opportunities in dementia research, disease-modifying treatment
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Here, Hilary Evans, Chief Executive at Alzheimer’s Research UK, outlines the current gaps and future opportunities in dementia research

This year, Alzheimer’s Research UK published the results of a detailed project to assess current approaches to dementia research. We spoke to experts in dementia research from universities, pharmaceutical companies and other charities and found a consensus that while dementia research is receiving greater support than ever before, there remain gaps in understanding and ways of work that must be addressed. These areas represent important opportunities to accelerate progress and bring about life-changing treatments for people with dementia.

The current crisis

The scale of dementia is now impossible to ignore. Globally, 50 million people are living with dementia, with that number predicted to triple by 2050. This sheer number of people with the condition cost the global economy $1 trillion in 2018.

Compounding this health crisis is a lack of effective treatments. Currently, while we can temporarily treat some of the symptoms of dementia, we cannot stop, slow or prevent the diseases, like Alzheimer’s, that cause the condition. It has been 17 years since the last new drug for dementia was made available and we believe that people living with dementia and their loved ones deserve better.

Current gaps in dementia research

To bring about change, we worked with experts in the dementia field to develop a strategic action plan to address gaps in our current understanding. We have called for reform in six key areas to ensure we:

• Investigate the effects of newly identified genetic risk factors on disease processes.
• Improve understanding of why some brain nerve cells are more resilient than others.
• Bolster early drug discovery work to identify the most promising new treatments opportunities.
• Select the right participants for clinical trials.
• Improve ways to measure how effectively drugs are working in people.
• Find ways to begin clinical trials in people decades earlier than we do today.

Our research needs to focus efforts on the most important biological processes driving disease. This will give us the best chance of bringing about the life-changing treatments people with dementia desperately need. It will require us to think carefully about how we design our clinical trials in the smartest ways to test potential new medicines.

Updating our approach

In 2013, the G8 committed to finding a disease-modifying treatment for people with dementia by 2025. Since then, research has moved on. While clinical trials of disease-modifying treatments have not yet borne fruit, we have learnt huge amounts about the complex diseases driving dementia.

But to continue making progress in research we must review what’s working well and what could be improved. And we need to take brave steps to move things forward to bring about new medicines.

The recommendations outlined in our report are all steps that industry, charity and funders can make, through training, rewards and funding programmes. While they’re bold steps, they are manageable and we must start to implement them at the earliest opportunity.

Speeding up progress

Progress in dementia research does not happen overnight – it requires commitment and a multi-faceted approach. We need to improve prevention strategies, work to detect the diseases that cause dementia earlier and expand our understanding of the biological underpinnings of disease at the same time.

An overarching resolution is to find new ways to incentivise collaboration between researchers, particularly between those from different scientific disciplines who may be able to offer new perspectives on the challenge.

We also need to efficiently and comprehensively share data at all levels across the scientific community. By standardising approaches to the way we collect and share data, we can more easily compare results and pick out important trends in the data, accelerating progress. It’s a huge task, but it’s one we must undertake together.

Funding makes breakthroughs possible

We know that research breakthroughs are made possible by sustained funding. Looking at cancer, in the UK alone, 50 years of committed and increasing investment from 1970 have led to a doubling in the cancer survival rate in this country. We hope to replicate this success for dementia.

But right now, a major gap exists between research funding for serious diseases. In 2016/17, cancer research received £269 million in UK government funding compared to £83.1 million for dementia in the same year.

Globally, we’re seeing governments commit to increasing budgets for dementia research – the U.S. now spends the equivalent of 1.5% of the annual cost of dementia on research, Denmark spends 2.4% and Canada has pledged to spend 1%. We must see the UK step up to join this global effort and commit to investing just 1% towards research to bring an end to the fear, harm and heartbreak of dementia.

We’re doing our part to close the funding gap too. This year, Alzheimer’s Research UK committed to spend a landmark £250 million in dementia research over the next five years thanks to our incredible supporters.

You can read our full report, here: (http://orca.cf.ac.uk/123032/3/Tackling%201-s2.0-S2352873719300216-main.pdf)

As Chief Executive Hilary has led the transformation of the charity to one of the leading medical research charities in the UK – seeing the charity more than triple its income in three years and, therefore, significantly enhanced the organisation’s ability to fund ground-breaking new projects.

Alzheimer’s Research UK currently funds 140 research projects with a network of over 2,000 researchers working on the causes, symptoms treatments and diagnosis of Alzheimer’s.

Before joining Alzheimer’s Research UK, Hilary led the campaigning work at Age UK, improving the lives of people in later life both in the UK and internationally. She holds an honorary doctorate in medicine from The University of Exeter.

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