14 Dec 2020
Dr Stephanie Ward is a geriatrician who is passionate about improving the quality of diagnosis and care for persons living with dementia. She is thrilled to have an appointment at CHeBA as the clinical and initiative lead for the Australian Dementia Network (ADNeT) Clinical Quality Registry. ADNeT is a nationwide initiative bringing together consumers, clinicians and researchers to improve research opportunities and clinical care for persons at risk of and living with dementia. The Registry is a central component of ADNeT centred on benchmarking clinical practise, highlighting variations in outcomes and driving improvements. Dr Ward’s clinical practice inspires her engagement in a number of studies investigating mechanisms of, or prevention of cognitive impairment and dementia. One such recent area of interest is the role of intergenerational contact in healthy ageing and she was the expert geriatrician on the award-winning ABC series “Old People’s Home for 4 Year Olds”.
How did you first get into research?
I got into research after obtaining my Fellowship in Geriatric Medicine and commencing specialist practice. I had a strong interest in quality improvement and was fortunate enough to be awarded a Robert Gordon Menzies Scholarship to attend Harvard University to complete a Master of Public Health. After returning to Australia (Melbourne), I was seeking an opportunity to complement my clinical work and was privileged to join the Monash University School of Public Health and Preventive Medicine to contribute to the development of a longitudinal sub-study - the ASPirin in Reducing Events in the Elderly (ASPREE) Longitudinal Study of Older Persons ("ALSOP). This was an amazing experience. It made me realise where there were distinct gaps in evidence concerning dementia risk factors, as well as the unique opportunity to help answer questions pertaining to these evidence gaps. For me, the question was focused on the role of sleep apnoea as a risk factor for dementia. With a group of fellow investigators, we established another sub-study to the ASPREE study to acquire research evidence to support the need to address this particular modifiable risk factor.
Did you experience a ‘defining moment’ which led you to this field?
As a clinician, we need to learn so much to care for our patients. Sometimes, time permitting, we can really dig deep into the literature on a topic and end up not only with more questions but also realising that we can be part of the solution. For my research, initially, this prioritised sleep apnoea; a condition I had assumed – as a clinician might! - that it may be harmful to brain ageing and increase the risk of neurodegeneration. I was genuinely surprised when I discovered that, at the time, the evidence either didn’t exist, or was largely inconclusive, and I recognised an important clinical question that needed an answer.
Do you have any personal interests or activities which are protective behaviours against cognitive decline?
I am reasonably active and often in an incidental manner, with physical activity undeniably positive for brain health. I love to walk places rather than drive, prefer to take the stairs, and I take full advantage of the CHeBA campus being located in a relatively hilly part of Sydney. I am also constantly and keenly learning and complex mental activity is considered protective against cognitive decline.
What are you currently researching?
I am fairly pre-occupied with working with the amazing ADNeT registry team - based across Australia - in establishing the first national clinical quality registry (CQR) for persons living with mild cognitive impairment and dementia.
CQRs are extremely powerful tools to drive improvements in clinical practice, and ultimately improve outcomes for people living with dementia.
CQRs can also improve the chances of connecting people with opportunities to participate in clinical trials. They also form a valuable infrastructure from which other research studies can be leveraged.
Outside of this, I am an investigator on the NeuRA-led Intergenerational Integration Initiative; a project funded by a UNSW Ageing Futures Institute seed grant. This project looks at evaluating the establishment of an intergenerational preschool involving community-dwelling older adults. I am a chief investigator on a number of other NHMRC-funded projects elucidating mechanisms of, or prevention of, cognitive decline and dementia.
Why is your research important?
My research is fundamentally practical and translational, and ultimately aimed at improving outcomes for people at risk of, or living with, dementia. This is no more so than with the ADNeT Clinical Quality Registry, which is explicitly aimed at the systematic collection of data to improve clinical care. However, I am also really excited about the potential of intergenerational contact, to not only improve health outcomes, but for its potential to bring joy, laughter, surprise and new experiences to older adults.
Who said that ageing shouldn’t be fun, or bring new opportunities?
I moved from Melbourne to Sydney two years ago, and sometimes still have to pinch myself now that I am at such an inspiring institute as CHeBA, recognised not only around Australia but internationally as a leading centre for research into healthy brain ageing. Co-Directors Professor Perminder Sachdev and Professor Henry Brodaty are giants of the field - and are yet as supportive as they are inspiring. There is such an extraordinary group of people working at CHeBA in so many diverse fields, and its humbling as well as invigorating. It is a lovely complement to my clinical work.
What is the ultimate hope you have for your research?
I hope that one day the Registry we are establishing is highly valued by the community, clinicians and other researchers alike, and that it is being used to improve clinical practice as well as leverage other important research initiatives.
This article was written during the COVID-19 self-isolation period. As a clinician, Dr Ward continued working at the Hospital throughout this period so remained socially connected while the majority of us were physically isolated.
Dr Stephanie Ward BMed FRACP MPH is a senior research fellow at CHEBA, as well as a staff specialist in geriatric medicine at The Prince of Wales Hospital. She is the Initiative and Clinical Lead of the Australian Dementia Network (ADNeT) Clinical Quality Registry, a nationwide initiative funded by the NHMRC that aims to systematically collect data on persons newly diagnosed with dementia and mild cognitive impairment to measure the quality of care. She is a co-investigator on the Intergeneration Integration Initiative that is establishing and evaluating intergenerational preschools that involve community dwelling older adults. She is also an investigator on a number of clinical trials funded by the NHMRC investigating interventions to reduce dementia risk.