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Alzheimer’s and Type 1 Diabetes: Q&A with Dr. Luciana Mascarenhas Fonseca

Dr. Luciana Mascarenhas Fonseca received funding from the Alzheimer’s Association Research Fellowship to Promote Diversity Program for her project, “Alzheimer’s disease biomarkers, vascular risk factors and cognitive variability in aging adults with Type 1 diabetes.” Here, we ask her some questions about her background and the important research she’s currently undertaking.

Tell us a little about yourself. How did you first become involved in Alzheimer’s research?

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Dr. Luciana Mascarenhas Fonseca

I am an early-career neuropsychologist and clinical psychologist with a background in Alzheimer’s disease and neuroimaging in minority and other at-risk populations. I am originally from Latin America (Brazil). My professional career has been in minority aging, at the intersection of Alzheimer’s disease and underprivileged populations such as low-income older adults in Latin America, people living with intellectual disabilities and Native Americans. 

Since I was a child, I had a very significant relationship with the elderly members of my family. In fact, I had a very close connection to my grandmother and slept in her bedroom until I was 17 — right up until I left my hometown to study psychology in São Paulo. 

Personally, I’ve always enjoyed being with the elderly. Since my early college years, I have been involved in working with disadvantaged elders. I focused all my interest in this area throughout my education. I took psychogeriatric courses in college and wrote my bachelor’s thesis on dementia in institutionalized elderly people. After that, I specialized in psychogerontology, neuropsychology and neuropsychological rehabilitation, focusing on understanding the cognitive processes involved with Alzheimer’s disease and other dementias in vulnerable, low-income populations in São Paulo. 

My master’s degree at the University of Padova in Italy was focused on the study of death and palliative care in older adults with dementia. During my doctorate from the University of São Paulo, in partnership with the University of Cambridge in the United Kingdom, I investigated Alzheimer’s disease in adults with Down syndrome. During a year of internship at the University of Cambridge, I worked on two research projects funded by the National Institutes of Health and Alzheimer’s Research UK, focused on neuroimaging and Alzheimer’s disease in individuals with Down syndrome. 

Since I first worked with older adults as a clinical psychologist and neuropsychologist in South America, I’ve been passionate about understanding successful and pathological aging and conducting research to address issues related to cognitive health during the aging process. I have always been intrigued by the elderly who were neglected or suffered from memory loss, because to me, it was very clear how important they are to our society. I intend to devote my entire career to the study of dementia in the hopes of improving the quality of life of individuals with this disease.

What types of research projects are you currently working on?

As a postdoctoral research associate at Washington State University, I am currently engaged in two research projects in cognitive decline and dementia. 

The present one, funded by the Alzheimer’s Association, is part of a parent grant from principal investigators Dr. Naomi Chaytor and Dr. Laura Germine, funded by the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health. This research aims to characterize the relationship between blood glucose excursions (low and high blood glucose) on cognitive performance in middle-aged and older adults with Type 1 diabetes. 

The second research project I am currently engaged in is funded by The Native Alzheimer’s Disease Resource Center for Minority Aging Research. It investigates Alzheimer’s disease and other dementias, intra-individual cognitive variability and its relationship to MRI findings in Native Americans. 

My research and career goals are to develop knowledge and necessary skills that will enable me to establish a career in minority aging research, ultimately contributing to narrowing the ethnic/racial disparities that continue to exist in public health and science. As a Latina, I understand the importance of research on underrepresented minority populations. 

Tell us more about the research project funded by the Alzheimer’s Association. Why is it important to study the cognition of individuals with Type 1 diabetes?

People living with Type 1 diabetes are a newly emerging aging population. Due to better treatments for controlling insulin and glucose levels, the lifespan of these individuals is growing exponentially. Many studies have demonstrated an association of Type 2 diabetes with greater risks of cognitive decline and dementia. We also know that Type 1 diabetes has consistently been associated with cognitive impairments, even at younger ages. However, very little is known about their cognition in old age, although initial research also suggests greater risk for dementia. 

This study will help us better understand how Type 1 diabetes impacts a person’s risk for developing Alzheimer’s. To do this, we will study the fluctuations in cognitive status in adults with Type 1 diabetes with brief and repeated cognitive assessments over a 15-day period using a smartphone. We will include blood sample collection for the analysis of blood-based biological markers of dementia, and we will check the fluctuations on blood sugar.

Why is this research important to the field? How will it help people living with Type 1 diabetes who may be at risk for developing dementia?

We expect this study will advance scientific knowledge of cognition and aging in individuals with Type 1 diabetes. This population has high risks of vascular aging and dementia, and yet, has been understudied in regard to neuro-geriatric aspects of cognition.

The study could shed new light on the interplay between vascular risk factors, biomarkers for Alzheimer’s and changes in cognition in aging individuals with Type 1 diabetes. If successful, the results hold promise for risk prediction and disease detection, as well as the development of early interventions to mitigate the impacts of dementia, consequently improving the quality of life for aging adults with Type 1 diabetes.

How will the funding you received from the Alzheimer’s Association help you fulfill your objectives?

Conducting this study and being able to participate in the Alzheimer’s Association Research Fellowship to Promote Diversity Program represents an important step in my career. This experience will further my development as a researcher focused on Alzheimer’s disease research in high-risk groups and allow for targeted training opportunities.  These include participation in advanced statistics courses, grant writing workshops, professional development seminars and attending conferences and seminars focused on risk prediction. 

Through my mentor in this project, Dr. Naomi Chaytor, I had my first contact with the topic of aging in people with Type 1 diabetes. Dr. Chaytor has been an invaluable support to my scientific growth since we met. I am very excited by the opportunity to learn and work with Alzheimer’s in individuals with Type 1 diabetes and the prospect of acquiring resources to conduct future research in the intersection of Alzheimer’s disease biomarkers and high-risk aging populations. 

About the Alzheimer’s Association Research Fellowship to Promote Diversity Program

The Alzheimer’s Association Research Fellowship to Promote Diversity (AARF-D) award is intended to support exceptional scientists from underrepresented groups who are working in Alzheimer’s or all other dementias research and are engaged in their post-graduate work prior to their first independent faculty positions. The objective of this award is to increase the number of highly trained investigators from diverse backgrounds whose research interests are grounded in the advanced methods and experimental approaches needed to solve problems related to Alzheimer’s and all dementias in general and in health disparities populations. 

The Alzheimer’s Association recognizes the need to increase the number of scientists from underrepresented groups participating in biomedical and behavioral research. The Association anticipates that, by providing these research opportunities, the number of scientists from underrepresented groups entering and remaining in biomedical research careers in Alzheimer’s and all other dementia will increase. The mentoring and involvement of researchers from diverse backgrounds and perspectives is essential to engaging cutting edge ideas and thinking in addressing scientific gaps for Alzheimer’s and all dementias.

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