I have always been fascinated by clinical research and my research focuses on understanding the neurobiological underpinnings of cognitive disorders. Being from a medical background, my initial work was on the clinical understanding of the various dementias and included understanding “how, when and why” a patient with dementia shows specific clinical phenomena which often gives clues to the diagnosis and subtyping the various forms of dementia. Understanding the role of reversible causes of dementia and its mitigation is therefore of paramount importance. As the ageing population is increasing, understanding the trajectories, modifiers and modulators of healthy ageing and transition from mild cognitive impairment to major neurocognitive impairment gains significance. Targeted interventions tailored to address the vulnerable elderly from middle age or even before would be the most important translational aspect of my research. Our team also tries to understand the role of hitherto considered benign white matter changes and its role in tilting the balance of mild cognitive impairment towards dementia. My PhD work was hence specifically focused on the role of specific molecular mechanisms driving cognitive deterioration in patients with Cerebral Small Vessel Disease. This work was seminal with respect to the fact that it looked in a holistic manner not just the clinical data but comprehensively assessed the neuropsychological, imaging and genetic correlates associated with respect to the same in a cohort of more than 200 patients. This work was further extrapolated during my MD studies wherein I looked into the role of APO E4 allele in modulating the course and prognosis in the cohort of patients with vascular cognitive impairment as further ahead during my DM wherein I tried to identify the various trajectories that late-life depression would take and its likely link and evolution into neurocognitive disorders like dementia. These are just humble beginnings and there is a need for more such cohort studies in understanding the role of modifiable risk factors including epigenetics that could increase the incidence of dementia in our elderly. My research also gives importance to the public health approach for dementias and in the role of developing policy considerations, ethical and sociological aspects of ageing and explores due concerns of the stakeholders especially patients with cognitive impairment and their caregivers, rehabilitation options and inputs for advocacy as well. It is opportune that this decade is considered as that of “Healthy Ageing” by the World Health Organization (WHO) and a comprehensive understanding of geriatric physical and mental health would pave way for developing better access to pathways of care and provision of early intervention strategies and “bench to bedside” translation of research.

VLOM (Verbal-Language/Orientation-Memory) ratio calculated from early versions of Addenbrooke’s Cognitive Examination (ACE) has been used to differentiate Alzheimer’s Disease (AD) and Fronto Temporal Dementia (FTD) previously. The present study used the current version called ACE-III to differentiate people with Mild Cognitive Impairment (MCI) from healthy controls.

Reference: Roy D, Varadharajan A, Joe N, Jain S, Sunny AS, Issac TG. “Relax, Refresh, and Refocus:” A Brief Account on the Potential Utility of Snoezelen in Dementia. Journal of Psychiatry Spectrum. 2023 Jul 1;2(2):109-12.