Transforming the way people age

By Shawn Lawrence

BaYCrESt

a centre of excellence for innovation in aging

Fully affi liated with the University of Toronto and located in Toronto, Baycrest is a centre that provides care and services to approximately 2,500 people a day through its geriatric heath care system. To any outsider, it looks like a large hospital. But a closer look reveals Baycrest as a place where world recognized cognitive neuroscientists and talented clinicians have created a dynamic venture research environment focused on brain health and successful aging.

“It’s one of the very few places in the world where you have a world-class cognitive neuroscience institute embedded within a very rich continuum of senior care services,” explains Baycrest president and CEO Dr. William Reichman. “That’s what’s amazing about this place, you have these world-class scientists working side-by-side with clinicians, and that means we can more readily translate the science into practical application that benefi t people. It’s an extraordinary opportunity to be able to conduct research in a real-world setting, with such a rich and varied aging population.”

What Dr. Reichman is alluding to is the presence of the Kunin-Lunenfeld Applied Research Unit (KLARU) for clinical research and the Rotman Research Institute (RRI) for brain research at Baycrest. The former conducts research alongside clinicians applying the results directly to client care; the latter a world leader in cognitive neuroscience. Usually such institutes are either free standing or they’re on the campuses of universities and are not in close relation to settings of actual care. According to Dr. Reichman, how all of these enterprises come together is what makes Baycrest unique.

“RRI scientists have made signifi cant contributions to helping us understand how we remember things, what areas of the brain are involved, and not only how we remember but also how we actually execute and get things done on a day-to-day basis,” he says, adding that the end goal is to take these fi ndings and use them to improve the aging experience and to better understand brain function.

Every fi ve years Baycrest research undergoes an external review conducted by highly respected scientists from around the world. In their most recent review experts called the cognitive neuroscience programs at Baycrest‘s RRI “world-class,” listing them among the best in the world alongside UC Berkeley, UCLA, University College London and MIT. Moreover, the panel pointed to Baycrest as a “wonderful resource” for targeted brain fi tness product development efforts with both government and private investors.

“That’s just an extraordinary achievement for a place that many construed for so many decades to be just a nursing home on Bathurst Street. Very few people I think fully understood what was going on behind the scenes at our centre in terms of the sophistication and caliber of the research,” he says, adding that it was the long standing reputation of research excellence at Baycrest that convinced him to leave his position as an internationally-known expert in geriatric health and dementia in the U.S., and accept the position of CEO and president of Baycrest.

In addition to being backed by a strong research pillar, Baycrest has made signifi cant gains in leveraging these strengths into partnerships with government and collaborations with health science organizations. The Baycrest Centre for Brain Fitness, which was launched in 2008, owes its existence in large part to this collaborative activity. The centre was established with a $10 million investment from the Ontario Ministry of Research and Innovation, plus $10 million in donor support.

The chair of Baycrest’s board of directors, Dr. Tony Melman, notes some of the innovations associated with the centre could save the Ontario healthcare

system up to $1 billion annually by helping aging adults live at home longer. In addition, he believes the Ontario government’s investment will help the province participate in the global brain fitness market, that has the potential to grow to between one and five billion dollars by 2015 (according to a May 2009 report issued by U.S. market research firm, SharpBrains).

“There are few things as frightening as the prospect of declining brain fitness as we age and the loss of our mental faculties. Baycrest’s strengths in aging brain research, cognitive assessment and rehabilitation make it well positioned to develop innovative, market driven research products that will transform the way we age,” states Dr. Melman.

Already research conducted at Baycrest has led to the development of innovative products such as a neurocognitive assessment tool that is currently being developed in collaboration with Sunnybrook Health Sciences Centre. The tool is a small computer tablet called INCAS (Integrated Neurocognitive Assessment System) which assesses memory, processing and reasoning in patients. Dr. Jon Ween, medical director of The Louis and Leah Posluns Stroke and Cognition Clinic; Dr. Donald Stuss, Baycrest; and Dr. Sandra Black, Sunnybrook are the principal investigators in the development of this tool.

As to the tool’s commercialization potential, Dr. Ween states, “this is an innovative and leading edge development and will need further R&D to be an enterprise class concern.”

As to who the target users are, Dr. Ween comments the tool will be most attractive to clinicians involved in stroke care or cognitive assessments in other populations. The tool should also be very interesting to pharma companies conducting multi-centred drug trials and clinical groups with multiple sites/participants. Ideally it will have applications throughout the medical community. “Potentially, there is a huge market for this cognitive assessment tool,” says Dr. Ween.

The prototype has been used on hundreds of stroke and MS patients so far, ranging in age from late 20s to 100. The test, a portable wireless system, will lead to faster and more accurate diagnosis of brain diseases associated with aging, facilitating earlier interventions.

“It allows clinicians to measure, in a simple and rapid manner, memory and processing in people who have had a stroke, may have Alzheimer’s or other memory challenges, or a traumatic brain injury. What the blood pressure cuff did for cardiac care, this tool has the potential to do for brain health,” Dr. Ween comments.

Another initiative of equal importance to both Baycrest and its Centre for Brain Fitness is its spin-out company Cogniciti. Established through a partnership between Baycrest and the MaRS Discovery District (an organization that helps science, technology and social entrepreneurs build their companies), Cogniciti is a for profit company in the business of creating and marketing products designed to help adults extend their cognitive abilities longer in the lifespan.

