NEUROLOGY
Dementia research in the spotlight
‘What is good for the heart is also good for the brain’, according to experts on dementia, yet more than a quarter of the British public are unable to correctly identify any potentially modifiable risk factor for developing dementia.
New figures released by the Office of National Statistics show that for the first time, Alzheimer’s disease and other dementias are the leading cause of death for England and Wales. Of the 529,655 deaths registered during 2015, dementia accounted for 61,686 (11.6%).1
Dementia affects
850,000 people in the UK, with that number predicted to rise to over one million by 2025 as the population ages.2 With no treatments currently available to affect the course of the underlying diseases, global efforts to develop disease-modifying treatments have begun to accelerate. Alzheimer’s Research UK’s recent report, Treatments of Tomorrow: Preparing for breakthroughs in dementia3
states that
“dementia research is in the most promising position for years.” It points out that there are now double the number of clinical trials for dementia, compared to three years ago, with over 150 interventional phase I-III clinical trials.
Although this is still relatively few, compared to clinical trials for cancer (where there are over 17,000), the charity is optimistic that we are entering a “hopeful new era for dementia treatment”.3
It points
out that the UK Government has committed to finding a disease-modifying treatment for dementia by 2025, while the Prime Minister’s Challenge has made dementia research a priority in the UK.3
Current and future breakthroughs
The report outlines a number of challenges and pressures in England’s healthcare system that may pose problems for the roll-out of disease-modifying treatments for dementia. The comprehensive report recommends a number of actions, including: l Better ‘horizon scanning’ to help forewarn the NHS about new treatments and diagnostic tools in development;
l Early discussions about the possible impact of disease-modifying dementia treatments between regulators, NHS decision-makers, the
Caption pharmaceutical industry and charities;
l Scope for drugs companies and the health service to agree early or conditional access to new disease-modifying treatments where appropriate, alongside ongoing ‘real world’ data collection to understand longer-term effects;
l Ensuring that any changes to the system recommended by the government’s Accelerated Access Review are suitable for new dementia treatments.
While there are some drug treatments that can help alleviate the symptoms, for some individuals – such as cholinesterase inhibitors and Memantine (Ebixa or Axura),4 as yet there are no treatments available to slow the progression or delay the onset of dementia.
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Alzheimer’s Research UK estimates that if a treatment could be found to slow the progression of dementia by 25%, from 2020, the cost of dementia would steadily reduce each year, resulting in a potential saving of £1.8 billion in 2050 (from £59.4 billion without a treatment compared with £57.6 billion with one). If progression could be slowed by 50%, the total costs would be reduced to £55.2 billion in 2050 – a saving of £4.2 billion.3
Prevention
While significant efforts are underway to develop interventions for patients with Alzheimer’s and other forms of dementia, prevention is – of course – better than cure. Dementia is not an inevitable part of ageing and there is a growing body of evidence
FEBRUARY 2017
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