Predicting disease progression in cognitive impairment using a brain ageing biomarker (360G-Wellcome-213996_Z_18_Z)

Earlier detection of the neurodegeneration that precedes dementia is needed if we are to address the rising burden that dementia places on our ageing global population. While cognitive impairment is an important risk factor, alone it is insufficient to identify who will experience pathological deterioration and subsequent dementia. Here, I aim to harness the power of neuroimaging as an objective and sensitive index of brain structure, using an ‘ageing biomarker’ framework to measure so-called ‘brain-age’ in people with mild cognitive impairment (MCI) or subjective cognitive impairment (SCI). This project aims to 1) validate the utility of brain-age for predicting future health outcomes in people with MCI or SCI, and then 2) implement a software pipeline to convey these individualised predictions directly to clinical settings. I will meet these goals by taking advantage of the large existing MRI database of memory clinic patients and linked electronic health records available at King’s. Collaborations with memory services across King’s Health Partners NHS Trusts will enable trial clinical deployment of my software pipeline. Using brain-age in combination with clinical expertise in memory services will enable optimal and cost-effective allocation of resources, moving towards the application of precision medicine to detect dementia risk earlier.