Dementia is a major issue in the UK – what has the government done to address this dilemma and what hope is there for the future?
Writer: Similoluwa Ayeniyegbe
Editor: Javier Bautista
Artist: Lola Artiles
Major medical advancements have resulted in longer life expectancies. Although medical advancements are worth celebrating, with longer life expectancies comes an ageing population, so dementia has become a pressing issue in the UK. Many people reduce their working hours in order to care for their loved ones and others leave work altogether, resulting in significant economic losses. Currently there is no cure for dementia, which is partly related to the brain’s complexity and the wide range of symptoms, both of which make clinical trials challenging to conduct. But what has the UK Government done to address this dilemma?
In 2011, a Dementia Commissioning Pack was launched, which contains resources for health and social care commissioners to improve the quality of dementia services for patients and their carers. It was developed after consulting people living with dementia and their carers, advocacy groups and health and social care commissioners. The pack addresses dementia services from diagnosis until end-of-life care. Besides dementia care, however, the UK Government has launched initiatives aiming to advance dementia research.
The Dementia Discovery Fund was established in 2015 ‒ a £250 million specialist venture capital fund with the aim of supporting future dementia treatments. The fund was established with the UK Government’s Department of Health and Social Care in collaboration with companies such as GlaxoSmithKline and the charity Alzheimer’s Research UK. This was the first venture capital fund solely focused on dementia research.
In 2019, the Dementia Discovery Fund and Alzheimer’s Research UK established a biotech company called AstronauTx. AstronauTx focuses on developing medicines which target astrocytes to treat neurodegenerative diseases. Astrocytes are a type of glial cell found in the central nervous system and have been implicated in Alzheimer’s disease (the most common form of dementia). The exact functions of astrocytes in Alzheimer’s disease are not fully understood, meaning that the research conducted by AstronauTx could be invaluable. What else could be done to improve the lives of people with dementia?
Evidence-based medicine is the explicit and reasonable use of modern evidence to inform decision-making about the care of individual patients. Adequate dementia care for an individual patient can be achieved when physicians combine their knowledge of best available evidence for dementia diagnosis with their clinical skills. Specifically, memory tests are often a key test required to diagnose dementia, however research suggests that this may not be the best way to identify the syndrome.
In the UK, positron emission tomography (PET) scans are occasionally used, but increased use could lead to more definitive dementia diagnoses. In Alzheimer’s disease, amyloid beta plaques accumulate in the brain. Amyloid PET imaging can help to map the spatial distribution of this brain pathology. Besides being helpful for diagnosis, determining the presence of amyloid beta pathology can also be used to monitor disease progression and for prevention studies. In clinical trials, PET scans have improved diagnostic certainty, so their widespread use in clinics could be invaluable for diagnosing and monitoring dementia. PET imaging is just one of various techniques that could increase our understanding of the syndrome.
Whether our understanding of dementia improves via PET scans or other research angles, a better understanding is crucial to improve treatment. Could this take us one step closer to resolving the UK’s dementia dilemma?