CBR-SANSCOG: India’s Largest Study on Aging and Cognition

What is this study?

CBR-SANSCOG study is a first-of-its-kind research project in India and one of the largest, longitudinal studies in the world conducted on the rural, aging population. This is a prospective, community-based, cohort study on healthy, aging individuals, 45 years and above (projected n = 10,000) hailing from the villages of Srinivaspura taluk (sub-district) located in Kolar district in the southern state of Karnataka, India. The study aims to identify risk and protective factors associated with cognitive changes due to normal ageing, dementia and other related disorders. This understanding will, in turn, help develop interventions to prevent or delay the onset of dementia, and therefore, improve quality of life of the elderly.

Why is this study important to India and the world?

For India, this is a very important study, as dementia including Alzheimer’s disease will be one of the major burdens that will affect the elderly and emerge as a major socio- economic challenge in the coming decades. India’s older population (60 years and above) is projected to be 19.1% of the nation’s population, that is, around 316 million, in the year 2050 and therefore, would be one of the leading contributors to dementia cases in the world.

India is unique in terms of genetic susceptibility, diversity in language, education and socio-economic backgrounds, risk factors – diabetes, hypertension, hypercholesterolemia, midlife obesity, smoking and the rapidly changing socio-cultural milieu wherein the joint family system is changing to nuclear families resulting in differential cognitive engagement. Therefore, the risk and protective factors of dementia could be different from what is known so far from studies conducted in Western countries.

Till date, there are no definitive or curative treatments for dementia anywhere in the world. However, previous research has established beyond doubt that the changes in the brain that eventually lead to dementia start at least two decades before the presentation of overt clinical symptoms. In this scenario, early identification of risk factors for dementia and translating this knowledge into preventive strategies would be key in addressing this massive public health concern.

How is this study carried out?

This study follows a multimodal approach that includes detailed clinical, neurocognitive, biochemical, genetic and neuroimaging assessments, with long-term follow up (minimum of 10 years). Thus, this study brings together experts from various disciplines – basic scientists, geneticists, clinicians, cognitive psychologists, social workers, etc., thus leveraging diverse perspectives and comprehensive skill sets. The study is a collaborative work of the Centre for Brain Research, Indian Institute of Science with the National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore and Sri Devaraj Urs Academy of Higher Education (SDUAHER), Kolar.

Unique recruitment and cohort engagement strategies in a rural Indian setting

Carrying out a large-scale research project involving human subjects in a rural setting in India comes with many challenges. So, this study has adopted unique recruitment and cohort engagement strategies to overcome these challenges. Prior to recruitment of participants, the CBR-SANSCOG study team liaises with the local public health officials and work closely with the grassroot level leaders and community health workers, to build better connections with the community and to create awareness about our study.

The study team’s field data collectors (FDCs), who are our first point-of contact with our participants, maintains periodic contact with participants through telephone or in-person house visits at least twice a year. We also actively engage the cohort through activities like general health awareness camps, street plays and sports events, during which participants are provided food. Though we don’t offer any treatment, the clinical team provides brief feedback on participants’ blood test reports, clinical tests, ECG and MRI, and makes appropriate referrals to the primary healthcare service, if necessary.

Recruited participants undergo detailed assessments that are done following a three-visit protocol. The first visit happens at the participant’s home, during which socio-demographic data and written consent to participate in the study is obtained. The second visit is at the project site office in Srinivaspura or in a mobile unit, where detailed clinical and neurocognitive assessments are done. Biochemical and genetic tests are done through periodic blood collection camps at the villages due to logistic reasons. The third visit involves neuroimaging, where a subset of the cohort undergoes brain MRI at the Indian Institute of Science (IISc) or National Institute of Mental Health and Neurosciences (NIMHANS) in Bangalore.

Flagship Projects

Prof. K. V. S. Hari

Director

Prof. K. V. S. Hari joins CBR with over 30 years of experience in research, teaching, and leadership. With a PhD in Systems Science from the University of California San Diego, he has been a Faculty Member of the Department of ECE, Indian Institute of Science, since 1992 and served as its Chair from 2015 to 2017.

Besides holding Visiting Faculty appointments at premier universities like Stanford and KTH, Stockholm, he built and nurtured enterprising collaborations with leading research groups at Oxford University, TU Delft, and CMC Vellore, among other institutes. He is a Fellow of IEEE, INAE, and INSA and Editor-in-Chief (Electrical Sciences) of Sadhana – Academy Proceedings in Engineering Sciences, published by Springer.

