Protecting our most valuable resources
An estimated one million people in the UK are projected to be diagnosed with dementia by 2025. Attacking our most valuable resources as humans, it erodes our thinking skills and our memories, destroys our personalities and takes an enormous toll on patients and their families. But pioneering collaborative research in Edinburgh is bringing us ever closer to effective treatments.
While much of the dialogue around dementia is bleak – there are no drugs that can stop decline and countless failed trials – projects in Edinburgh provide a beacon of hope. The University’s Centre for Dementia Prevention (CDP) – led by Professors Craig Ritchie, Jean Manson and Charlotte Clarke, representing clinical, social and basic sciences – was established to understand brain changes in early dementia and factors that influence its onset. Figuring this out will be key to the ultimate goal – preventing dementia.
Recent evidence shows that Alzheimer’s disease – the most common cause of dementia – attacks the brain decades before symptoms. The CDP works with participants in their 40s and 50s to pinpoint the first psychological and biological changes that dictate the likelihood of developing dementia. Scientists believe that the delay between brain changes and the onset of symptoms offers a window of opportunity to alter the course of the disease.
Professor Tara Spires-Jones, Programme Lead at the UK Dementia Research Institute at the University of Edinburgh, is a lab-based neuroscientist whose work focuses on synapses – tiny connections that allow chemical and electrical information to flow between brain cells and that are key to learning and memory. Synapse loss is thought to be vital in the progress of Alzheimer’s disease, ‘leaking’ proteins into the brain’s cerebrospinal fluid (CSF) as they go. Exactly how these proteins might relate to cognitive changes is unknown, but could be a key early marker of disease.
Research works. If you look at cancer and HIV, there’s beena huge amount of investment and now there are life-changing treatments.
A new PhD study is set to harness the multi-discipline approach of CDP, investigating synaptic proteins in CSF and how this relates to cognitive data from participants. By using the expertise and equipment found across Edinburgh, this CDP study has a unique opportunity to bridge the gap between science and patient care.
Tara believes that bridging that gap is important in everyday lab life and that bench-based researchers can make special efforts to learn from people with dementia. Lab members have recently taken part in a scheme set up by former lab member Dr Chris Henstridge to link scientists with affected families, named Dementia Buddies.
“We find Dementia Buddies so motivating because we see how real people’s lives are affected. It changes our research perspective too as we find out what research questions could be most important to people who are actually living with dementia,” says Tara. Working with clinical teams at CDP has also been invaluable for advancing their basic science: “A lot of ideas are generated over a cup of tea. I might tell the team about some exciting lab results and the clinicians will say ‘okay, great, but how will that look in a patient?’ We push each other to be the most effective that we can from multiple angles.”
On the patient-facing side, Dr Laura McWhirter, a psychiatrist and clinical researcher, studies cognition. Her work with CDP participants is focused on better distinguishing between those with a neurodegenerative disease, such as Alzheimer’s, and those whose cognitive decline is due to another cause. Laura is testing if these insights could help improve the accuracy of clinical trials: “Is part of the reason that trials are failing because we are actually trialling drugs with the wrong people?” Her data may shed light on some aspects of why so many pharmaceutical studies have led to such disappointing results.
While some of us will develop dementia no matter what, due to unlucky genetic and developmental makeup, studies suggest that others might be able to reduce risk and that lifestyle factors are key to prevention. So how can we as individuals ensure brain health as we age? “Physical activity keeps your brain healthy and leading a healthy lifestyle in midlife could be key. There is less evidence that lifestyle changes can help once you have the disease, but keeping healthy and exercising could help reduce risk”, says Tara.
CDP is the home of EPAD – the European Prevention of Alzheimer’s Dementia – a pioneering pan-European study of almost 40 institutions and thousands of participants. Working with drug companies, EPAD aims to identify people who are most at risk of developing dementia to fast forward the search for effective interventions.
Tara believes that these types of pioneering approaches mean that we should be optimistic. “Research works,” she says. “If you look at cancer and HIV, there’s been a huge amount of investment and now there are life-changing treatments. The same will be true for Alzheimer’s disease and other dementias if we continue to invest and bring smart people in.
“This type of scientific research results in life-changing treatments. I am convinced that this will happen for dementia as long as we keep the momentum going.”