More than 900,000 people in the UK now have dementia—and this figure is expected to rise to over a million in the next few years. This means that most of us probably now know at least one person with dementia, often more. There are around 200,000 new cases of dementia diagnosed each year. Alzheimer’s Disease is the most common type of dementia, seen in around six out of ten cases.
There is currently no cure for dementia—but that doesn’t mean that it is not treatable. There is also growing evidence that, like cancer, an earlier diagnosis means that treatment is more likely to be effective. Dr. Tarun Kuruvilla, Medstars consultant psychiatrist, and Visiting Professor at the School of Health and Social Care at the University of Gloucestershire, is involved with clinical trials on several new treatments for Alzheimer’s Disease.
“There are four drugs currently licensed to treat Alzheimer’s Disease, and they have been around for about 20 years. They all deal with the symptoms, not the underlying pathology. We are currently running intensive trials for new treatments that actually deal with the pathology, what’s going on in the brain.”
What causes dementia?
In Alzheimer’s Disease, we know that the problem is a build-up of ‘amyloid plaques’ in the brain. These are groups of proteins that have got wrongly folded, and ‘clog up’ the brain. They first form in the area of the brain that deals with memory, which is why memory problems are often the first sign of dementia. Tarun explains that the new treatments target these plaques directly.
“Most of the new treatments target the amyloid proteins themselves. They are actually amyloid antibodies, so similar to part of the immune system. This means that we can deal with the underlying pathology of Alzheimer’s, not just control the symptoms. However, we need to give these treatments in the very early stages: when people only have very, very mild memory problems.”
The usual ways to diagnose dementia are based on clinical features—what you can see. However, Tarun believes that the advances in treatment options mean that we need to diagnose much earlier, before most symptoms appear. He therefore uses MRI scans to look for characteristic early features. If needed, he also uses PET scans to detect the amyloid proteins in the brain.
Changing the culture around dementia
It is fair to say that most people do not immediately consult their GP when they start to experience memory problems. Most of us probably put memory problems down to aging, at least for a while. Even once you are referred, pandemic-related backlogs mean that most NHS memory services currently have long waiting lists for appointments. Additionally, very few have access to scanners for early diagnosis.
These issues combine to mean that many diagnoses of dementia are very late. Tarun believes that we need to change the culture around dementia, and start thinking much more proactively.
“I’d like to see much earlier diagnosis, with routine use of brain scans. We need to get rid of the stigma. When I see patients for a private memory assessment, most of them just have very minor memory problems. If we diagnose Alzheimer’s Disease early, they have so many more options. They may be able to get involved in clinical trials for these new treatments. However, even if they don’t want to do that, the current treatments are more effective if started earlier. And an early diagnosis means they have more time to plan ahead, and get their affairs in order. It’s just so much better—for everyone.”
To book an appointment with Prof. Tarun Kuruvilla, click here.