A cure for dementia would transform millions of lives world-wide and Edinburgh-based Professor Craig Ritchie, believes that will happen within the next ten years.
The world-renowned dementia expert is the founder and CEO of Brain Sciences Scotland, and he maintains that taking an entirely new approach to Alzheimer’s disease would result in it becoming a rarity.
90,000 people in Scotland have dementia. 65% of care homes occupants live with it and it’s amongst the leading causes of death in Scotland. By 2031 it’s estimated to cost the country between £2.6 – £2.9 billion every year, but the emotional cost of the illness is almost immeasurable. How can that be turned around in just ten years?
“The most recent research clearly reveals that Alzheimer’s disease can start decades before symptoms appear, so we’re approaching our research and clinical trials from a much younger perspective,” says Ritchie “We’re now recruiting younger volunteers as we need to look at it as a brain disease that you could potentially have from your 50s or even younger, but many years before symptoms emerge.”
This is the foundation to his belief that it’s time to change how we look at Alzheimer’s. At present, he says people with moderate to advanced Alzheimer’s aren’t “treated” but rather their symptoms and care are managed. Although there are some medications available for Alzheimer’s disease none claim to be a cure. They have no effect on some people, and the hope with others is that they can temporarily slow down the progress of symptoms affecting everyday functions and activities.
However, Ritchie’s aim is to prevent the next generation from developing symptoms, using a test which looks for the presence of amyloid protein, a known contributor to the many neurological, behavioural and cognitive symptoms typical of the disease. A new treatment, Lecanemab, can help clear these proteins from the brain but it’s not yet in NHS use because it’s considered too expensive.
“It won’t work for anyone beyond the early stages so we must be realistic about the new treatments being developed,” says Ritchie “They’re for a younger generation, who need to be brain disease aware much earlier. We aim to identify those who have it and give them treatments to clear amyloid protein from the brain. Scottish Brain Sciences needs volunteers from Scotland who are 55+ and are concerned because there’s dementia in the family, or they have mild cognitive impairment or early Alzheimer’s dementia. These are the people who will prove the science, that brain disease can be treated before it becomes a severe dementia.”
His claim is that the approach to Alzheimer’s treatments has barely changed in decades, with medical students still being taught about it in exactly the same way as 40 years ago. In 97/98 Ritchie helped establish one of the first memory clinics in the world which opened in Melbourne and says there was very little difference between that and the one he worked in, in Edinburgh two years ago.
“We should create a new and dedicated speciality in the Alzheimer’s field, bringing together neurologists, psychiatrists and others under the banner of Brain Health and Neurodegenerative Medicine,” says Ritchie “That specialism would shift the focus to brain disease that starts in midlife which could then be prevented from developing into later stage disease – currently described as ‘dementia’. And we need to do it fast.”
He says that being realistic means having a big plan, recognising that those already in advanced stages of the disease get the right care and at the same time this new specialty in brain health and neurodegenerative medicine is being developed. It also means understanding how clinical trials work and potential side effects.
“This new generation of treatments won’t suit everyone and will have some quite serious side effects so specialists will need to closely monitor patients in their care” says Ritchie ‘But these are the first generation and many more treatments will follow, with 2nd, 3rd, 4th generations that will be even more targeted, safer and more effective.”
“I don’t just expect a cure for Alzheimer’s disease in ten years,” says Ritchie “I also expect that with early detection, managing risk factors and powerful new treatments, advanced Alzheimer’s disease – dementia – will be very rare.”
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