“The statistics are frightening: Dementia is the biggest killer in the UK. It has been the leading cause of death for women since 2011,” says Hilary Evans, CEO of Alzheimer’s Research UK and cochair of the UK Dementia Mission. “One in two of us will be affected by dementia either by caring for someone with the condition or developing it ourselves.”
There are causes for optimism, nonetheless, with Alzheimer’s researchers reaching extraordinary breakthroughs within the remedy of the illness. In May 2023, drugmaker Lilly introduced that its new Alzheimer’s drug, donanemab, slowed cognitive decline by 35 %; in 2022, one other drug, lecanemab, registered equally promising outcomes. “For a long time, dementia research has been a costly, even hopeless cause,” Evans says. “But we are now at this real tipping point for change with the arrival of the first ever Alzheimer’s drugs that tackle the root cause of the disease rather than just the symptoms.” Donanemab and lecanemab act as antibodies, clearing the amyloid plaques that kind in Alzheimer’s sufferers’ brains.
“Like many first-generation treatments, however, the benefits are modest and also come with serious side effects,” Evans says. “We need to look back at how we started off the first generation of treatments for diseases like HIV, which often had limited efficacy and difficult side effects, but paved the way for combination medicines that have revolutionized outcomes for the next generation of people with the condition.”
Evans has causes for optimism. Currently, there are greater than 140 scientific trials ongoing for quite a lot of potential Alzheimer’s therapies, starting from compounds able to eradicating poisonous proteins to medication that may restore the operate of broken mind cells. “I’m in my mid-forties and I really think our generation will benefit from the progress that we are now witnessing,” says Evans. “Developing safer and more effective drugs is really a matter of when and not if.”
Evans, nonetheless, is worried that these new therapies will stay out of attain for sufferers if they will’t obtain a well timed and correct prognosis. Recent analysis within the New England Journal of Medicine additionally confirmed that somebody will be within the early levels of Alzheimer’s 20 years earlier than the onset of detectable signs. “New treatments will rely on the diagnosis of people earlier on in the disease,” Evans says. Furthermore, prognosis of the illness within the inhabitants stays woefully insufficient. “It hasn’t changed in over two decades,” Evans says. Pen-and-paper cognitive checks stay the commonest diagnostic methodology; solely 2 % of sufferers endure the gold commonplace take a look at—lumbar puncture and PET mind scans.
Even although the UK authorities has set a nationwide dementia prognosis goal at 67 % of sufferers, that concentrate on is missed in lots of elements of the nation. Those sufferers who do get a prognosis have needed to wait on common two years; for sufferers underneath 65, that ready time goes as much as 4 years. “One in three people with dementia in England never get a diagnosis at all,” Evans says. “This isn’t something we would accept in any other health condition.”
This might be modified by the introduction of correct digital cognitive checks, as an illustration, which might permit sufferers to be evaluated in real-time and entry care quicker. Researchers at Moorfields Eye Hospital are additionally growing AI algorithms which may probably display screen for indicators of Alzheimer’s illness within the eye. “The retina is a particularly attractive target because it’s closely related to brain tissue and can be examined noninvasively during routine eye checks,” Evans says.
Alzheimer’s UK can also be supporting analysis to seek out blood biomarkers for the illness. “Research has shown that a blood test could be as effective as a standard lumbar puncture and a brain scan, and it could be used as an initial triaging tool,” she says. “People are naturally much keener to take a blood test than something that’s very invasive. This could revolutionize the way that dementia is diagnosed.”
This article seems within the July/August 2024 challenge of WIRED UK journal.