Centre for Brain Research, IISc

Vision

Age-related disorders are a major area of concern with increasing longevity. The number of people suffering from dementia increases from the age of 65 onwards. Alzheimer's disease (AD), one of the most common forms of dementia is a devastating condition of memory loss and cognitive dysfunction, mood swings and behavioral changes leading to progressive decline in the quality of life until death. AD is now recognized to be the most common cause of dementia accounting for about 60-70% of dementia cases. In the absence of preventive treatments the prevalence is expected to triple by 2050. AD and other dementias cause immense burden to the caregiver and exhaust social, financial and physical resources over time. Treatment modalities for people affiliated with dementia consists of palliative measures, which provide symptomatic relief. There are no treatments currently available for curing the disease, slowing the progression (disease modifying therapies) or providing prophylaxis.

Considering the enormous burden it is imperative to discover methods for early diagnosis and intervention strategies to slow down the progression of the disease. Since age is a major risk factor for AD, we need to understand the normal aging process in the brain, which often results in decline of specific cognitive functions, heterogeneously in the population. Such an understanding can help promote normal aging and delay dementia, which is important considering the increasing life span. In developed countries, 10% of the population, 65 years or older, have dementia. The prevalence doubles every five years after the age of 60 and reaches nearly 50 percent after the age of 85 years. An estimated 35.6 million people worldwide were living with dementia in 2010. This number is estimated to nearly double every 20 years, to 65.7 million in 2030, and 115.4 million in 2050. The numbers in developed countries are forecast to increase by 100% between 2001 and 2040 on average, but by more than 300% in India, China, and their south Asian and western Pacific neighbours. In 2010, 57.7% of all people with dementia lived in low and middle-income countries, which is expected to rise to 63.4% in 2030 and 70.5% in 2050. In India, AD is the most common cause of dementia, accounting for 54% of dementia patients. In addition, the high burden of cardiovascular risk factors such as hypertension, diabetes, obesity, smoking, alcoholism and stroke in developing countries, including India, results in cerebrovascular disease-vascular dementia. In 2010, there were 3.7 million Indians with dementia and the numbers are expected to double by 2030.

Stroke and vascular factors, such as hypertension, dyslipidemia, hyper-insulinemia, type 2 diabetes and obesity are associated with greater risk of dementia. Vascular dementia constitutes the second commonest form of dementia in India and mixed AD with cerebrovascular disease is common in Indian population. Given that India has the highest prevalence of diabetes (30% above 50 years have diabetes), the prevalence of dementia may increase along with the increase in aging population. Genetic susceptibility for AD in Indian population is not well characterised. Further, diversity in language, education, socioeconomic background and changing social structure (joint family system vs nuclear families that has resulted in differential cognitive engagement) will contribute to the prevalence of dementia including AD.

Accumulating evidence suggests engagement in cognitively stimulating activities has impact on neural structure and is a protective factor against development of dementia. Cognitive training, in particular restorative strategies is promising in the treatment of AD. Traditional Indian knowledge such as Yoga, meditation and Ayurveda are reported to promote healthy aging. However, scientific examination of their efficacy is lacking. Importantly their potential role in delaying the onset or slowing the progression of AD is unexplored.

Despite tremendous advances in computing, our computers are still inferior to humans on many aspects of perception (vision and speech) and cognition (reasoning, artificial intelligence, language). What makes the brain so superior? The answer might lie in its distinct hardware or in the algorithms. Both approaches have been investigated extensively by computer scientists in the last few decades. The hardware approach involves building neuromorphic devices that share the properties of neuronal networks such as low power consumption, analog asynchronous signaling and massive parallel processing. It also involves detailed synapse-level anatomical reconstruction of brain circuits with the hope of using them to build smarter computers. The algorithmic approach involves building neuromorphic algorithms that mimic how the brain represents and processes information, allocates attention and so on. Despite the obvious appeal of these two approaches, they have not yet fulfilled their promise but offer an exciting opportunity to develop unique computing platforms.