RESEARCH INTERESTS
I work to develop and evaluate better treatments for people with dementia and for psychosis in older people by investigating the mechanisms underlying symptoms and through the conduct of independent clinical trials. For example, our trials have shown the cognitive, functional and independent living benefits of continuing dementia drugs until the late stages of Alzheimer's disease (DOMINO) and of antipsychotic treatment in people with very late-onset schizophrenia-like psychosis (ATLAS). Currently, I am trialling the effectiveness of problem-adaptation therapy in people with dementia who are depressed (PATHFINDER) and the usefulness of withdrawing/continuing antidepressants on older people (ANTLER 75+).

I work with Suzanne Reeves to identify ways in which psychosis in older people can be treated most effectively and safely through optimising the use of existing antipsychotics and investigating the potential of novel and repurposed agents (e.g. ondansetron in the TOP HAT trial). Suzanne and I are working with Emma McLachlan and Neil Burgess at the ICN to understand how dysfunction of the hippocampus and associated structures might underpin confabulation and delusion formation in AD.

With Kathy Liu and Jon Roiser we are investigating the structure and function of central noradrenergic pathways whose dysfunction might underlie the common and hard-to-treat agitation syndrome seen in people with AD. Kathy and I are interested in the evaluation of new dementia treatments and how we can help colleagues to better understand the benefits and costs that come with them.

With Harry Costello and Jon Roiser we are investigating the contributions of dopamine and reward sensitivity to depression in people with Parkinson's disease.

With Jemma Hazan and Nick Fox we are exploring how plasma biomarkers for Alzheimer's disease might best be used to support diagnosis and treatment within NHS Memory Services.

Anxiety disorders are the most difficult mental health problems to treat successfully in older people. With Becky Gould and colleagues, we are looking at Acceptance and Commitment Therapy with the CONTACT-GAD trial.

With Hamish Naismith we are looking at the prevalence and timing of self-harm and thoughts of self-harm associated with diagnosis of dementia.