Dedicated to improving the assessment and diagnosis of memory problems, the Oxford Brain Health Clinic uses cutting edge technology to offer detailed dementia assessments not usually available in routine NHS care.
This innovative and pioneering approach has resulted in more accurate dementia diagnoses, identified potential risk factors in patients so they can make lifestyle changes, and, crucially, saves NHS doctors’ time. It has also improved patient participation in research, with recruitment rates significantly higher than the national average.
The Clinic, based at the Warneford Hospital, was initially set up as a pilot in August 2020 as part of the National Institute for Health and Care Research (NIHR) Oxford Health Biomedical Research Centre, a partnership between the University of Oxford and Oxford Health NHS Foundation Trust.
Patients are invited to the clinic having been referred by their GP to local memory clinics. Before attending their local memory clinic appointment, patients go to the Oxford Brain Health Clinic for an advanced brain health assessment. This assessment includes an MRI scan, a neuropsychological assessment, clinical questionnaires, and an interview with the patient's companion. These comprehensive evaluations provide detailed clinical reports to help doctors make a diagnosis.
Over the past five years:
- A quarter of Clinic patients would be eligible for further investigation into new drug therapies. More than two thirds have risk factors (from depressive symptoms, BMI, physical inactivity, sleep duration, and alcohol consumption), which could be modified to help manage their illness.
- The Clinic team adapted and refined brain imaging techniques that were used to scan 100,000 people for the UK Biobank to work for memory clinic patients. These innovations are now being applied at other brain health clinics.
- The Clinic has reduced the barriers for patients to participate in research, with more than 90% of the Clinic’s patients (plus more than 75% of their relatives) choosing to contribute. Nationally, only 2% of people with dementia have signed up to hear about research opportunities, and only 1% of those who could participate in a clinical trial do so, according to Alzheimer’s Research UK.
Professor Clare Mackay, from the Department of Psychiatry at the University of Oxford, is the academic lead for the Oxford Brain Health Clinic, and Theme Lead for Dementia at the NIHR Oxford Health Biomedical Research Centre She said:
For our research to provide the direct and rapid benefit to patients that we’re seeing, it was vitally important that the Brain Health Clinic was properly embedded into clinical services.
It is making a real difference, not only to the hundreds of patients who come through our doors and get the best quality assessment available, but also to people across the UK at risk of dementia, who benefit from the research we are able to carry out as a result.
Having so many patients agreeing to be part of wider research means that we are finding better ways of preventing, diagnosing and treating dementia sooner. We are hugely grateful to our patient participants for being part of this work and also the dedicated team who have contributed to running the clinic over the past five years.”
Dr Lola Martos, the clinical lead from Oxford Health NHS Foundation Trust, said: “The Brain Health Centre has been a dream come true, not only for patients who benefit from advanced imaging and pioneering research opportunities, but also for doctors working directly with people at risk of dementia.
“Before the Clinic was launched, clinical assessments in memory clinics had not changed significantly for many years. Now doctors in our memory clinics get a clear and detailed clinical report to help get the most accurate diagnosis possible.”
Every patient attending the clinic is given the opportunity to participate in research. They can consent to the storage of their anonymised clinical data in the clinic's research database, complete additional research assessments, and choose to be contacted about future research opportunities. As a result, the participants for this research tend to be older and more representative of people at risk of dementia, whereas participants for most medical research are much younger, and less likely to be relevant for age-related illnesses.
Dr Isolde Radford, Senior Policy Manager at Alzheimer’s Research UK, said: “Reaching 500 patients is a significant milestone for the Oxford Brain Health Clinic, and a testament to the dedication and compassion of its team. It's inspiring to see how the clinic is transforming the experience for people seeking answers about their memory problems.
“With demand for memory assessments rising it’s vital we build on innovations like this to transform dementia diagnosis across the UK. Everyone living with dementia deserves an early, accurate diagnosis to get the answers they need and the best chance to benefit from future treatments.
“Dementia is the greatest health challenge of our time, and innovative clinics like this show what’s possible. That’s why Alzheimer’s Research UK were proud to help set up the Brain Health Coalition UK, working alongside the Oxford Brain Health Clinic and others. Together, more than 100 healthcare professionals and researchers are finding ways to make care better for patients by bringing the latest research into everyday medical practice.”
Patient and public involvement has been central to the Oxford Brain Health Clinic to reduce the barriers for patients to participate in research. This has included co-producing patient-facing documents, dry runs of consent processes and different study procedures, and getting input on disseminating findings and engaging with the public.
One participant, who did not want to be named, said: “It has been an honour to be a PPI contributor to Oxford Brain Health Clinic. We are treated as partners, and I have learnt so much about the research process. One particularly interesting contribution was our involvement in a presentation to thank a group of patients who had been involved in research. We were able to ensure that the language and visual aids used were appropriate to this group. It was very satisfying to attend this presentation and realise that our comments had been listened to and acted upon.”