Speeding up the battle against slowing minds

Christopher Devas has Alzheimer’s
disease , the most common form of
dementia. For his wife, Veronica, this not
only means watching Alzheimer’s rob
Christopher of his memory and identity, it
also means watching their shared
memories slip away.
“Close couples are joint custodians of each
other’s experiences,” says Grayson Perry,
the artist who has helped raise awareness
of Alzheimer’s in his Who are You?
exhibition at the National Portrait Gallery
in London, and in a Channel 4 series on
British identity. “I have portrayed it as a
demonic figure snipping up all their
family snaps.”
Dementia is one of the biggest challenges
of our time. Last year, dementia became
the third most common cause of death in
the UK. Each year 225,000 of us will
develop dementia. There are already
850,000 people living with dementia in the
UK, and 1 in 20 of these are under 65. The
annual economic cost is £26.3 billion –
enough to pay the annual energy bill of
every household in the country.
Understandably, scientists are racing to
find out what causes dementia, and what
can be done to treat – and ideally, to
prevent it. But so far, results from studies
have been largely conflicting. GPs can treat
some of the common symptoms of
dementia, such as depression, and can give
their patients advice about how to manage
some of the dangerous effects of memory
loss. But we’re still very much stabbing in
the dark when it comes to treating the
disease itself.
To determine the risk factors linked to
progression of a disease, it’s possible to
follow a group of people who are highly
prone to developing that disease, and to
try and identify what seems to be tipping
them over the edge.
In the biggest meta analysis of its kind,
published last week, researchers at
University College London (UCL) looked at
subjects with mild cognitive impairment
(MCI), a state between normal ageing and
dementia. In MCI, the sufferer’s starts to
slow more quickly than would be expected
for someone their age. MCI affects one in
five people aged over 65, and nearly half of
all people with MCI will progress to
dementia within three years.
The UCL analysis, involving 15,950 people
with MCI, revealed that two factors are
clearly linked with progression of MCI to
full-blown dementia. Having diabetes
increased the risk of progression by 65%,
and having symptoms of psychiatric
conditions, including depression, doubled
the risk.
It is already known that older people
without MCI who have diabetes are at
increased risk of dementia. And there is
some evidence that people with
Alzheimer’s may benefit from changes in
diet and lifestyle, and even from diabetes
treatment. But the reasons for these links
are still unclear.
Diabetes damages the peripheral blood
vessels and nerves such as those in the
hands, feet and brain. This could, over
time, cause memory loss, cognitive
impairments and other symptoms of
dementia. There may also be genetic
factors at play – where certain gene
variations could be at the root of diabetes,
psychiatric symptoms and dementia.
This new study helps researchers know
that they are on the right track in the
battle against dementia. It also suggests
that ensuring MCI is detected and treated
is a good place to start. By addressing the
causes and symptoms of related conditions
that we know an awful lot more about,
such as diabetes, we might be able to
prevent MCI from developing into
dementia.
“These results give a good idea about what
it makes sense to target to reduce the
chance of dementia,” says senior author
Professor Gill Livingston.
The Alzheimer’s Society charity
recommends that, to help prevent
dementia, people stay socially and
physically active, and eat a diet high in
fruit and vegetables and low in meat and
saturated fats.
“There are strong links between mental
and physical health, so keeping your body
healthy can also help to keep your brain
working properly,” says the study’s lead
author, Dr Claudia Cooper. “Lifestyle
changes to improve diet and mood might
help people with MCI to avoid dementia,
and bring many other health benefits. This
doesn’t necessarily mean that addressing
diabetes, psychiatric symptoms and diet
will reduce an individual’s risk, but our
review provides the best evidence to date
about what might help.”
The results came as David Cameron
announced last week that the government
will be spending over £300 million on
research into dementia, as detailed in the
challenge on dementia 2020 plans. As he put
it,
“What today’s announcement is about is a
very simple but bold ambition, and that is to
make the United Kingdom the best place on
the planet in terms of researching into
dementia, in terms of diagnosing people with
dementia and then in terms of treating,
helping and caring for them.”
Standards of care in diagnosing MCI have
already improved in recent years, thanks
to public health campaigns encouraging
early help-seeking. There has already been
a great deal of interest in the new findings,
and perhaps this means that more people
and their loved ones can be sooner and
better prepared for the fight against
dementia.