Alzheimer’s: research into early detection

Figures quoted by the National Audit Office in a 2010 interim report1 state that the number of people with dementia in England is expected to double within 30 years. Estimated costs of care will rise from £15.9 bn in 2009 to £34.8 bn by 2026. The report concluded that, despite the Department of Health’s announcement in 2007 that dementia was a national priority and the resulting publication of its “Living well with dementia” strategy in February 2009, the dementia strategy has not been given the levers or urgency normally expected for such a priority. Alzheimer’s disease, the most common form of dementia, is a gradual degenerative disease of the brain, which currently affects nearly 500,000 people in the UK – one in six aged over 80 – but in rare cases it can occur as early as 40. Symptoms include progressive defects in cognitive function, memory and language abilities with the first and most obvious symptom being the loss of recent memory, particularly the ability to place new information into long-term storage. As the disease advances, early-stage memory lapses, language deterioration and visuospatial skills worsen, systematically destroying cognition, personality and the ability to function. With current trends predicting an ageing global population the anticipated impact on society over the coming decades will be enormous – medically, financially, psychologically and emotionally.

The most feared disease

A recent YouGov poll, commissioned by Alzheimer’s Research UK, has also identified that dementia is one of the most feared health conditions, more so even than cancer. The poll revealed that 31% of respondents feared dementia most, with 27% fearing cancer most and 18% fearing death most. Dementia fears extend to all ages, with 52% of UK adults aged 30-50 fearing dementia for their parents, compared to 42% fearing cancer and 33% fearing heart attack. Among retirees, 34% worry about health the most, more than other issues, such as money (33%). When asked specifically which conditions they worry about, 52% worry about dementia, 33% worry about cancer and 30% worry about stroke. Despite the national fear of dementia and the potential care costs, it would appear that research funding is far behind that spent on other serious diseases. Dementia costs the UK economy £23 bn, more than cancer (£12 bn) and heart disease (£8 bn) combined. Figures produced by Alzheimer’s Research UK reveal that research capacity does not match public concern – for every UK research scientist working on dementia there are six working on cancer. To balance this, there have been some research advances into the early detection of Alzheimer’s. At the Alzheimer’s Association International Conference this year researchers from the US discussed the findings of research which points to the fact that people with the earliest signs of Alzheimer’s disease are more likely to suffer from falls, suggesting that problems with balance and visual perception may appear before cognitive decline. Researchers at Washington University, in St Louis, studied 114 healthy older people over an eight-month period. Brain scans were used to measure the amount of the protein amyloid in the participants’ brains, while levels of amyloid and a second protein, tau, were also measured in their spinal fluid. Amyloid and tau both build up in the brain in Alzheimer’s disease sufferers stopping nerve cells from working properly. Participants were asked to record each fall they experienced in a diary. Researchers found falls were more common in people with higher levels of amyloid in their brains, and more tau in their spinal fluid – described by the researchers as “preclinical” Alzheimer’s. People with high levels of amyloid in their brain were five times more likely to fall than those with normal brain scans.