The challenges for healthcare systems are unprecedented, exacerbated by the burdens of infectious and chronic disease, ageing populations, inequalities, fragmented systems and workforce shortages. New technological approaches are needed to harness the potential of routine and novel health data and digital solutions to enable transformational improvement of care pathways and outcomes.
Our doctoral training programme will address this deficit by creating a new coordinated training curriculum, partnering world-leading academic and NHS organisations and industry, such that graduates can co-create and ideate, design, develop, evaluate and implement evidence-based digital health technologies.
Cortical visual impairments (‘brainsight’, not eyesight loss) are disabling consequences of dementia associated with particular diagnostic and management needs. Such impairments have been reported in the majority of people with Alzheimer’s disease, particularly in posterior cortical atrophy (‘visual-led dementia’) where these symptoms precede loss of memory, language and insight.
People with dementia-related visual impairment are usually seen first by eye health professionals. They are frequently misdiagnosed with eye or psychological conditions, repeatedly change glasses or undergo surgery before determining their visual loss arises from cortical, rather than ocular deficits. Tests of cortical visual function are used rarely except by highly specialised neurology/neuro-ophthalmology diagnostic services. These diagnostic scenarios often delay diagnosis and treatment for years.
Key knowledge gaps and significance:
- There is a lack of tests to detect brainsight loss and distinguish this from eyesight loss.
- There is a gap in evidence-based tests to diagnose brainsight loss caused by dementia. There is a gap in tests suitable across eye and dementia clinic settings.
- The reasons behind why some people with dementia are more susceptible to brainsight loss are largely unknown.
Determining the causes and consequences of visual system vulnerability in dementia has important fundamental and translational implications for understanding variable disease onset and progression.
Project outcomes include promoting equitable access to novel disease-modifying therapies targeting Alzheimer’s disease (the most common atypical form of Alzheimer’s disease is visual-, not memory-led).