Who are the partners in BIRD-NL?

Eleven research organisations collaborate within BIRD-NL.

The consortium forms part of the Dementia research programme. It is funded by ZonMW. The research is divided into four so-called work packages.

Who’s who?

Dr Frank Wolters and Prof. Dr Arfan Ikram (both from Erasmus MC) jointly lead BIRD-NL.
Dr Leonie Visser, Prof. Monique Verschuren, Dr Mirjam Geerlings and Prof. Martien Kas coordinate the various work packages (you can read more about this under ‘Working on which problem?’).

Collaborating partners

• Erasmus MC, lead applicant
• Amsterdam UMC
• Maastricht University
• Pharos
• University of Groningen
• UMC Groningen
• Erasmus University Rotterdam
• BK Locum Service
• National Institute for Public Health and the Environment
• The Brain Foundation
• Alzheimer Nederland

Read more on Zonmw.nl: find out more about the Dementia Research Programme.

Reducing the risk of dementia

Prevention is better than cure when it comes to dementia. BIRD-NL is conducting research to gain a better understanding of dementia risks and is investigating what works in practice to reduce these risks.

The research is divided into four so-called work packages: PERCEIVE (perceiving), EXPLAIN (explaining), PREDICT (predicting) and PREPARE (preparing).

The NDPI consortium is also working on preventing dementia, but focuses primarily on investigating which lifestyle programmes or interventions are truly effective in preventing dementia.

PERCEIVE: What is your risk?

Many people do not know what factors increase or decrease their risk of dementia. For example, it is not widely known that an unhealthy lifestyle increases the risk of dementia. At the same time, there are misconceptions. For instance, that certain nutrients might reduce the risk, whilst there is no scientific evidence to support this. That is why, in this work package, BIRD-NL researchers are investigating: how high do people estimate their risk of dementia to be? And to what extent are they willing to change their lifestyle to reduce this risk?

In this way, the researchers will discover the best way to inform people, and what policymakers and other stakeholders need to better support prevention. The aim of this work package is to develop communication strategies that work, as they are tailored to the target group’s prior knowledge and perceptions.

EXPLAIN: What information is still missing?

Previous research has already shown that smoking, high blood pressure and diabetes increase the risk of dementia. However, these risk factors account for only around forty per cent of dementia cases. What, then, accounts for the rest?

In this work package, researchers are investigating whether there are any further risk factors. These could include environmental influences, social circumstances or childhood experiences. They are also investigating how multiple risk factors and genetic predisposition affect the development of dementia. This could yield new avenues for better preventing dementia in the future.

PREDICT: How do you predict who is at risk?

The risk of dementia varies from person to person. How significant is each risk factor? And what is the effect of genetic predisposition? In this work package, BIRD-NL is investigating how a mathematical model can provide a better understanding of dementia risk: which factors influence the likelihood of developing dementia, and in whom?

If you know who is at the highest risk, you can provide them with the best support. This will enable tailored preventive measures in the future.

PREPARE: What exactly should you test for?

There is strong evidence that a healthy lifestyle helps to reduce your risk of dementia. However, there is a lack of hard evidence that lifestyle programmes lead to fewer cases of dementia. Why is that? Do these programmes fail to target the most important risk factors? Do they not start at the right time? And what benefits do these programmes actually deliver, for the individual and for society? In this research programme, BIRD-NL is investigating these questions. The answers will form the basis for follow-up research, which may provide an answer to the question: (how) can you really prevent dementia?

Epidemiological and applied research

BIRD-NL investigates how dementia can be prevented through a combination of epidemiological and applied research.

BIRD-NL identifies risk factors, develops models to predict the risk of dementia, and works on methods to accurately measure the impact of prevention. This is done in close collaboration with members of the public and other stakeholders.

Investigating what people know about prevention

To find out what people know about their risk of dementia, the impact of lifestyle on this risk, and what changes they are willing to make, BIRD-NL carries out what is known as participatory research. This means that members of the public are involved in the research. Among other things, researchers organise focus groups, develop questionnaires and carry out behavioural studies. This gives them an insight into what people think, feel and do regarding the risk of dementia.

