“The statistics are frightening. Dementia is the biggest cause of death in the UK and has been the leading cause of death in women since 2011.” Alzheimer’s Research UK Co-Chairs Dementia Mission UK“One in two of us will be affected by dementia, either by caring for someone with dementia or developing dementia ourselves.”
But there is reason for optimism, as Alzheimer’s researchers are making incredible progress in treating the disease. In May 2023, pharmaceutical company Lilly announced that its new Alzheimer’s drug, donanemab, has Slowed cognitive decline by 35%In 2022, another drug, lecanemab, recorded similarly promising results. “For a long time, dementia research has been expensive and hopeless,” Evans says. “But we’re now at a real turning point for change with the arrival of the first-ever Alzheimer’s drugs that address the root cause of the disease, not just the symptoms.” Donanemab and lecanemab act as antibodies to remove amyloid plaques that form in the brains of people with Alzheimer’s.
“But like many first-generation treatments, it has only modest efficacy and serious side effects,” Evans said. “We need to look back at how the first generation of treatments for diseases like HIV began — with limited efficacy and often distressing side effects — that paved the way for drug combinations that have transformed outcomes for the next generation of people suffering from this disease.”
Evans has reason to be optimistic. Over 140 Clinical trials of a variety of potential treatments for Alzheimer’s are underway, ranging from compounds that can remove toxic proteins to drugs that can restore function to damaged brain cells. “I’m in my mid-40s, and I really think our generation will benefit from the advances we’re witnessing now,” Evans says. “The development of safer, more effective drugs is really a matter of when, not if.”
But Evans worries that these new treatments could be out of reach for patients if they don’t receive a timely and accurate diagnosis. A recent study from the New England Journal of Medicine It also turns out that Alzheimer’s can be in its early stages 20 years before detectable symptoms begin to appear. “New treatments depend on diagnosing the disease at an early stage,” Evans says. Moreover, diagnosis of the disease in the population remains woefully under-done. “It hasn’t changed in over 20 years,” Evans says. Pen-and-paper cognitive tests remain the most common method of diagnosis. Only 2% of patients undergo gold standard testing—Lumbar puncture and PET brain scan.
The UK government has set dementia diagnosis targets across the country, 67 percent of patientsBut this target is not being met in many parts of the country, with patients who are diagnosed having to wait an average of two years, and for those under 65, the waiting time is four years. “One in three people with dementia in England has not been diagnosed,” Evans says. “This is unacceptable for any other health condition.”
This could change, for example, with the introduction of accurate digital cognitive tests, allowing patients to be assessed in real time and receive treatment sooner. Development of AI algorithms This could potentially allow researchers to test the eye for signs of Alzheimer’s. “The retina is a particularly attractive target because it is closely connected to brain tissue and can be examined non-invasively during a routine eye exam,” Evans says.
Alzheimer’s UK is also backing research to find blood biomarkers for the disease. “Research has shown that a blood test can be as effective as a standard spinal puncture or brain scan and could be used as an early triage tool,” she says. “People would naturally prefer to have a blood test rather than a very invasive test. This could revolutionise the way dementia is diagnosed.”
This article appears in the July/August 2024 issue. WIRED UK magazine.
