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182 As a neuroscientist I have been involved in both clinical and basic brain research. Our clinical research team is composed of myself Drs.Nelleen Baboolal and Gershwin Davis. We have enjoyed a very fruitful collaboration for well over a decade. Our group is mainly involved in dementia research. We are all the co-directors of Dementia Awareness and Research of Trinidad and Tobago DARTT a nonprofit company established and incorporated in order to better pursue our research goals and to extend the aware- ness of dementia to the general population. Our research can be considered as a three-pronged approach. We have been searching for a biomarker to differentiate Alzheimers disease patients from other dementias establishing the degree of burden for persons caring for relatives with Alzheimers disease and we are establishing the prevalence and economic cost of dementia in Trinidad and Tobago. Clinical Neuroscience Research Biomarkers Predicting who develops Alzheimers disease AD is problematic due to the very nature of the disorder.There is a need therefore for biomarkers to flag early cell death as this may allow for treatment interventions which could arrest or postpone neuropathological processes.Biomarkers are currently detected in either the cerebro- spinal fluid or serum. One of the most important aspects of a biomarker is that it can distinguish Alzheimers disease patients from other dementias and aged matched controls. A popular choice of biomarkers has been abnormal proteinswhich are major players in the pathogenesis of the disorder.Thus a major effort has been devoted to detecting these proteins in the cerebrospinal fluid. However other factors such as inflammation also play a significant role in the events leading up to Alzheimers pathology. The microglia cell which is the immune cell of the brain plays a significant role in the early events leading to AD pathology. Thus in view of its role in the pathogenesis of AD our demonstration that the cerebrospinal fluid of AD patients contained an antibody directed against microglia provided a strong argument to pursue these antibodies as potential biomarkers. The preliminary results indicate that for CSF antibodies we have a new ELISA test that is at best good at distinguishing AD patients from controls. This test should be studied not only in patients with Alzheimers disease but also in other groups of patients such as those classified as mildly cognitive impaired. With the presence of antibody in patients and not controls it is anticipated that the CSF biomarker would find an application in the most sophisticated clinical settings as well as the most remote ones. We are interested in extending the further development of this ELISA to detecting antibodies in the serum of patients. Caregiver burden in Trinidad and Tobago Dementia is a gradual and progressively degenerative disease that is accompanied by challenging changes in the affected persons emotions and presenting behaviours. Caring for an individual with dementia is globally recognized as being a considerable burden and stressful. The burden of providing care for dementia patients places caregivers at risk for physical and emotional problems. In view that the level of caregiver burden is unknown in Trinidad and Tobago we have been investigating caregiver burden in individu- als caring for patients with dementia. Our study included 75 caregivers and their relatives. To establish the level of caregiver burdenindividuals were administered two questionnaires. The investigation established that 80 of caregivers in Trinidad and Tobago are femalein keeping with the international trend. Thus far the profile of caregiver burden in Trinidad and Tobago is as followsMore than half of the caregivers 55 had moderate to severe burden 45 of the caregivers experienced little or no burden.This might reflect the easy acceptance of dementia for the elderly in the Trinidadian population where taking care of the elderly is a normal intergenerational experience. Another issue that this ongoing study hints at is the impact of unpaid care-giving on the financial health of caregivers who are middle aged and have other responsibilities including taking care of their own families. Our findings underline the global impact of caring for a person with dementia and support the need for caregiver supporteducationtraining and access to medical care.. Prevalence and economic cost of dementia in Trinidad and Tobago Very little is known about the prevalence and cost of dementia in Trinidad and Tobago even though we are an aging nation. Our investigation is the first prevalence of dementia survey in Trinidad and Tobago and will also provide strong indicators about the economic burden of the disorder. The key research instrument known as the Community Screening Instrument for Dementia has successfully established the prevalence of dementia in a number of countries including Latin America Caribbean Asia and Africa. This instrument was created by the 1066 Dementia Research Group based in the UK. This questionnaire together with a socioeconomic questionnaire MEDICAL SCIENCES Professor of Human Anatomy Department of Preclinical Sciences Tel 868 645 2640 ext. 4633 E-mails PROF. AMANDA McRAE