Identifying risk factors

BIRD-NL investigates the influence of various risk factors by analysing large datasets. How much does each risk factor contribute to the overall risk? And how do risk factors influence one another – do they reinforce each other, for example?

The data comes from large cohort studies (such as Lifelines at UMC Groningen and the ERGO study at Erasmus MC). These are studies in which large amounts of data are collected over a long period from large groups of people. By cleverly combining the data and carrying out repeated measurements, the researchers are mapping the overall effect of environmental influences. In this epidemiological research, BIRD-NL also examines differences between groups, for example according to age, educational attainment and migration background.

Building and testing predictive models

To determine who stands to benefit most from prevention, BIRD-NL is building models that can predict the risk of dementia based on risk profiles that take into account lifestyle or genetic predisposition. Researchers are also investigating whether artificial intelligence (AI) can help to make these models more accurate. The models are being tested across various target groups, including people visiting their GP’s surgery.

Preparing for future prevention research

To find out whether dementia can actually be prevented, you need to test this on large groups of people. But how do you design such a study properly? What exactly do you need to measure, when, and in whom? BIRD-NL is working on preparing such large-scale studies. This is done first and foremost at population level, using simulation models to calculate the benefits of prevention. It is also carried out at individual level, through studies that measure behaviour and health in real-world settings. Finally, BIRD-NL also works at the cellular level: using mouse models to help us better understand the biological mechanisms underlying prevention.

Knowledge and resources to prevent dementia

These findings from BIRD-NL are valuable for the healthcare sector, the scientific community and society as a whole.

These include information materials, models capable of assessing individual risk of dementia, and recommendations for prevention policy. Naturally, BIRD-NL also publishes scientific articles, including this one (in English):

• ‘Involving Societal Stakeholders in Dementia Risk Reduction: An Exploratory Study’ on pubmed.ncbi.nlm.nih.gov.
• ‘Chronotype as a potential risk factor for cognitive decline: The mediating role of sleep quality and health behaviours in a 10-year follow-up study’ on pubmed.ncbi.nlm.nih.gov.
• ‘Midlife dementia risk scores in a multi-ethnic population in the Netherlands: the HELIUS study’ on pubmed.ncbi.nlm.nih.gov.

For an overview of publications, see: zonmw.nl.

Information materials

The researchers at BIRD-NL are developing knowledge products designed to help prevent dementia in the future. These include leaflets, animations and websites in which BIRD-NL explains, in plain language, what factors increase the risk of dementia and, above all, what you can do yourself to reduce that risk. These information resources are intended for members of the public, healthcare professionals, policymakers and other researchers.

For other researchers

BIRD-NL publishes research findings in scientific journals. BIRD-NL is also developing a data infrastructure: a system for collecting and exchanging data from various cohort studies. This will enable researchers to answer research questions more quickly in future.

Proven effective interventions

BIRD-NL also aims to deliver effective prevention interventions: programmes that have been proven to help people change their behaviour, or that demonstrably make the environment healthier. Examples include support for giving up smoking or changes to the living environment that encourage people to be more physically active.

Contributions to national prevention programmes

The insights gained by BIRD-NL regarding the links between known risk factors or newly identified risk factors are used in national prevention programmes.

Ensuring that results are put into practice

BIRD-NL works in partnership with members of the public, people with dementia and their carers, and care professionals, such as those in primary care. BIRD-NL does this to ensure that the research is feasible and reflects the experiences of those involved. BIRD-NL has involved them from the outset, for example through focus groups, brainstorming sessions and questionnaires.

In addition, BIRD-NL has set up a stakeholder committee comprising professionals from the field, policy-making and research. They regularly contribute to discussions on the content and application of the findings.

Ultimately, BIRD-NL aims to increase the relevance of its work to society and ensure that research findings are put into practice. In this way, BIRD-NL ensures that its research is not only scientifically sound but also effective in society and contributes to better prevention and care in relation to dementia.