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OPTIMA - The Oxford Project To Investigate Memory and Ageing

OPTIMA was founded in 1988 by Professor David Smith (Professor of Pharmacology), Dr Kim Jobst (Senior Research Fellow), Elizabeth King (Senior Research Nurse) and Professor Margaret Esiri (Professor of Neuropathology) to study one of the great medical and social challenges of our time: the causes of dementia, especially Alzheimer's disease.

Professor Gordon Wilcock took over from Professor Smith as Director in 2008 and Sharon Christie was appointed Senior Research Nurse in 2007 following Elizabeth King's retirement.

OPTIMA's mission has been: To advance our understanding of the causes, treatment and prevention of dementia in the context of providing support and education for research participants and carers.

METHODS

OPTIMA has collected information on both cognitively impaired and cognitively normal elderly people during life and correlated this information with the findings at post mortem brain examination, if consent to brain donation has been given.

The data collected from the OPTIMA cohorts includes:

  • A detailed medical history and physical examination
  • Neuropsychological assessments
  • Brain scans - Computed Tomography (CT), Functional Magnetic Resonance Imaging (fMRI) and Magnetic Resonance Imaging (MRI)
  • Blood, urine and csf samples
  • Histopathological information following brain donation
  • DNA is also available

THE COHORTS

1. THE MAIN OPTIMA COHORT

OPTIMA began recruiting in 1988 and continued until 2008. Participants in the main cohort were seen at least annually, in most cases until death. If they became unable to participate fully in the assessments information continued to be obtained from a study partner (someone who knew them well). Some OPTIMA participants went on to join the LEAD cohort.

2. THE LEAD (LONGITUDINAL EARLY AD) COHORT

Lead researcher: Professor Gordon Wilcock

In 2009 we began recruiting to a cohort of people with early Alzheimer's disease, people with mild memory problems, and also normal subjects, who were followed up for three years. There are 200 LEAD subjects, including 32 control participants, 45 with subjective memory impairment, 45 with Mild Cognitive Impairment, 28 with probable early AD, and others with different causes of cognitive impairment.

3. CHALLENGE COHORT

In September 1997 OPTIMA recruited 158 cognitively normal elderly people in the community, under the MRC 'Foresight Challenge Initiative'. Participants underwent similar protocols to the main OPTIMA cohort but in addition had serial volumetric MRI scans, and more advanced neuropsychology. This was initially a four year study but we have been fortunate in having opportunities to reassess the Challenge cohort at various time points.

4. VITACOG

Lead researchers: Professor Robin Jacoby, Professor A David Smith, Professor Helga Refsum

VITACOG was a two-year randomised, placebo-controlled pilot trial to determine the effect of treatment (vitamins B6, B12 and folic acid) on the rate of shrinkage of the brain and on memory function in people over 70 years with Mild Cognitive Impairment (MCI). The study ran from 2005 to 2009. Participants had neuropsychological assessments, MRI brain imaging, blood and urine tests and examination of vital signs (heart rate and blood pressure). Data, imaging and biosamples are available from the study.

Contact Professor David Smith: david.smith@pharm.ox.ac.uk

ACHIEVEMENTS & PUBLICATIONS

OPTIMA's work has had a significant medical and social impact on the quality of life for people with dementia, especially that caused by Alzheimer's disease. The cohort exceeds 1,100 people. The detailed study of such a large number of people followed through until they die, with one of the highest brain donation rates of more than 80%, has enabled OPTIMA to make an important contribution to understanding the diseases that cause dementia, improving diagnosis and developing therapeutic strategies.

A full list of publications can be downloaded from the Optima website