How far away is a dementia ‘cure’?

Recent discoveries have been hailed as a ‘turning point’ for treating dementia, with new drugs and diagnosis methods giving scientists hope, but a more complex picture lies behind the headlines. 

Alzheimer’s Research UK and Alzheimer’s Society today launched a joint research venture to bring new blood tests to the NHS in five years.

The charities hope that, along with other diagnostic methods, these tests will help close the dementia ‘diagnosis gap’ which has seen a quarter of a million cases go undiagnosed.

These tests will also help the NHS administer new drugs should they become available. The US regulator recently approved two new medicines that slow dementia progression. So far, they’re not licensed in the UK.

Here, we look at the difference these breakthroughs could make to people living with Britain’s most deadly disease. 

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How would a dementia blood test work?

These blood tests look at biomarkers – external indicators of internal conditions. Scientists know that certain levels of tau or amyloid protein in the brain could indicate dementia in a patient.

If the tests were rolled out widely on the NHS, doctors and specialists would have an easier time giving a diagnosis, but traditional cognitive testing would still be required.

The tests would help with treatment, too. The new dementia drugs licensed in the US target amyloid proteins, which may or may not be the cause of a patient’s dementia. A test result would help medical professionals determine if patients are suitable candidates for these drugs.

A new nationally representative survey from Alzheimer’s Research UK and Alzheimer’s Society found that 94% of respondents would be willing to take a dementia blood test if one became available.

This is much higher than the 54% who said they would undergo a lumbar puncture, also known as a spinal tap, which is the only current biomarker test available. Due to NHS resources, lumbar punctures are extremely rare at the moment – only 2% of dementia diagnoses use them.

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Could new drugs cure dementia?

The groundbreaking drugs recently licensed in the US have been found to slow the progress of dementia, but not pause it or reverse it. 

While some scientists have questioned the value of this, Susan Kohlhaas, executive director of research and partnerships at Alzheimer’s Research UK, feels passionately that this would make a difference for patients. 

‘I think it’s really important that we slow decline,’ she said. ‘What slowing decline by 30-35% means for people could be very important. It could mean the difference between being present at your daughter’s wedding, for example.’

She also said these drugs could have a longer term benefit that hasn’t yet been discovered.

Even if these new treatments are never licensed in the UK, they still represent hope that dementia – which has long been virtually untreatable – can be treated.

Dr Joanne Rodda, a psychiatrist at a Kent NHS memory clinic, said: ‘Disease modifying treatments are realistically for the first time on the horizon.’

Her optimism was shared by Fiona Carragher, Director of Research and Influencing at Alzheimer’s Society. She sees this as the start of science really beginning to tackle dementia in a new and effective way. ‘New drugs targeting early-stage Alzheimer’s disease are just around the corner,’ she said.

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How long will patients have to wait for new dementia treatment?

According to Carragher, the new blood test will be ‘truly game-changing’ in the fight against dementia.

The charities’ joint project aims to make them available on the NHS in five years’ time. Even without new medications, blood tests would help speed up the diagnostic process, which can be drawn out and painful for patients and their families. In some cases, it can take up to four years.

Tara Spire-Jones is group leader at the UK Dementia Research Institute. As we spoke to her over the phone from her lab at the University of Edinburgh, she was seated at a microscope where she had been examining the brain of someone who had died of Alzheimer’s.

A key sticking point for Spire-Jones is funding. ‘We’ve been chronically underfunded compared to other critical conditions like cancer,’ she says. ‘The microscope I’m using now costs at least £350,000.’

If more funding goes towards cancer research, the field can pay scientists more, meaning they’re more likely to choose jobs in this area over dementia research.  

We asked Spire-Jones if there will ever be an overall cure for dementia. ‘Without a crystal ball, you can never tell,’ she says. ‘But I’m optimistic.’

Spire-Jones believes scientists could prevent Alzheimer’s altogether – drugs that could do this are in clinical trials already – but it could take a long time for them to become available. ‘From discovering amyloids were a factor to getting the first drug licensed took 30 years,’ she said.