance training), cognitive training, or simulation with cognitive batteries, or the ADAS-cog as the primary outcome measures (Schneider and Sano, 2009). Results have usually been positive demonstrating beneficial effects on cognition; however, here as well the longitudinal effects are unclear. Since Dementia is likely to have a multifactorial origin (Coley et al., 2008), it requires a multidimensional assessment to capture all factors. At the same time, the consequence for prevention programs must be to establish a multidomain approach to prevention as well (exercise, nutrition, cognitive stimulation).
How will we achive our goals ?
We have established an online-based cognitive training and assessment program. Phase 1 of P.O.N.D.E.R, will be comprised of activities and questionnaires that are fully computerized, thus avoiding the need for time and labor intensive home or laboratory visits. You, the participants, will perform the initial signing up, setting up, and first assessment from the comfort of your own home. We will use a combination of established tests, together with brain games that have been used for cognitive training, and have shown promise in maintaining high cognitive functioning, or slowing down cognitive decline with age.
Once phase 1 has been completed, we will have a database of adult subjects with longitudinal cognitive assessments which will allow us to identify the cognitive domains that show subtle changes long before the onset of the disease. In a subsequent step, through assessment of lifestyle, dietary, exercise, and cognitive training variables, we then anticipate to determine the factors that might impact on these cognitive changes. This phase will be followed up by endocrine assessments (through saliva samples sent by mail), as well as inviting participants from the local community for follow-up testing using standardized laboratory and neuroimaging assessments.