Dementia healthcare needs a revolutionary rethink

Clinical services for people at high risk of dementia need a radical rethink in line with the latest scientific understanding of the condition, say leading researchers.

There is a crucial need for new strategies to diagnose and treat the condition in light of significant challenges that health services will face in future, according to experts from across the UK.

Disease assessment

Their report – The Edinburgh Consensus – which has been coordinated at the University of Edinburgh and led by the UK’s most prominent researchers in the field, focuses on a new era of Alzheimer’s disease assessment and treatment.

It relates to the search for a new generation of drugs aimed at tackling the early underlying biological causes of dementia – treatments that are referred to as being disease-modifying.

Dementia treatments

This approach presents one of the best hopes for preventing dementia, according to scientists.

Implementing these new treatments, however, will pose huge challenges to how the condition is managed in healthcare settings in the UK and globally.

It will require a much more detailed assessment of patients, with a reliance on tests not normally available in existing services.

Focus on prevention

Disease-modifying drugs are based on evidence that Alzheimer’s disease – a condition that leads to problems with memory and confused thinking if not treated – has its roots in middle age, with changes in the brain occurring many years before the final symptoms of dementia develop.

Delay symptoms

Scientists say this offers a window during which treatment could limit brain damage before the development of dementia. Delaying the emergence of these symptoms by a few years would have a huge impact on the number of people affected by dementia.

Brain changes that lead to dementia begin decades before symptoms. Experiences at all stages of life can influence the likelihood of developing dementia and it is never too early to think about reducing your risk. What we have to ensure is that clinical services keep step with scientific advances to make sure the public and patients benefit.

Professor Craig RitchieDirector, Centre for Dementia Prevention

Early intervention

Identifying people who are most likely to benefit from early intervention will require gathering specialist information such as genetics and brain scan imaging, which current services cannot deliver on the required scale, experts say.

Edinburgh Consensus

The Edinburgh Consensus was written by Alzheimer’s disease researchers and clinicians from UK universities alongside the Royal College of Psychiatrists, the Association of British Neurologists and the charities Alzheimer Scotland, Alzheimer’s Society and Alzheimer’s Research UK.