According to Dr. Reichman, Cogniciti represents the true spirit of collaboration in that Baycrest, through RRI, is able to provide scientific validity to Cogniciti’s products, while MaRS brings expertise in executive leadership, branding and marketing experience to the table.

Cogniciti’s first product, Memory@ Work™, targets the aging brain in the workplace by strengthening and maintaining the user’s cognitive abilities. Dr. Reichman describes the product as an exercise tool for the brain.

“As you get older it gets harder to lift heavy things and so can you learn new techniques of how to lift things, and how to build up your muscle strength so it’s not as hard. Memory@Work works the same way, except it’s not your muscles that are being worked, it’s your brain,” he says.

Cogniciti is also developing more general brain exercises and fitness products that can be played on web-based and hand-held devices scheduled for test-marketing in 2011 and 2012.

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“We’re starting to learn a lot from the science that’s accumulating that we can actually exercise our brains and improve our cognitive abilities. The trick though is to embed the training into activities that people are willing to do and enjoy.”

Dr. Reichman believes the company has a tremendous opportunity to make headway in the brain fi tness market as both a pioneer and as a leader. The need has never been greater as demographic characteristics in developed countries are changing, especially in the Greater Toronto Area where it is expected that the senior’s population will grow to 1.5 million by 2025.

“Many more people who are 65 today are still quite healthy, dynamic and vital. They’re not ready to retreat from the world or retire. I think that the boomers are going to stay in the workforce longer for economic as well as other reasons and they want to stay on their game. They want to still be productive and effective at work. That’s why Memory@ Work™ is an idea that’s resonating as a good market opportunity for us, and it’s a really nice extension of the science we do here.”

For a centre that has traditionally been more focused on the research than the development side, this is a huge step, but it is one that Dr. Reichman believes the centre is more than capable of taking. It’s also a great example of how collaboration can lead to the successful commercialization of scientifi c excellence.

“Cogniciti is a very important lesson of how no one part of society can do this on its own. We’ve had private philanthropy get us started with the science, it then gets matched by a government investment (through MRI), it’s then partnered up with an incubator or a think-tank that understands commercialization (MaRS), and then you bring the academic community into it. This is our model. As long as everyone’s aligned with a common purpose, that’s when the great chemistry starts to happen. This is a really good example of a private-public partnership that can help position Ontario, certainly Canada, in a sector that wasn’t well positioned before. It’s a great thing, and I’m hopeful that our success will lead the Ontario government to continue to invest in these kinds of innovations.”

Lead scientists involved in the product development for Cogniciti are:

Dr. Fergus Craik

Dr. Fergus Craik, a senior scientist with the Rotman Research Institute and Professor Emeritus at the University of Toronto, has contributed immensely to the understanding of how human memory works and the effects of aging on those processes. His research has found that certain types of cognitive processes hold up better than others in later life. Dr. Craik has published extensively in scientific journals, written book chapters, and co-edited nine books, including The Oxford Handbook of Memory (with co-editor and Gairdner Award recipient Endel Tulving). In 2009, Dr. Craik was elected as a Fellow of The Royal Society of London for his experimental study of human memory processes.

Dr. Brian Levine

Dr. Brian Levine is a senior scientist at the Rotman Research Institute at Baycrest and a professor in the departments of Psychology and Medicine (Neurology) at the University of Toronto. Dr. Levine has his Ph.D. in clinical psychology and completed his postdoctoral fellowships in clinical and research neuropsychology. Dr. Brian Levine represents Baycrest as a Site Director for the Heart and Stroke Foundation Centre for Stroke Recovery.

Dr. Levine’s key areas of interest are assessment of executive function, episodic memory and recovery, and reorganization of brain function following traumatic brain injury.

Dr. Kelly Murphy

Dr. Kelly Murphy is a Clinical Neuropsychologist in the Cognitive and Behavioural Health Program. Her research focuses on cognitive aging, memory intervention, and mild cognitive impairment (MCI). She specializes in early detection and treatment of memory decline in older adults with mild cognitive impairment who are at risk of developing future dementia. Dr. Murphy runs a clinical service at Baycrest comprised of the Memory Intervention Program which provides education around lifestyle factors affecting memory ability plus memory training in practical techniques for use in everyday life as well as psychosocial support for clients with MCI and their family members.

Dr. Donald Stuss

Dr. Stuss is a senior scientist at the Rotman Research Institute at Baycrest and former Vice-President of Research. He was named the first Director of the Rotman Research Institute (RRI) at Baycrest in 1989, and under his stewardship the RRI evolved into a world-class centre for aging brain research

He has dedicated 30 years to the study of human frontal lobe function and has made significant contributions to better understanding the human mind. He is the Reva James Leeds Chair in Neuroscience and Research Leadership, and a University of Toronto Professor of Psychology and Medicine (Neurology and Rehabilitation Science). He has published several books, including co-authoring the 1986 classic reference, The Frontal Lobes. He is a former Scientific Director for the Heart and Stroke Foundation, Centre for Stroke Recovery.

Dr. angela troyer

Baycrest clinical neuropsychologist and director of Psychology Dr. Angela Troyer is an adjunct faculty memory, Faculty of Graduate Studies (Psychology), York University and an internship supervisor, Neuropsychology Assessment and Memory Intervention rotations. Dr. Troyer’s primary clinical practice involves neuropsychological evaluation of dementia and memory intervention in normal aging and early dementia. Her research interests focus on memory changes in normal aging and dementia; effectiveness of memory interventions; and relationship between executive functions and memory.