Recently, we caught up with Richard Brown, KMMS' Clinical Academic Training Office (CATO) Lead, to hear more about his work.
Tell us about you and your role
I’m Richard Brown (BSc (Hons), MBBS, MRCP, MRCPsych), Consultant Old Age Psychiatrist at Kent and Medway NHS and Social Care Partnership Trust (KMPT), and recently appointed KMMS Clinical Academic Training Office (CATO) Lead.
Describe your work
What links my research with my clinical role is a focus on cognitive disorders, work with whole families and the community, and curiosity about the experiences of later life.
How long have you been involved in medical education and research?
It’s been over 10 years. I had early support to gain experience and exposure to research as a higher trainee at the Maudsley Hospital. I was later the Director of Undergraduate Medical Education at KMPT for ten years during a period of expansion and the introduction of brand-new medical school programmes. We’ve evaluated the different stages of our teaching programme, worked hard to improve student experience on clinical placements, and supported our education fellows and junior doctors to start their own journeys getting into research.
Tell us more about your areas of clinical interest
My clinical work is in the mental health of later life, cognitive disorders in young and old, and complex dementia care. The overlap is with seeing people not just in isolation, but often as part of a family and a wider community, with complex stories and usually with several things going on at once. That’s the pleasure of psychiatry, and of old age or geriatric psychiatry especially — it’s all about complexity and the need for a lot of curiosity.
How did you get into research?
My initial research exposure at the Institute of Psychiatry looked at the use of opioids and management of pain in dementia. I collaborated with a colleague at St Christopher’s Hospice and Professor Robert Howard at the Institute of Psychiatry to develop a proposal for a RCT for a research fellowship. That led on to designing and completing a Cochrane review. At KMPT, I have been a PI involved in drug trials in dementia — for example, the Minocycline in Alzheimer’s Disease (MADE) NIHR-funded multi-centre trial, which explored the repurposing of the well-known antibiotic minocycline to see if it could delay cognitive or functional impairment in people with Alzheimer’s disease.
What would you like to achieve with your research?
The gap that I am most interested in is to develop meaningful interventions for people with functional cognitive symptoms — be that brain fog or functional cognitive disorder. I am keen to move beyond a disease model to think about the lens of functional medicine and lifestyle.
Is that what led you to become involved in research?
The initial interest was born from the urgency about needing safer treatments to alleviate agitation in dementia and the appeal of repurposing drugs as an efficient way to make a difference in dementia. More recently, I have been concerned by the limited offer for people with memory symptoms who do not have dementia, and the need to help people then look at how to live better. We have expertise locally at our two partner universities at KMMS, including very developed groups working in sleep research and the gut microbiome, which aligns to a lifestyle medicine approach.
What is the most significant or surprising thing to come out of your research so far?
The impact of proper supportive management in reducing agitation in people living with dementia — particularly adequate control of pain relief — is at least as effective, if not more so, than seemingly more powerful drugs like antipsychotics, for instance. I have seen that in my service development work as well as the research. The potential to improve people’s lives with being more holistic in your approach and rethink the problems that traditionally have had an excessive focus on drug treatments.
Tell us about your current research projects
I’m excited to be involved in working in collaboration with Dr Jo Rodda with the ADAPT study, looking at long-awaited blood biomarkers for Alzheimer’s disease. I’m also involved in the GRACE study, which proposes to develop and evaluate a structured model of post-diagnostic dementia support that can be delivered in our less advantaged coastal communities to help people feel better equipped to live with dementia and support loved ones. I believe clinical diagnostic accuracy in dementia is going to become ever more important, particularly as we’re approaching a time when there is a prospect of more disease-modifying treatments for dementia.
What advice would you give a researcher just starting out in research?
You don’t have to do this on your own. Mentoring is important (especially if you feel that you are not from a background with a lot of role models already in research) and getting guidance from people who are further along their research journey.
And finally, when you’re not working in your various roles, what do you love doing?
Spending time with my wife and daughter. I draw my energy from the countryside and the coast. I have a painting class once a week, which helps me to protect the time. And I like cultural things, such as going to the cinema, poetry, reading.
If you’d like to contribute to the development of the CATO programme or share ideas for dementia research, please contact Richard.