Professor Carol Brayne, Director of Cambridge Institute Public Health, has been made a Commander of the Order of the British Empire (CBE) for her services to public health medicine – one of two awards bestowed on Institute academics in this year’s Queen’s Birthday Honours.
Earlier this week, she was also awarded the Faculty of Public Health’s 2017 Synergy Award.
Professor Brayne’s research focuses on dementia and brain health with ageing. Much of her work involves longitudinal studies of older people, following changes over time in cognition, dementia natural history and associated features with a public health perspective. Her studies have shown that dementia has declined age for age in contemporary UK populations and the possible protective role of factors such as education.
We take this opportunity to congratulate her, and showcase her current work and career in this interview:
Q: Congratulations on receiving your CBE, what is your reaction?
A: It is a great honour to receive this award and I’m privileged to work in public health with outstanding colleagues, in a field that contributes so much to the health and wellbeing of the public worldwide.
Q: How did you first become involved in dementia as a research area?
A: I became interested in epidemiology as an environmentally aware medical student, its Sherlock Holmes approach and potential to make change. When I had done some more medicine, my interest in epidemiology and change was sustained when I saw people with entirely preventable conditions commonly presenting in A&E and clinics. When I then went on to do Neurology as a junior doctor I focused my interests on neuro-epidemiology (the study of the distribution and dynamics of neurological disease in human populations and of the factors which affect them) and the need for deep examination of whole populations. It was clear that ageing of populations was becoming a major societal change. Dementia is part of this and the division of dementia from brain ageing was emerging as a fundamental question, one which is at the heart of our concept of ourselves as humans and one which links us to history, philosophy and the Enlightenment.
Q: What is your view on societal approaches to dementia now and into the future?
A: My view is that we have not used our research monies well for current and future equitable health for populations including dementia (nor many other conditions). We have done much brilliant research as a species which has transformed health for many populations, but it has not met major challenges and indeed has almost certainly exacerbated others. These need a much broader societal research programme. Dementia is one part of this – a pill for a specific aspect of a brain change might work for those families with early onset dementias, and for these families this would be a huge advance, but it seems unlikely (on the basis of our own and others’ research) that this approach will do much to address the challenges of an ageing population in a sustainable world. Our dementia research is beginning to converge with the recognition of life-course influences, both risk and protection, on dementia expression in later life. This research suggests a more effective course of action would be a multi-pronged approach in which drug discovery is just one part with balanced investment. This is not something that we see at present.
Q: Can you tell us about some of the achievements and milestones in your career to-date, as well as some projects you are currently working on?
A: My career has given me the privilege of setting up and running training in epidemiology, in my previous role as head of department at Cambridge University’s Department of Public Health and Primary Care (whose name we changed at the time from Community Medicine to Public Health and Primary Care). I was also fortunate to be able to be fully research active whilst having ‘ad feminam’ programme training in Public Health. It was really this teaching and training of public health trainees, and being linked to local service, that grounded my approach to what Public Health is and its role in society.
Over the past 30 years I have been part of the growing Public Health community in Cambridge, where my role is often as facilitator and encourager of things I feel will enhance our community. Within my group, The Public Health of Ageing Research Unit, we have strong themes of work led by many wonderful colleagues within the NIHR School of Public Health Research, the NIHR Collaborative Leadership in Applied Health Research and Care, along with our brain ageing focused older population cohorts. It is important that we sustain our research aimed at understanding change in dementia over time, whether preventive strategies are possible and also how to support research within population settings on living and dying well with dementia and frailty.
Since becoming the Director of Cambridge Institute of Public Health I have worked to develop leadership for public health as a powerful community at the University and have also been the Chair of the national Faculty of Public Health’s Academic and Research Committee. As part of my role at the Academy of Medical Sciences. I was heavily involved with the Health of the Public 2040 report and hope that our community in Cambridge can help make the recommendations come alive. I think we can make a major contribution here.
Q: What would you most like your legacy to be?
A: My legacy will mainly be through those I have been privileged to train and support during their careers in a range of disciplines – public health service, public health research, gerontology, geriatric medicine, psychiatry, psychology, neurology, neuropathology, neuroscience, epidemiology, biostatistics and so on!
I hope that collectively we can make Cambridge more visible to the world as a major player in Global Public Health, by which I mean Public Health for the globe.