Over the years, he earned unique recognition for his exemplary contribution through several prominent leadership positions in academia and industry.

His current research interests are centred on data science and applications of signal processing to solve problems in neuroscience and medicine.

Please visit https://ece.iisc.ac.in/~hari/ for more information.

Prof. Y. Narahari

Former Director

Dr. Y. Narahari has been on the faculty at the Department of Computer Science and automation, Indian Institute of Science since February 1988. He was Chair of the Department during December 2009 – July 2014. He was the Dean, Division of EECS (Electrical, Electronics, and Computer Sciences) at IISc from August 2014 till July 2021. He was chairing the Office of DIGITS (Digital Campus and Informational Technology Services) during January 2016-December 2020. He is a part of the AI Research Cluster and has been the convener of the Pratiksha Trust Initiative on Brain, Computation, and Data Science at the Institute since 2015.

He is an elected fellow of: IEEE, New York (FIEEE); Indian National Science Academy (FNA), New Delhi; Indian Academy of Sciences (FASc), Bangalore; Indian National Academy of Engineering (FNAE), New Delhi; and the National Academy of Sciences (FNASc), Allahabad. He is a recipient of the J.C. Bose National Fellowship from the Department of Science and Technology, Government of India. In 2009, he received the IISc Alumni Award for Research Excellence in Engineering at the Indian Institute of Science.

He has authored or co-authored three books: Game Theory and Mechanism Design (IISc Press and World Scientific) (2014); Game Theoretic Problems in Network Economics and Mechanism Design Solutions (2009) (Springer Monograph); and Performance Modeling of Automated Manufacturing Systems (Prentice Hall, Englewood Cliffs) (1992).

His work has been driven by talented and brilliant students: 23 of them have completed Ph.D.; 18 have completed Master’s by Research; more than 100 have completed M.Tech. projects. Currently, the group consists of 6 Ph.D. students and 6 M.Tech. project students.

The main thread in his research is to apply game theory, mechanism design, and artificial intelligence techniques to research problems at the interface of computer science and economics. He is also exploring the application of AIML techniques to digital agriculture and public health problems.

Please look up https://gtl.csa.iisc.ac.in/hari for more details.

Prof. Vijayalakshmi Ravindranath

Founding Director

Dr. Vijayalakshmi Ravindranath obtained her Ph.D from the University of Mysore in 1981. In 1986, after completing her post-doctoral training at the National Institutes of Health, USA, she joined the Department of Neurochemistry at National Institute of Mental Health and Neurosciences, (NIMHANS) Bangalore. In 1999, the Dept. of Biotechnology (DBT), Government of India sought her out to help establish the National Brain Research Centre (NBRC), an autonomous institution of DBT, Ministry of Science and Technology as a centre of excellence and to co-ordinate and network neuroscience research groups in the country. She continued as Founder Director, NBRC till May 2009, when she returned to Bangalore at the Indian Institute of Science (IISc) as Professor and Founder Chair of the newly created Centre for Neuroscience. She is currently Founder Director, Centre for Brain Research (CBR) at Indian Institute of Science.

During her tenure as Director of NBRC, she provided visionary leadership at NBRC, which in a very short period attained a position of being an internationally acclaimed centre of excellence. NBRC was granted “Deemed University” status in May 2002 to help promote human resource development in an inter-disciplinary manner. She networked 45 institutions around the country with NBRC with a goal to share resources and promote neuroscience. She then established the Centre for Neuroscience at IISc leveraging the expertise at IISc in mathematics, computation and engineering. The newly established Centre for Brain Research is a unique public-private partnership between IISc (a public funded institution) and Pratiksha Trust (a philanthropy) that funds CBR. Research at CBR is focused on aging brain and a large, prospective longitudinal study of 10,000 againg individuals has been initiated for the first time in India. In addition, she has received generous funding from Tata Trusts, which has paved the way for starting a longitudinal study in an urban cohort.

Dr. Vijayalakshmi Ravindranath is elected Fellow of all the 3 science academies in India, namely Indian National Science Academy, Indian Academy of Sciences, National Academy of Sciences, India. She is also a Fellow of the National Academy of Medical Sciences, India, Indian Academy of Neurosciences and Third World Academy of Sciences. She is a recipient of the prestigious S.S. Bhatnagar award (1996), Omprakash Bhasin Award (2001) and the J.C. Bose National Fellowship (2006), S.S. Bhatnagar Medal, INSA (2016) and the civilian honour, Padma Shri (civilian honor, 2010). She is also a fellow of American Academy of Advancement of Science, USA (2019).

CBR-SANSOG