Dementia, diagnosed in its earliest stages, should be treated the same way as breast cancer, although experts praised “real advances” in care and screening.
Professor Craig Ritchie, a University of Edinburgh-based world pioneer in dementia, said that developments in blood-based biomarkers open the door to “reliable and effective screening and early treatment” for neurodegenerative diseases.
He said screening is around five to 10 years away for the early stages of Alzheimer’s disease, but may be implemented earlier if plans to create four new dedicated brain health clinics move ahead.
The first was introduced in Edinburgh, but its implementation has reportedly been “severely limited” by the pandemic.
The distribution of covid in nursing homes may have been increased by ventilation, although the study calls for a “protect but not confine” redesign.
Latest research shows that 40 percent of the incidence of dementia is attributed to 12 “modifiable” risk factors for lifestyle: high blood pressure, obesity, smoking, physical activity, diabetes, social isolation, hearing loss, depression, poor education, traumatic brain injury, excessive consumption of alcohol and air pollution.
The researchers conclude that the remainder of the risk of the disease is possibly due to a complex interplay of irregular tau and beta-amyloid proteins.
In people likely to develop dementia later in life, Ritchie, who leads more than 30 drug studies, compared the midlife period to a “silent period” for brain disease.
“But it’s only silent because we’re not listening,”But it’s only silent because we’re not listening.
He said he foresees a future in which Brain Health Scotland’s clinic networks will play a central role in early detection, individual risk reduction and ongoing disease management.
“There is good evidence that the diseases we know as dementia or late-stage neurodegenerative diseases in later life actually begin to appear in midlife,” he said.
My point is that in these communities, it is time to concentrate our efforts on diagnosis as early as possible, since it is the best chance that we have to influence the trajectory of the illness.
‘Early detection of dementia or neurodegenerative disease could become like breast cancer, where precancerous or early tumors can be identified by mammograms, and where the disease can be managed successfully with the right therapies.
As dementia and stroke deaths increase after closure, the charity calls for urgent screening
“I think screening for the earliest stages of Alzheimer’s disease – not necessarily dementia – is about five to 10 years away, but it could be piloted earlier once we establish Brain Health Clinics.”
He said early detection would have the added benefit of creating a growing community of people with potential disease-modifying drugs eligible for Phase IV trials.
Mr. Ritchie said that although “significantly withdrawn,” charitable support for research, funds were made available from the Scottish Dementia Research Alliance to reduce the losses.
He said the next phase of treatment will be in new secondary prevention, where people will benefit from emerging disease-modifying anti-amyloid and anti-tau drugs detected early through screening as being at high risk for cognitive decline and dementia.
Six such disease-modifying drugs have been in Phase III trials in 2019, and their findings are eagerly anticipated.
One of them, aducanumab, which is given every four weeks by infusion, was submitted to the U.S. Administration of Food and Drugs for expedited review; a decision is expected by March 2021.
Think Dementia fact sheet: Beginning a dementia discussion
Ritchie said another goal of Brain Health Clinics is to treat an estimated one-third of patients who do not have dementia and are misdiagnosed with the disorder with functional cognitive impairment.
They will live 10 to 15 years assuming they have dementia, he said, but they do not experience cognitive loss.
“We are doing a massive disservice to these people by giving them a false positive diagnosis,” he said.
Henry Simmons, Alzheimer’s Scotland Chief Executive and deputy director of Br