Dementia: innovative approaches in therapy, care and diagnostics

Late last year, ministers, researchers, pharmaceutical companies and charities from around the world gathered together at the G8 dementia summit  to make a declaration and commitment for global action against dementia. This led to a significant increase in the budget to spend on research into the prevalence, diagnosis, clinical care, and policy issues in dementia, and the latest advances in these topics were highlighted last week at the 16th national conference on dementias in London. Some of the main discussions from the meeting have been highlighted below.

Prevalence and improving quality of life

Martin Prince gave an excellent overview of groundbreaking global epidemiological studies including some from the 10/66 Dementia Research Group. One of these studies showed a substantial underestimation of the true prevalence of dementia in low-income and middle-income countries, and other recent evidence indicates that the burden of dementia is rising in China. Dementia prevalence in Europe was outlined by Karim Saad, who described the latest Alzheimer’s Cooperative Valuation in Europe (ALCOVE) project that seeks to determine the timely and accurate diagnosis of dementia and to develop preventive and care recommendations to facilitate policy and health care decision making in European countries. In addition, the UK Medical Research Council Cognitive Function and Ageing studies (CFAS I and II) indicate that populations aged 65 years and older in 2008-2011 have a lower risk of dementia than populations from between 1989 and 1994.

Complexity of dementia due to multimorbidities was highlighted by Sube Banerjee in an exceptional presentation showing that dementia patients are admitted into hospital because of a number of physical illnesses but are given sub-optimal care. The recent world Alzheimer’s report 2013 has recommended better long-term care for patients with dementia that involves integrated and coordinated services. Interestingly, end-of-life care was emphasized by Louise Robinson with the necessity for advance care planning schemes. Other UK initiatives were described by Jeremy Hughes including dementia friendly communities and Dementia Action Alliance to promote public awareness and to improve quality of life of dementia patients and their carers.

Advances in diagnostics

Only 44% of people with dementia in England, Wales and Northern Ireland receive a diagnosis, which was highlighted in an impressive update from John O’Brien on the use of Florbetapir (18F) (trade name AMYViD) in Positron Emission Tomography (PET) imaging for early detection of Alzheimer’s disease. This method has recently been approved in Europe and has previously been shown to be correlated with the presence and density of β-amyloid. A rapid diagnostic system to provide “timely” diagnosis of the condition was further presented in a fascinating talk by Derek Hill on the Assessa digital tool that seeks to combine imaging measurements with results of computerized or traditional cognitive assessments to enable patients to be compared with age-matched normal and diseased subjects.

Therapeutics

Roy Jones gave an excellent summary on the current developments in clinical trials of treatments for dementia. These included various agents that are being tested such as immunotherapy, reduction of amyloid and others that effect tau and chlolinergic systems. There is also growing interest in preventing dementia based on lifestyle factors. Once such factor is diet, and David Wilkinson discussed a new nutritional approach for treating Alzheimer’s disease based on clinical trial evidence and the EU funded trial (LipiDiDiet), which is currently underway to determine whether a lipid-based diet reduces the risk of Alzheimer’s disease and whether it has a stabilizing effect on cognitive performance in aging.

The evidence presented at the meeting on prevalence, diagnosis, therapies and care in dementia revealed the importance of further research to help reduce the burden of this devastating disease. We look forward to the results of the ongoing trials, which will hopefully improve diagnosis and help in the treatment and management of patients with dementia. We are keen to publish research advances on these topics, so if you have any potential submissions you would like us to consider, please get in touch at bmcmedicineeditorial@biomedcentral.com.

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