Research in Ageing and Cognitive Health (REACH)

Athena SWAM Bronze award

Our aim is to improve the lives of older people and people with dementia through research.

Our research themes are:

Maintaining cognitive health in later life

Living well with cognitive impairment and dementia

Supporting family care

The Centre for Research in Ageing and Cognitive Health (REACH) is a joint venture between the School of Psychology in the College of Life and Environmental Sciences, the University of Exeter Medical School Institute of Health Research, and PenCLAHRC. The aim of REACH is to improve the lives of older people and people with dementia through research focused on three main themes: maintaining cognitive health in later life, living well with age-related cognitive disability and dementia, and supporting family care.

Our research contributes to emerging knowledge about the potential for preventing, delaying or reducing the risk of developing age-related cognitive disability and dementia. In our observational studies we focus on the role of personal and lifestyle factors associated with cognitive reserve and resilience against brain pathology, and on the social and psychological processes that influence lifestyle choices and the potential for behaviour change. As collaborators in CFAS-Wales and part of the CFAS study group and CFAS DTC, we are able to examine the influence of these factors in a large population-representative cohort of older people. Recently in the BANC study we have also examined the cognitive effects of bilingualism. Findings from observational studies inform the development of behaviour change interventions for primary and secondary prevention of dementia, such as the Agewell study conducted with healthy older people, the LaTCH memory management group programme for healthy older people and people with MCI, and the INDIGO trial of physical exercise for sedentary individuals with MCI. We are developing our work on cognitive health as part of the Centre for Research Excellence in Cognitive Health, led by the Australian National University, Canberra.

Our observational research examines the psychological and social impact of dementia, and contributes to a growing understanding of the experience of living with dementia or providing care for someone with dementia. We have focused in detail on the psychological and social processes implicated in awareness and disturbances of awareness in dementia, and outlined a theoretical framework that can guide future research. We have explored the way in which people with dementia understand and make sense of the condition, and examined the impact of dementia on self and identity, attachment, marital relationships, and quality of life. This strand of work has culminated in the IDEAL cohort study which explores how social and cultural capitals, assets and resources influence the potential for people with dementia to live well with the condition in a large group of participants throughout the UK. Our intervention studies involve the development and evaluation of interventions aimed at improving the lives of people with dementia. We have pioneered the application of cognitive rehabilitation for people with dementia, and this is currently under evaluation in the multi-centre GREAT trial as well as being piloted for people with Parkinson’s disease in the CORD-PD trial. We have recently completed a pilot trial of self-management groups in the SMART study, contributed to the RESERVE-DSD trial of a cognition-focused intervention for delirium superimposed on dementia, and undertaken the AwareCare trial focused on improving quality of care and quality of life for people with severe dementia in residential care and nursing homes.

Our research explores the experience of caring for a family member with dementia and supports the realisation that family carers are crucial to the individual well-being of people with dementia and that their social and economic contribution is invaluable and irreplaceable. We have conducted research on the way in which carers experience and find meaning in their role, and examined the impact of caring on psychological well-being, marital relationship and quality of life. In the IDEAL cohort study we are exploring the ways in which social and cultural capital, assets, and resources influence the experience of living with, and caring for a person with, dementia. We are developing interventions to promote wellbeing and enhance resilience in family carers, as well as international comparative studies of suicide and homicide risk in family carers.

REACH currently comprises 11 staff and doctoral students, holds grants totalling around £7 million, and collaborates in several other large projects in the UK and internationally. Our work draws primarily on perspectives from social gerontology, clinical and behavioural psychology, neurorehabilitation and public health, but we collaborate with colleagues in many fields. We undertake evidence syntheses, observational studies and intervention trials. We use a range of methodological approaches; our focus is primarily quantitative, but we incorporate qualitative methods where appropriate to the research questions under investigation. We work closely with voluntary sector partners, and we engage older people and people with dementia in the process of developing and conducting our research and disseminating the findings. Alongside our research programme we contribute to local, national and international initiatives aimed at developing policy and practice and creating dementia-friendly communities. These include, among others, the Exeter Dementia Action Alliance, the British Psychological Society Dementia Advisory Group, the Cochrane Dementia and Cognitive Improvement Group, and the Global Council on Brain Health.